Virginia Injury Report Form

State:
Multi-State
Control #:
US-1340837BG
Format:
Word; 
Rich Text
Instant download
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Description

This form is an example of an injury report form that may be used by a Company in order to report injuries on the job.

How to fill out Injury Report Form?

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FAQ

In addition, this duty to accommodate generally covers personal illness not related to the job. This protection ensures that an employer cannot terminate an employee simply because the employee is ill.

Workers' compensation insurance likely provides coverage to employees injured in areas maintained by their employer outside of the workplace, such as walkways, sidewalks, and parking lots. Even if the employer hires a third party to maintain these areas, they are still responsible for what happens on their property.

The Ontario Human Rights Code protects employees who have a ?disability?, which includes most injuries whether the injury occurred inside or outside of the workplace. Your employer has a duty to accommodate your disability.

In Virginia the workers compensation waiting period is seven (7) days. You will not receive wage loss benefits for the first seven calendar days of disability resulting from the workplace accident.

You may file the claim: In person: Complete the Claim for Benefits Form and deliver it to any of our office locations. ... By mail: Complete the Claim for Benefits Form and mail it to: Virginia Workers' Compensation Commission, 333 E. ... By fax: Complete the Claim for Benefits Form and fax it to: 804-823-6956.

The non-economic loss benefit you receive is only for the impairment resulting from your work-related injury or illness. In addition to your work-related impairment, you may also have non-work-related pre-existing conditions. The non-economic loss benefit relates only to the work-related impairment.

Workers' comp will pay for the medical care you need to help you recover from your injury. Your employer may have a list of approved workers' comp doctors but you may be able to choose your own (this varies by state). You'll also receive weekly payments to cover some of the wages you're losing because you can't work.

If your doctor says you cannot work because of your work-related injury or illness, you may be entitled to compensation equaling 66 2/3% of your regular wages based upon earnings for the 52 weeks prior to your injury. This amount is subject to a statewide maximum reimbursement amount.

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Virginia Injury Report Form