Here are a few situations that warrant contacting a lawyer:
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As a general rule, you may be able to get by without an attorney if all of the following statements are true: 1. You suffered a minor workplace inj...
In addition to making sure you file all the necessary forms and meet the deadlines, an experienced attorney will know how to gather the evidence ne...
The workers' compensation system may have been intended to provide prompt and fair compensation to injured workers. But now, it seems to work mostl...
Reporting regulations and deadlines vary from state to state, but it should typically take no longer than 30 days to complete this process.
A lawyer will file the paperwork on time, build your case, negotiate with the insurance company and draft a settlement, if one is agreed on. If it’s not, you’re headed for a hearing.
If the insurance company doesn’t agree with the rating, it can require you to get an independent medical exam (IME) by a doctor of its choosing. Chances are that doctor will give you a lower rating than what you (and your sore neck) feel you deserve. A lawyer can help convince a judge you are entitled to a higher rating.
An attorney not only will prepare your argument, he or she will prepare you to say the right things in testimony. They also will cross-examine the insurance company’s witnesses. That job should not be left up to amateurs. Unlike civil cases, workers compensation law has a safety net of sort.
Unless you’re an attorney or enjoy reading workers compensation manuals in your spare time, probably not. Handling a case on your own is usually a bad idea, especially since the insurance company will be represented by someone who’s probably handled hundreds of cases.
If you have a third-party claim – You can go outside the workers comp system and file a workers comp lawsuit if someone other than your employer contributed to your injury. For instance, if a negligent driver hits you while you are driving for work, you can sue that person for damages.
They can reject the settlement if they feel it’s not reasonable and the employee is getting a raw deal.
However, the appeals process can be complicated. It involves tight deadlines, formal paperwork, and detailed knowledge of substantive and procedural rules . An experienced workers' comp attorney can help you present your case in the most convincing light possible, by helping you prepare for the workers' comp hearing, highlighting the strengths of your case with supporting evidence, and questioning witnesses effectively. A lawyer can also ensure that you don’t lose your case on a technicality because you failed to follow a certain rule, meet a deadline, or submit a particular document.
You should consult with a workers' comp lawyer if the insurance company denied your claim or disputes any part of it, such as your need for certain medical treatment or time away from work. Insurance companies often routinely deny workers' comp claims, assuming that injured employees won’t appeal or challenge the decision. Unfortunately, some workers take the denial at face value and miss out on the benefits they're entitled to receive.
If your work-related injury or illness affects your long-term ability to work, a lawyer can be essential to getting a settlement or award that's large enough to cover a fair portion of your future wage loss. This is especially true if you'll never be able to work in the same capacity as you did before your injury. Permanent disability benefits can be very expensive for the insurance company, and it will do everything it can to minimize your disability rating (the measure of your long-term limitations). Insurance companies usually have high-powered lawyers working for them; having an experienced lawyer on your side will level the playing field.
When the insurance company puts up a fight, you could face tactical delays, demands for independent medical exams, or low-ball settlement offers. An experienced workers’ comp lawyer will know how to deal with these types of insurance defense tactics and can help you get your medical expenses covered and receive a fair settlement or award.
After a workplace injury, your top priority is probably getting paid for your medical bills and lost wages as quickly as possible. Sometimes, hiring a workers’ compensation lawyer is the best way to make this happen. Other times, you may be able to handle the case on your own successfully, particularly if you had a minor injury, your employer acknowledges that it happened on the job, you didn't miss much work, and you don't have any complicating medical issues like preexisting conditions.
With an attorney in the picture, the insurance company will be more motivated to negotiate, and your lawyer will be able to evaluate whether you should accept the settlement offer.
Before discussing the merits of hiring a workers' comp attorney, it makes sense to ask whether you can afford to hire one. Fortunately, workers’ comp attorneys almost always work on a contingency fee basis (by taking a percentage of the settlement or award they're able to win for you). This means the lawyer only gets paid if you get paid, and you don’t need to worry about paying the fees up front. According to our survey of readers with workers' comp claims, workers' comp attorneys charge an average of 15 percent of their clients' award or settlement.
With that in mind, these are the top reasons for hiring an attorney. 1. Hire a Workers’ Comp Attorney to Evaluate the Claim .
An experienced workers’ compensation attorney will work to protect your rights. They are on your side, which means they are focused on what course of action is in your best interest. Employers want to protect themselves, and the insurance company wants to spend as little money as possible.
One reason for denial is if you have a pre-existing condition in the area of the injury. A workers’ comp doctor may say all your pain is from the other condition and not from the injury , so the claim is denied. 6. An Attorney Can Negotiate a Settlement Offer.
If one subcontractor was responsible for another’s an injury, they might be liable instead of the owner of the job site. 5. A Worker’s Comp Attorney Can Appeal a Denial.
