Material Misrepresentation on an Employment Application as a Defense to Workers' Compensation Claims

A Resource to Utilize in Workers' Comp Defense

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Using Social Media Evidence to Defend Workers' Compensation Claims

By: Eva C. Roffis

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No Medical Progress? Consider a Change in Treating Physician

By: Eva C. Roffis, Esq.

Often times we find a claim has stalled because the claimant’s treating physician is offering inadequate care. In these situations, either party may seek a change in treating physician.

In Virginia, the circumstances that justify a change in treating physician are as follows:

  • Inadequate treatment is being rendered;
  • Specialized treatment is needed and is not being provided;
  • A lack of progress or improvement of the claimant's condition without any adequate explanation is shown;
  • Conventional modalities are not being used;
  • No plan of treatment for a long-term disability is established; and 
  • The treating physician fails to cooperate with discovery proceedings ordered by the Commission.

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A Winter Wonderland of Slips, Trips, and Falls on Snow and Ice

By: Amanda Tapscott Belliveau, Esq.

amanda-belliveau.jpgThe recent cold snap will likely result in an increase in claims alleging slips or falls on snow or ice.  The claims must be analyzed on a case-by-case basis in order to determine whether the injury arose out of and occurred in the course of the employment.

Arising out of Analysis

Generally, ice or snow will be considered an added risk.  However, a claimant must relate an injury to the ice or snow in these cases.  

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The Street Risk Doctrine

By: Worker's Compensation Practice Group

The busy months of November and December bring with them lots of traveling, which means employees may be driving in higher traffic conditions, sometimes on icy roads.  In regards to the compensability of motor vehicle accidents, Virginia follows the “street risk doctrine.”

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Explaining the Unexplained Accident

By: Brian M. Frame, Esq.

brian-frame.jpgHow often have you heard, “I don’t know why I fell?” Quite often, claimants will be unable to explain how the accident occurred but they will file for workers’ compensation benefits because the injury occurred at the workplace. These situations are known as unexplained accident claims and they can be difficult to navigate because the claimant has suffered an injury, which occurred in the course of her employment, but she can provide no explanation of how the accident occurred.

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Smoking, Surgery, and Suspending Indemnity Benefits

By: Esther King, Esq.

With the cost of medical treatment ever on the rise, it is imperative that Claimants cooperate with the recommended medical care to optimize results, minimize the likelihood of repeat procedures, restore their health, and enable them to return to the workforce.

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OSHA Rules Out Mandatory Post-Accident Drug Screening

Employers need to keep in mind that, while tempting, mandatory post-accident drug/alcohol testing is no longer permitted.  Effective August, 2016, new OSHA reporting rules require employers to establish a reasonable procedure for employees to report workplace accidents and injuries – free from intimidation or retaliation.

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Medical Fee Schedule Coming to Virginia in January 2018

By: Lauren Ebersole Hutcheson, Esq.

Historically, in Virginia, an employer’s pecuniary liability for medical, surgical and hospital treatment has been limited to the prevailing rate in the community to determine the reasonableness of the charge pursuant to Va. Code 65.2-605. The uncertainty of the prevailing rate in the community resulted in numerous claims filed by medical providers against employers and carriers for reimbursement of write-offs. As of March 2016, Virginia was one of only 7 states to be without a standardized fee schedule.

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Injury By Accident In Virginia: It’s Alive Again!

By: Emily C. Whitaker, Esq.

Virginia case law has consistently held that in order to prove an “injury by accident,”  a claimant must show: 

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