Workers’ compensation is a state-mandated insurance program that provides medical, wage replacement, and rehabilitation benefits to employees who sustain work-related injuries or illnesses. In Virginia, this system is governed by the Virginia Workers’ Compensation Act (VWCA), specifically Title 65.2 of the Code of Virginia. David Falcon has been representing accident victims and injured workers since 1999. He has handled thousands of cases before the Virginia Workers’ Compensation Commission, as well as numerous appellate matters before the Virginia Court of Appeals. David Falcon (Ackerman & Falcon Law Firm – Virginia) believes that effective legal advocacy means placing his clients’ interests first and achieving the best possible result requires a proper blend of negotiation and litigation. David’s extensive experience gives him the advantage necessary to secure the benefits his clients need to be fully compensated for their injuries. Lawyer Monthly recently caught up with David to discuss workers compensation in Virginia.
Please introduce yourself to the readers of Lawyer Monthly.
My name is David Falcon and I am in my 25th year of practice representing injured persons in the Washington DC Metropolitan area. In 2016 I started my own firm Ackerman & Falcon together with my partner Howard Ackerman. We handle personal injury and workers’ compensation claims in Virginia, Maryland and Washington DC.
What are the benefits of workers compensation in Virginia?
Like most states, Virginia has a no-fault system designed to pay benefits to persons injured on the job. What this means is that if a person is injured while at work and meets certain legal criteria, their medical expenses and lost wages are paid by their employer. If their injury becomes permanent, they may also qualify for loss of use benefits for certain injuries.
What are the most common areas of Workers Compensation claims or cases you handle?
We see a tremendous number of clients who suffer back injuries, usually resulting from lifting heavy objects. Also very common are surgical injuries to the knees and shoulders. In our experience, people working in the construction industry by and large suffer more injuries than any other type of worker.
What are some of the common elements shared by the state workers’ compensation laws when it comes to benefits?
Almost all states allow injured workers to recover 66% of their wages for every week they are unable to work. Similarly, most states provide for payment of medical expenses related to an injury. Lastly, most states have a means of compensating workers if their injury becomes permanent and they sustain a loss of use of the body. Where state laws largely differ is the duration for which these benefits can be paid. For example, Virginia has a lifetime medical award, which allows the injured worker to claim medical benefits that are reasonable, necessary, and causally related to his or her injury for life. In contrast, many states limit medical benefits to a fixed period, such as 5 years. Virginia also provides for lifetime wage loss benefits for a person who becomes permanently disabled due to a work-related injury. Not all states allow for lifetime wage loss benefits.
What actions should be taken when an accident happens at work?
Report your injury to a supervisor as soon as possible! Virginia has a 30 day notice requirement, and we see many cases where an injured worker with a serious injury fails to report his claim, thus giving the employer/insurer a means of denying the claim. In addition, it is critical to seek medical attention as soon as possible. Many times injured workers disregard injuries that appear to be minor, only to have the injury worsen over time. The sooner you see a physician following an injury, the better.
What are the steps involved in the Workers’ Compensation settlement process?
Settlement is a voluntary process where the claimant agrees to accept money from the employer/insurer in exchange for closure of a workers’ compensation case. Once a client is ready to settle his case, we prepare a settlement evaluation with them to determine how much to demand (request) from the employer/insurer. If the employer/insurer offers an amount that the client finds acceptable, the settlement proposal is submitted to the Virginia Workers’ Compensation Commission for review and approval. Once approved, the client receives his settlement funds and the case closes.
Which expenses do Workers’ Comp settlements cover?
When settling a workers’ compensation case it is important to account for the closure of the claimant’s medical award, the loss of income replacement, and potential loss of use compensation. Will the claimant require surgery in the future? If so, then the cost of that surgery, as well as the aftercare, should be included in the settlement amount. If the claimant will continue to be disabled in the future, then either total or partial wage replacement should also be included in the settlement. Lastly, if a claimant has sustained a permanent injury, then a disability rating should be obtained which can be used to calculate loss of use compensation.
What are the typical Workers’ Compensation settlement amounts?