An attorney can determine the cost of your injury with current and future medical expenses and help you decide what is a fair and adequate amount for a settlement.
They can offer legal advice to warn you of possible complications that would require their services. At the very least, it will help you feel more informed and better prepared for dealing with the insurance and employer.
A Worker’s Comp Attorney Can Appeal a Denial. Many times, a workers’ compensation claim will be denied. The person may have waited too late to file a claim or filed it incorrectly. They may have left out important information, or some other reason caused the denial.
Additionally, many states place caps on contingency fees in workers' comp cases. The percentage varies from state to state, but is generally between 15% and 25%. However, the fee can be as low as 10% and as high as 33% in some states . (For more information about fees, see our article on how much it costs to hire a workers' comp lawyer .)
If your injuries are not clearly work-related, require extensive medical treatment, involve long periods of time off work, or result in permanent disability, you should call a workers' compensation lawyer.
Your permanent disability rating is disputed. The bulk of most workers' comp settlements and awards are for permanent disability benefits. These benefits are calculated based on your permanent disability rating. If the insurance company doesn't agree with the rating assigned by your treating doctor, it can require you to attend an independent medical examination (IME) with a doctor of its choosing. The IME doctor will likely assign a much lower disability rating, which the insurance company will use to justify paying you less in benefits. A lawyer can be essential to getting you a fair settlement or convincing a judge that you are entitled to the higher rating. (To learn more, see our article on how permanent disability ratings work .)
For example, the insurance company might claim that your injury wasn't work-related or that you filed your claim too late. (To learn more, see our article on common reasons workers' comp claims are denied .)
If you can never work again, you'll need to maximize your workers' comp benefits and structure them in a way to last well into the future. If you need to change careers, you'll need to secure training in a new line of work. A lawyer can help you do both.
Any time you're in a dispute with the insurance company, you should consider hiring a lawyer to represent you. You will need to gather evidence in order to challenge the insurance company's position, which may include taking depositions, requesting an independent medical examination, and hiring expert witnesses—all of which require legal knowledge and skill.
Insurance companies often deny—or delay in approving—expensive medical treatments, such as surgery. A lawyer can put pressure on the insurance company to approve necessary medical treatments in a timely manner. Your ability to work has been affected.
The first step to take when your workers’ compensation has been denied or reduced is to request a hearing before a Workers’ Compensation Board judge. In this situation, you want to have experienced, aggressive legal representation on your side fighting for benefits that are rightfully yours.
Unfortunately, if your injury requires surgery or extensive treatment, the insurance company will likely prolong approving the necessary care. A workers’ compensation lawyer will be able to put pressure on the insurance company and get you the treatment you need.
If you’re receiving Social Security Disability Insurance (SSDI) benefits, they may be reduced if you start receiving workers’ compensation benefits as well. Both programs come with several intricacies that determine much of the amount you can receive, and how the programs may interact with one another. For this reason, it is extremely important to consult with an experienced attorney if you are hoping to collect Workers’ Compensation and/or Social Security Disability Benefits.
Workers compensation cases are unlike third-party liability lawsuits in which the endgame is clear: The plaintiff will win, or be denied, a pot of money. It’s the rare liability claim that extends beyond a handful of years.
Ideally under workers comp, the injured employee receives the care (s)he needs to become healthy and productive once more, as well as tax-free wages to pay the bills; the employer gets a healthy worker and avoids costly litigation.
As mentioned above, the length of time a workers comp case can last depends on the unique circumstances of each claim. Some last for decades, long enough to follow the client to the grave. Some sail smoothly to conclusions in mere months.
By contrast, because there routinely are ongoing disputes over evolving issues — your claim is denied; you’re having trouble getting medical care; you’re unable to return to your previous job; your disabilities are disputed — workers comp cases can last for years, even decades.
A 2015 survey of workers compensation clients by the law firm Martindale-Nolo indicated the average case took more than 15 months to resolve. Cases involving permanent disabilities, or negotiated settlements, or clients represented by lawyers — boat-rockers all, it would seem — stretched out an additional two to three months.
You are permanently disabled, either totally or in part, and the insurer resists your rating. Your employer and insurer fail to pay workers compensation benefits promptly, counting on you not to file an appeal.
Employers, who despise the knock-on effects of higher premiums associated with claims, will attempt to dissuade workers from filing a workers comp claim “even when they’ve had a legitimate on-the-job accident, ” she says.
You can get workers compensation and Social Security Disability Insurance (SSDI) benefits together. However, depending on their combined amount, either one could get reduced. This will apply if all your benefits exceed 80% of your average pre-disability income.
These acts can be subtle, such as always questioning your work or judgment. Your boss may also be harassing you by increasing your workload without extra pay.