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!

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

“(1) an identifiable incident; (2) that occurs at some reasonably definite time; (3) an obvious sudden mechanical or structural change in the body; and (4) a causal connection between the incident and the bodily change.”  Chesterfield Co. v. Dunn, 9 Va. App. 475, 476, 389 S.E.2d 180, 181 (1990).  “Repetitive activity” or “repetitive trauma” injuries are not covered by the Virginia Workers’ Compensation Act.   However, in Van Buren v. Augusta County., 66 Va. App. 441 (2016), the Court of Appeals held that a firefighter who noticed neck and shoulder pain after a 45-minute rescue suffered an injury by accident.  The Commission followed that decision in Dugger v. Riverside Regional Jail Authority, JCN VA00001117636 (Jan. 3, 2017), holding that the claimant proved an injury by accident where she noticed a swollen knee after engaging in 4 hours of physical tactics training.   Those decisions suggested a fundamental change in the definition of “injury by accident.” 

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Are Injuries Sustained During Social Events Compensable?

By: Eva C. Roffis, Esq.

Typically, an injury sustained by a worker at a social or recreational event is not compensable. However, numerous factors must be examined in order to determine whether the claimant’s accident arose out of the employment.

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De Facto Award for Workplace Fall

By: Amanda Tapscott, Esq.

Claimants are arguing that de facto awards apply in their claims with increasing frequency.

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Occupational Diseases in Virginia Workers’ Compensation Claims

By: The Worker's Compensation Team

When we think of workers’ compensation in Virginia, we typically think of injuries by accident.  Virginia law instructs us to look for a specific and identifiable event as the cause of an injury.  That being said, there are situations where a person is entitled to compensation for injuries that lack any type of identifiable event, these are known as “Occupational Diseases.”   

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An Overview of Liability Under the Statutory Employer Doctrine

By: Workers’ Compensation Practice Group

The leaves are beginning to turn and the holiday season is quickly approaching, which means it is the time of year when retail establishments often take on additional employees.  Some businesses contract out certain duties rather than having their own employees perform that work.  In Virginia, a business that contracts out work can be liable as a “statutory employer” if an employee of the contractor is injured on the job.  

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Amanda S. Tapscott Named Chair of VADA Workers’ Compensation Section

Amanda Tapscott, a Director in our Workers' Compensation practice group, was recently named chair of the Worker's Compensation Section of the Virginia Association of Defense Attorneys (VADA).

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Understanding the Legal Issues with Long-Term Opioid Use in Virginia Workers’ Compensation Claims

By: The Workers' Compensation Team

Long-term opioid abuse has become a front page issue throughout the country, as doctors, claimants, insurance companies, and employers struggle with the drastic increase in opioid prescriptions in recent years and the potentially disastrous effects of these medications.  A quick glance at recent statistics is alarming, as there have been 4,400 deaths in Virginia linked to opioids since 2007.  

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When Does Inferring Go Too Far?

By: The Workers’ Compensation Practice Group

There has been a lot of discussion recently regarding the Commission’s ability to infer facts, particularly from the standpoint of the initial compensability of a claim. From the defense perspective, the willingness of the Commission to infer facts to support causation/compensability has been a cause for concern. Recently, the Court of Appeals addressed a Full Commission finding that the claimant’s injury arose out of his employment, based on an inference made by the Full Commission, in the case of United Airlines, Inc. v. Bryan Andrew Taylor, an unpublished Opinion.

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The Coming and Going Rule

By: The Workers' Compensation Practice Group

On December 15, 2015, the Full Commission released its Opinion in Stiltner v. Pike Electric, JCN VA00001006840 (December 15, 2015), clarifying one of the exceptions to the coming and going rule. It is well-established that an accidental injury sustained when an employee is going to or leaving from his or her place of employment has not occurred in the course of the employment and is not therefore compensable. 

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