Why can't I use Worker's Comp instead of sick leave if I'm injured at work?
I fell at work and badly hurt my knee. Why do I have to use my sick leave to get paid after being injured at work?
Workers’ compensation is a complicated topic that cannot be fully covered in a short explanation, but I can offer some key points. For helpful source documents, see the Virginia Workers’ Compensation Commission (VWC) web site (www.tinyurl.com/CompCommission) and the Guide for Injured Employees from the Virginia Workers’ Compensation Commission (www.tinyurl.com/CompGuideVA).
As the VWC Guide explains, the injured worker must give prompt written notice of work injury, must be treated by an employer-authorized physician, and must file claim at the VWC within 2 years of the accident. I hope you notified your school in writing that you fell and were injured. You should have been given a list of at least three different physicians authorized to treat work injuries, and you should have been treated by one of the authorized physicians. Not every accident or injury at work will be compensable. The employee claiming workers’ compensation bears the burden to prove injury “by accident arising out of and in the course of employment.” Each section of the phrase has a specific legal meaning. Virginia courts denied compensation to a nurse who felt something snap in her leg while walking straight ahead down a clean, dry, well-lit corridor, and to a clerk who twisted her ankle while walking to answer a phone. The courts found no connection between the work and the injury. You must be ready to describe the work activity in which you were engaged, and how that work activity actually caused the accident and injury. The workers’ compensation insurer or administrator for your school division can deny your claim to make you prove each of the requirements. The VWC decides contested claims after a hearing.
Workers’ compensation is not full pay. There is a seven-day waiting period before any compensation for time lost from work is due. The employee can receive workers’ compensation benefits for the first seven days if disability lasts more than 21 days. Workers’ compensation benefits for time lost from work are 2/3 of the injured employee’s average weekly wage, subject to a cap which is based on statewide average wage. For the 12-month year beginning July 1, 2010, the maximum workers’ compensation benefit is $885 per week. Other employment benefits, such as contributions to group health insurance and retirement, are not covered by workers’ compensation and would be subject to other policies such as FMLA or unpaid leave. Your Uniserv Director can help you report an accident, communicate with your school supervisors about your injury and absence, and review your status. Consult an attorney of your own choosing at your own expense if your claim for benefits is contested.