The Workers’ Compensation system was put in place so that employers and employees would have an efficient and speedy alternative to the court system when workers are injured on the job. In the best-case scenario, a minor injury that occurs at work can be resolved through the system, paying the injured worker for his/her medical costs and compensating them for any time they may have missed from work as a result.
But what if your case isn’t so straightforward? Should you hire a lawyer?
Below are some situations where you may want to consult an experienced workers’ compensation attorney:
You’re not familiar with the workers’ compensation system
To the uninitiated, the workers’ compensation process can seem overwhelming. Those who file for compensation often feel inundated with paperwork and forms that must be properly completed and returned in a timely fashion. You may also be concerned about your rights, what you should or shouldn’t say and how to take the proper steps in your case. An experienced workers’ compensation attorney is familiar with the intricacies of the claims process and can assist you in completing the many required forms, ensuring that all of your injuries, no matter how minor, are properly documented and submitted.
The insurance company denies your claim
If the insurer denies your claim, as they often do, you would do well to consult with an attorney. The insurance company is hoping that you won’t appeal the judge’s decision, and too often that’s exactly what happens. You should be aware that most employers pay workers’ compensation insurance premiums to an outside insurance company. Insurance companies are in the business of making a profit, like any other business, and will therefore try to pay out as little as possible on each claim. A workers’ compensation attorney will work with you to collect the necessary evidence, arrange for medical examinations to be performed and represent you before the Workers’ Compensation Board, if necessary, to make sure you receive the benefits you’re entitled to.
You have a preexisting condition or a previous injury
If you injure a body part at work that has been previously injured, the insurance company is likely to argue that they shouldn’t have to pay for your current claim. A workers’ compensation attorney will assist you in obtaining the medical evidence needed and present your case before a judge to help you receive the maximum possible award.
You have a repetitive injury
A repetitive injury is one that isn’t the result of a single accident or incident at work, but is the result of performing the same type of work activity over and over. There are many examples of this type of injury and they can be slow to develop. Often, you’ve been engaging in the same type of work for many years, and for different employers. A skilled workers’ compensation attorney will be instrumental in proving that your injury was primarily caused by your work duties.
You’re having difficulty getting the medical care you need
Insurance companies will often deny or delay paying for expensive medical procedures and surgeries. An attorney can bring a claim before a judge to expedite this process.
A third party may be responsible for your injury
The workers compensation system was developed to shield employers from civil claims and provide compensation for workers regardless of who was at fault. However, if you were injured due to defective machinery, for example, you may have a civil claim against the manufacturer of that equipment. A civil claim can result in a much higher damage award and is not limited to just economic damages, but to non-economic damages as well, such as pain and suffering. As each case is different, an experienced lawyer can determine when it is appropriate to sue a third party.
You disagree with your employer’s doctor that you can return to work
If you are required to see a physician that your employer (or their insurance company) has selected, that doctor may say that you are fit to return to work, or that you can return to work with some limitations on your duties. If your own doctor disagrees, a workers’ compensation attorney can take your case before a judge, effectively present evidence and persuasively argue on your behalf.
You plan to file for Social Security Disability Insurance (SSDI) Benefits
Any SSDI benefits you may be entitled to can be reduced by the award you receive from a workers’ compensation settlement. A workers’ comp attorney, in conjunction with attorneys skilled in Social Security Disability claims, can help you balance all the factors to maximize the benefits you receive from all sources, as well as advise you on how to set aside a portion of your workers’ compensation benefits to cover future medical costs, as may be required by Medicare.
After receiving benefits for some time, your employer or their company requests a medical exam or other evaluation
Even if you have been approved for benefits, your employer or their insurer may seek to reduce or terminate those benefits after a period of time by trying to show your condition has improved. To that end, they will ask you to submit to an Independent Medical Exam (IME), usually with a doctor of their choice. You should speak with a qualified attorney to ensure you won’t have your benefits reduced or eliminated unfairly.
You don’t develop symptoms from your injury right away
Many injuries, specifically head injuries, herniated discs and sprain/strain injuries, may not show symptoms until days or even weeks after the fact. Medical issues in workers’ compensation cases can be complex and consequential injuries can develop as a result of you initial injury. For example, an injury to your leg that causes you to favor that limb while walking/moving may result in new symptoms developing in your hip, back or other leg. An experienced workers’ compensation attorney is aware that sometimes injury symptoms don’t appear right away and can help you obtain the medical evidence needed to file your claim within the statutory time limits.
You may be wondering what hiring a workers’ compensation attorney will cost. Workers’ compensation attorneys don’t require a retainer or charge an hourly fee like most attorneys. Instead, they receive a percentage of any money you are awarded for your claim, and this amount is set by the judge in each case. That means that your attorney will only get paid if they are successful in obtaining a monetary award for you.
While the workers’ compensation system was designed to help injured workers receive fast and adequate compensation, today it too often works in favor of employers and their insurance companies. Insurers employ teams of adjusters and lawyers to make sure their company pays as little as possible on your workers’ compensation claim. Having your own team of seasoned, highly trained workers’ compensation lawyers and legal professionals on your side will go a long way in making sure you receive the benefits you deserve.