Is it Compensable or Not?!!?

Frequently, people call the ABRAMS LANDAU Workers Compensation Team to find out why they are not getting paid workers compensation benefits. The common belief is that ANY accident on the job, or industrial disability, should be covered. However, that is not the law in the Commonwealth of Virginia.

Let’s say Doug Landau couldn’t get out of bed after noticing that his back was really sore after digging ditches for a week. However, he still went to work, where he was then taken by ambulance to the hospital and diagnosed with a herniated disc in his lumbar spine (lower back) — that case would be a loser under Virginia Law.  This is because even though the injury occurred at work, there was no specific, identifiable accident that arose in the course of employment. There must be a specific, sudden, anatomical change, that can be recognized with reasonable certainty. The injured worker doesn’t have to be looking at their watch, but if it happened “after the lunch break” or “right before quitting time,” that might be sufficient.

Judges, lawyers, adjusters, and claims managers discussed what kinds of workplace injuries are covered and NOT covered under Virginia law at the annual Virginia Workers Compensation Commission Educational Program in Richmond. One of the reasons workers comp insurance is so inexpensive in the Commonwealth is because so many kinds of work injuries are simply not recognized. or covered. It is important to seek out a lawyer who is experienced in trying and winning  workers comp claims if you have sustained a permanent injury on the job.

Likewise, if a luggage handler lifted 30 suitcases during a shift, but could not identify which bag caused the injury, they would lose under Virginia law. Even cases where the employee is working on their knees or squatting, if there is no specific risk that comes with employment, they cannot prevail.

There are cases where a high school teacher, wearing sneakers as instructed, tripped going from smooth polish flooring to a carpeted surface in front of the principal’s office. The Virginia Workers Compensation Commission (“VWC”) found that there was no “defect” in the flooring. Her injury was not from some  “actual risk of the employment.” as opposed to a condition that is not unusual or different from what she would experience outside her job.  Where an employee is injured walking up steps, if there’s no: defect in the steps, missing railing, or slippery substance, those cases can all be denied by the VWC.

Several times, Doug Landau has been contacted by a family where a loved one has sustained a heart attack while working. Unless the individual works in law-enforcement, fire-fighting, emergency rescue, or other specific professions, a heart attack on the job may not be recognized as compensable. No benefits may end up being paid. If a bank teller suffers a heart attack during a hold up, that may be different. Cases of sudden fright, shock, and PTSD are sometimes successful. However, being over come by extreme weather conditions, pneumonia, and other common diseases are usually denied by the employer’s compensation insurance carrier.

Other kinds of cases that are typically denied are where the employee parks their car to go into the workplace and sustains an injury. Usually these are “slip & fall,” car accidents or “trip & fall” injuries. Unless the parking lot is owned by the employer, controlled by the employer and/or designated for employee parking, these claims are viewed as no different than “commuting cases,” which are typically denied by workers compensation insurance companies. In contrast, if the employer supplies a shuttle bus or van, and there is a crash, the injuries to the workers who are passengers (and the driver) are often ruled as compensable, and benefits are required to be paid.

It is not an easy “yes” or “no” when it comes to Virginia Workers Compensation claims and compensability. Getting the assistance of an experienced workers comp lawyer, who devotes much of their time to these kinds of administrative claims, can help make the difference between winning and losing.

If you, or someone you know has any questions, please do not hesitate to contact us at 703–796–9055, or email