Virginia workers' compensation insurance: Your ultimate guide

Who is covered?

Policies include protection for full-time and part-time workers, seasonal and temporary employees. The one exemption from Virginia workers’ compensation is sole proprietors with no employees that don’t hire subcontractors.

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Covered injuries and illnesses

Workers' compensation covers a range of work-related injuries and illnesses, including physical injuries resulting from an accident and occupational diseases developed over time due to job conditions.

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Benefits provided

Virginia workers’ comp insurance provides two types of benefits for work injuries:

• Medical benefits
• Lost wages and other monetary compensation

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These benefits include:

• Medical treatment for work-related accidents, injuries and/or illnesses 
• Mileage reimbursement for travel to and from an authorized doctor
• Temporary disability benefits 
• Permanent disability benefits
• Death benefits to surviving dependents 

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Benefits received rely on many factors, such as the employee’s: 

• Average weekly wage before the injury 
• Injury severity
• Length of recovery and ability to continue working

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Virginia workers’ compensation rates

In Virginia, the weekly compensation rate is 66 2/3% of a person’s average weekly wage based on earnings for the 52 weeks before the injury. This amount is subject to a statewide maximum reimbursement amount.

Find more information on annual Virginia’s workers’ compensation rates here.

Filing a workers' compensation claim

In the event of a work-related injury or illness, employees must promptly notify their employer and seek medical attention.

In Virginia, employees should report immediately and no later than 30 days from the date the accident occurs or within 30 days of the date the doctor says they’re suffering from a work-related injury. 

Filing a claim is the employer's responsibility in the case of a workplace-related injury or illness. Employers must file a report of the accident or disease within 10 days to their workers' compensation insurance carrier. The injured employee should complete the necessary forms and provide supporting documentation to initiate the claims process.

Choosing a healthcare provider 

If the workers’ compensation insurance carrier accepts the claim, benefits will be issued promptly to ensure timely care.

Employers in Virginia should provide the injured worker with a panel of providers from which to choose a treating physician. The physician chosen becomes the authorized treating physician.

Employees must seek medical treatment from these designated providers to ensure coverage.

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Payment of medical bills

Healthcare services must be paid for within 60 days of the receipt by the employer or the employer’s workers’ compensation insurance carrier.

If any services are contested, denied or considered incomplete, the employer's workers' compensation insurance carrier should notify the healthcare provider within 45 days with the following information: 

• The reasons for contesting, denying or considering the services incomplete
• Any additional information required to make a decision
• Solutions available to the health care provider if the health care provider disagrees

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Compensation for missed work

If an employee is out of work:

• Less than seven days: They are not eligible for temporary total disability payments. 
• More than seven but less than 21 days: They are eligible for lost time benefits beginning on the eighth day. 
• More than 21 days: They are eligible for benefits retroactive to the first day they stopped work. 

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Resolving disputes

The Judicial Division of the Virginia Workers’ Compensation Commission serves as the administrative body responsible for resolving these workers’ compensation claim disputes. This involves mediation, hearings and appeals.

The Alternative Dispute Resolution (ADR) Department provides an informal dispute resolution process where a neutral third party facilitates communication to reach an agreeable solution.