Legal Question in Workers Comp in Virginia

I am at MMI for my surgically repaired (L)rotator cuff tear and my treating physician has allowed me to return to work with moderate level work restrictions permanently due to the fact I am on peritoneal dialysis for renal failure. I was sent to an FCE where they allowed me only < 30 lbs lifting/pushing etc- as per order from my nephrologist. My workers comp doc has retained the restrictions as per the report of the FCE and has made them permanent. My company does not have a position for this level of restriction - so what happens to the TTD Checks which I have been receiving from the Insurance carrier- is it converted to permanent disability and if so how long will it last OR as my Nurse case manager told me that with MMI my case would be closed as restrictions were placed due to my kidney failure condition and not due to my work injury shoulder problem.

Asked on 10/01/13, 7:44 am

2 Answers from Attorneys

Gerald Lutkenhaus Virginia Workers Compensation & Disability Lawyer

OK, if your restrictions are due to your renal failure and not due to your shoulder injury, then you have a problem. If the company does not have a position due to youir renal failure work restrictions, then your TTD checks may end. This is so because the reason you cannot work is due to your renal failure and not your shoulder injury. You did not indicate if your "arm" was given a rating. It if was then you would be entitled to some additional weeks of compensation. You get two weeks of compensation for each rating point when it comes to an arm. So, if you have lost 10% of your arm, you would be entitled to 20 weeks of compensation. If there has not been a rating, you should ask for one. It may be wise to have a WC attoney like myself review this FCE. Perhaps, there is something that saves you. I would also need to review the WC doctor report.

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Answered on 10/01/13, 8:10 am
Peter M. Sweeny, Esq. Author:Virginia Workers' Compensation Case Finder

If your worker's compensation physician placed restrictions upon you which are due, in part, to your shoulder, then you may be in a position to continue to receive weekly benefits. I have clients all over the state and I do not allow nurse case managers to work with them. Based on my 35 years of experience, I would not rely on your nurse case manager's "interpretation" of the law. I am the author of a legal reference used by the Virginia Workers' Compensation Commission and attorney's throughout the state and there is a section in the book just dealing with medical management by insurance company nurse case managers.

You need to consult a knowledgeable Virginia workers' compensation attorney as soon as possible and before you inadvertently allow the insurance company to stop your benefits.

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Answered on 10/01/13, 10:15 am

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