Occupational Workplace Injuries / Workers' Compensation
West Virginia Workers' Compensation Lawyer
Workers’ compensation is insurance for employees who were injured at their workplace during the course of their employment. Compensation can include temporary total disability benefits while the injured worker is unable to work, payment for medical bills, permanent partial disability benefits, or permanent total disability benefits.
In West Virginia, workers’ compensation benefits are controlled by the following:
Chapter 23 of the West Virginia Code
Special rules and regulations approved by the legislature
The West Virginia Insurance Commissioner
West Virginia workers’ compensation may include some of the following:
Medical treatment related to your injuries
Prescriptions related to your injury
100% coverage for your medical treatment and prescriptions related to the injury (you should not have to pay a penny for treatment related to your workers’ compensation injury)
Payment for your lost wages, physical and vocational rehabilitation if you, the injured worker, cannot assume the same job as a result of your injuries
Occupational hearing loss compensation
Occupational lung disease compensation
Other occupational diseases such as carpal tunnel syndrome
If your doctor has determined that you have reached your maximum medical improvement due to your permanent injury or impairment, you are entitled to a permanent partial disability settlement. If your work-related injuries result in your total disability, you can apply for workers’ compensation that will give you permanent total disability benefits.
If a worker dies on the job, his or her surviving spouse is entitled to survivor’s benefits.
Jacobs Law Office will work for and alongside you to get you the BENEFITS that you deserve.
Attorney Pat Jacobs is a workers’ compensation lawyer in West Virginia who has been representing injured West Virginia workers for over 40 years.
Pat was recently quoted while discussing the difficulties that workers face while trying to obtain workers’ compensation benefits:
“In my years of practicing law and representing injured West Virginia workers, I have never seen the system work against workers as badly as it is today. Ever since the West Virginia workers’ compensation laws privatized West Virginia workers’ compensation benefits, there has been a steady and drastic change in an injured worker’s ability to get fair and adequate medical treatment and benefits for their work-related injuries. Insurance companies have taken over the delivery of workers’ compensation benefits for injured West Virginia workers. I have seen outrageous decisions by insurance adjusters, such as:
Denial of compensability (denying that the claim and injuries happened at work),
Failure to properly name all of the compensable components of an injury (all of the physical body parts or psychological injuries caused by the physical injury),
Denial of medical treatment and prescription medications recommended by the injured worker’s treating doctor,
Denial of the treating doctor’s referral to a medical specialist; denial of physical therapy and pain management injections;
Denial of lost wage replacement, commonly referred to a temporary total disability;
Low-ball settlement offers or extremely low percentage ratings for permanent partial disability
If you’ve been referred to Dr. Mukkamala or Dr. Bachwitt or any other doctor by the workers’ compensation insurance company, WATCH OUT! These doctors work for the insurance company and are against the injured worker. Basically, since the privatization of West Virginia’s workers’ compensation, the system has been DENY DENY DENY!”
WORKERS’ COMPENSATION IS NOT YOUR ONLY OPTION.
You may have a deliberate intent claim.
If you were injured on the job, you’ve probably been told that the only compensation that you can receive will come from the workers’ compensation insurance of your employer. Although this is the general rule, there are many exceptions, situations in which you may be able to sue for damages caused by your injuries:
If a defective product injured you, you might be able to bring a products liability action against the manufacturer of the product.
If a toxic substance injured you, you might be able to bring a toxic tort lawsuit against the manufacturer of that substance.
If you were injured because of your employer’s intentional or egregious conduct, you might be able to bring a personal injury lawsuit against your employer.
If your employer does not carry workers’ compensation insurance, you may be able to sue your employer in civil court, or collect money from a state fund.
If a third party caused your injury, you might be able to bring a personal injury lawsuit against the person.
Many injured workers are not fully aware that workers’ compensation is not the only source of compensation that can be received. There are times that a third party can be held responsible.
As an example, if the injury was caused by unsafe equipment, then the manufacturer of that equipment will be held liable. The employer can also be held liable over and above workers’ compensation in some situations.
The West Virginia Supreme Court has stated:
“As a general principle, the West Virginia Workers’ Compensation Act provides immunity to covered employers for employee suits for “damages at common law or by statute” resulting from work-related injuries. An employer’s immunity is lost, however, when it acts with “deliberate intention” to cause the employee’s injury. If the deliberate intention exception applies, the employee may file an action for damages in excess of workers’ compensation benefits.
This Court has recognized that “`[a] plaintiff may establish a ‘deliberate intention’ in a civil action against an employer for a work-related injury by offering evidence to prove the five specific requirements provided in [W.Va. Code § 23-4-2(d)(2)(ii) (2010)].’ Under West Virginia Code § 23-4-2(d)(2)(ii),12 a plaintiff must prove the following five elements to establish a deliberate intention cause of action:
(A) That a specific unsafe working condition existed in the workplace which presented a high degree of risk and a strong probability of serious injury or death;
(B) That the employer, prior to the injury, had actual knowledge of the existence of the specific unsafe working condition and of the high degree of risk and the strong probability of serious injury or death presented by the specific unsafe working condition;
(C) That the specific unsafe working condition was a violation of a state or federal safety statute, rule or regulation, whether cited or not, or of a commonly accepted and well-known safety standard within the industry or business of the employer, as demonstrated by competent evidence of written standards or guidelines which reflect a consensus safety standard in the industry or business, which statute, rule, regulation or standard was specifically applicable to the particular work and working condition involved, as contrasted with a statute, rule, regulation or standard generally requiring safe workplaces, equipment or working conditions;
(D) That notwithstanding the existence of the facts set forth in subparagraphs (A) through (C), inclusive, of this paragraph, the employer nevertheless intentionally thereafter exposed an employee to the specific unsafe working condition; and
(E) That the employee exposed suffered serious compensable injury or compensable death as defined in section one, article four, chapter twenty-three whether a claim for benefits under this chapter is filed or not as a direct and proximate result of the specific unsafe working condition. (citations omitted, emphasis added).
If you think you have a Deliberate Intent claim, call Jacobs Law Office as soon as possible for a FREE case evaluation.
YOU CANNOT BE FIRED OR LOSE YOUR HEALTH INSURANCE FOR FILING A WORKERS’ COMPENSATION CLAIM
In West Virginia, employees have specific rights concerning their employment after they file a workers’ compensation claim:
1. No employer shall discriminate in any manner against any employee because the employee received or attempted to receive West Virginia workers’ compensation benefits.
2. Any employer who has provided medical insurance for an employee and his/her dependents by paying premiums, in whole or in part, shall not cancel or decrease employee or dependent benefits while the employee is claiming or receiving West Virginia workers’ compensation benefits. If the medical insurance policy required a contribution by the employee before the employee was injured with his/her workers’ compensation injury, then the employee must continue to make the contribution that was previously required.
3. It is against the law and a discriminatory practice for an employer to terminate an injured employee while the injured employee is off work due to an injury and is receiving or is eligible to receive temporary total disability benefits, unless the injured employee has committed a separate dischargeable offense.
4. It is against the law and a discriminatory practice for an employer to fail to reinstate an employee who has sustained an injury to the his/her former position of employment once the employee is released to return to work without restrictions.
Once you file a West Virginia workers’ compensation claim, your employer cannot reduce your medical/health insurance coverage, your employer must put you back to work at your old job once you are released to return to work without restrictions, and your employer cannot fire you unless there is a specific reason such as theft or drug use.
For more information regarding any aspect of West Virginia workers’ compensation benefits, sit down with Pat for a FREE consultation.