There is no typical workers’ compensation settlement. A worker who becomes paralyzed and confined to a wheelchair would likely be entitled to medical care and wage loss replacement for the rest of his life and could be entitled to a seven-figure payout. In contrast, a worker who sustains a minor finger injury and quickly returns to work could receive a de minimis settlement of less than $1000.
Returning to Work After a Workers’ Compensation Claim.
Fortunately, most injured workers can return to work. I run my practice with that goal in mind. I want to make sure that my clients’ medical needs are covered, and they are financially protected until they can return to earning income. If they are unable to do so, I want to make sure they are fully compensated for the fact that their body is not the way it was before the accident.
What Happens if You Can’t Agree on a Workers’ Comp Settlement?
Not every case can settle. Many employers/insurers refuse to settle cases where the injured worker is still employed with the preinjury employer. Some municipal employers do not settle cases as a rule. Still other cases do not settle simply because there is no meeting of the minds between the parties. If a case cannot be settled, my job is to make sure that my client continues to receive the full benefit of his or her lifetime medical award and is fully compensated for the time they are unable to work. Lastly, if their injury worsens over time I want to make sure that they receive additional compensation for the deterioration of their condition.
What can I do if my workers compensation claim is denied in Virginia?
Call an attorney as soon as possible for a consultation. Many injured workers hesitate to consult with a lawyer and lose valuable benefits as a result. Most workers’ compensation attorneys in Virginia offer a free initial consultation which is completely confidential. The attorney will advise you on what steps to take to protect your rights, and you can decide whether hiring an attorney is the right step to take.
Should I hire a workers’ comp attorney, or can I handle my own case?
Not all injured workers need an attorney. I speak to many potential clients where the employer/insurer is paying for their medical care and their wage loss following their injury. They ask me what else I can get for them, and I tell them candidly: nothing. You are receiving all the benefits you are currently entitled to. However, if your case has been denied, you very well may need to hire an attorney. The reality is that most individuals do not understand the complexities of legal pleadings, deadlines and the burden of proof. An attorney is trained to handle these types of cases, and they will be responsible for making sure you meet the requirements of Virginia law.
The moment any complexity arises in your case is the moment you should hire an attorney. What are some examples of situations that call for a lawyer’s intervention?
Certainly, if you are notified your case has been denied you should consult with an attorney. Other red flags that may call for a lawyer to intervene are if the insurance company wants to take a statement from the injured worker or want the worker to respond to written questions. Lastly, if you receive a letter telling you your case is scheduled for a hearing do not hesitate to contact a workers’ compensation lawyer.
What will a Virginia Workers Compensation lawyer do for me and what should I expect?
The role of a workers’ compensation lawyer is to listen to the client’s needs, educate the client on the law and advocate for the client’s interests. Because every case is different, there is no single approach that works for every case. One case may require immediate litigation and might only be resolvable by a judge. Another client might be fearful of going to court and confronting his or her employer, which could lend itself to mediation or another form of alternative dispute resolution. Only by listening to the client’s needs will the lawyer be able to best handle each case. Furthermore, because many laws are written in a manner difficult for non-lawyers to understand, it is the job of the lawyer to explain this to the client so they comprehend it. Once the client and the lawyer agree on the best strategy, it is the lawyer’s job to implement this strategy: to advocate for the client to achieve a successful result.
Do you have a particular style or approach – what are the essential ingredients of a healthy and effective lawyer-client relationship?
Our firm’s approach is best described as compassionate advocacy. What often makes a business stand out from its competitors is the way they treat and care for their customers. A law firm is no exception. Injured persons do not want to be treated like they are a number, or valued according to what their case is worth. We provide the same customer service to our clients regardless of the severity of their injury or the size of their claim. We take care of clients, not cases, and believe that this approach has made Ackerman & Falcon one of the top firms in our field.
Contact
David Falcon, Ackerman & Falcon, LLP
8221 Old Courthouse Rd #201, Vienna, Virginia 22182
Tel: (703) 288-1400 | Fax: (703) 636-3052
www.ackermanfalcon.com
