VII. Benefits A. Medical Benefits 1. Medical Benefits Generally
Virginia presently awards lifetime medical benefits for compensable injuries and diseases. This has not always been the case and, if you are dealing with an older claim, you are encouraged to consult the table found here to determine the period of entitlement for medical benefits. If the claimant has proven at trial a compensable injury or disease, the Commission will automatically award lifetime medical benefits, even absent a specific request to do so.
2. Panels of Treating Physicians
Virginia Code Section 65.2-603 requires that the employer furnish, free of charge, a physician chosen by the injured employee from a panel of at least three physicians selected by the employer and such other necessary medical attention.
In creating this panel, it is important that the physicians be unaffiliated (they cannot all practice in the same group or in groups owned by the same corporation). They must also be within a reasonable distance from the claimant. Additionally, inclusion of hospitals and/or urgent care facilities is not appropriate and will invalidate the panel. The panel must include actual physician names who are qualified to treat the claimant's condition. To be valid, the list must only contain physicians who are willing to treat the claimant. The failure to offer a valid panel can justify the claimant's choice of a non-panel physician.
Treatment recommended by the chosen panel physician, including referrals to other health care providers, is presumed to be reasonable and necessary medical treatment.
The panel should be offered as soon as possible, but if you deny a claim, the claimant may treat with a physician of his own choosing. Once a course of treatment has begun, however, he may not switch doctors, absent permission from the Commission or agreement by the employer/carrier.
