Why You Should Hire a Workers’ Comp Attorney
How to Determine When and Why You Need to Hire a Workers Comp Attorney
The workers’ compensation system is designed to provide wage loss benefits, coverage of medical costs and other benefits for those who have been injured in the workplace. The system was developed to ensure employees could secure benefits after being injured on the job, regardless of fault. In addition, the system is designed to prevent lawsuits against employers in cases where a worker is injured.
Since the workers’ compensation system is designed to help those who have been injured, many injured workers assume they don’t need a workers’ compensation attorney. After all, why hire a workers’ comp attorney if there already is a system in place to protect you in the event of an accident, injury or work-related condition?
In reality, however, workers’ compensation is funded either by an employer or, more commonly, by an insurance company. Insurance companies and employers do not want to pay out the full amount of compensation possible in every case. To do so shrinks profits and makes shareholders unhappy.
In addition, there are often situations where there is a lack of clarity surrounding what caused an injury. There may also be accusations that an injury occurred outside of the workplace or was caused by a pre-existing condition rather than a workplace incident. In these and other situations, a workers’ compensation attorney can protect your rights and work to ensure you get the compensation you are entitled to.
Why Hire a Workers’ Comp Lawyer?
Ideally, in a workers’ compensation case, your injury is relatively minor, and there is no question you will get benefits. Unfortunately, this situation doesn’t always occur. You’ll want to hire a worker’s compensation attorney if any of the following apply to you:
- You have a pre-existing condition. If you have any serious underlying health condition, contact a workers’ compensation attorney. Unfortunately, your previous condition may be used as an excuse to deny you compensation benefits. Insurance companies and employers may claim your pre-existing condition is what caused your current ailment, and your injury is, therefore, not related to a workplace injury. However, a pre-existing condition does not disqualify you from receiving benefits.
- Your employer denies an injury occurred in the workplace. If your employer refuses to acknowledge your injury occurred in the workplace or is due to your work duties, you need a worker’s compensation attorney to clearly establish the link between your injury and your work. Without this link, you may be denied benefits that are rightfully yours.
- Your benefits are denied or delayed. Unfortunately, 80% of workers whose workers compensation benefits have been denied fail to pursue benefits. Even if you have been denied or you find your benefits are delayed, you can appeal or turn to other legal remedies. A workers’ compensation attorney can guide you through the process and can secure the medical documents that may be needed to prove your case.
- Your benefits do not cover all of your medical bills and lost wages. Sometimes, you may have concerns about the way your wage loss benefits are calculated. If you’re getting less wage loss benefits than you think you should be getting, the wrong calculations may have been used. If all of your medical bills are not covered or if you’re expected to pay a deductible or some of your costs, contact a workers’ compensation attorney to ensure you get the benefits you need to pay for quality medical care.
- You have been seriously injured and cannot work for an extended period of time. If your injury is permanent or long-term, your medical costs and the medical treatment you may need might be considerable. It is more likely that your employer or its insurance company will fight more aggressively to reduce your benefits in these cases so they don’t have to pay monumental costs. If you have been permanently or seriously injured, however, you need a workers’ compensation attorney to ensure you get the benefits you deserve. The last thing you want is to be seriously injured, unable to work and worrying about finances.
- You may have a claim against a third party. Workers’ compensation benefits were designed partly to shield employers from civil claims. However, you may have a civil claim in some cases. For example, if a defective piece of machinery caused your injuries, you may have a claim against the manufacturer of that machinery. Civil claims may result in larger settlements because you can pursue noneconomic as well as economic damages. An attorney can help you determine the best way to proceed in these cases.
- You face retaliation in the workplace because you have been injured. If you file a workers’ compensation claim and your employer seems to be retaliating against you by reducing your hours, demoting you, harassing you, terminating your employment or engaging in other retaliatory behavior, you need to speak with a workers’ compensation attorney immediately.
- You and your employer disagree about your ability to work. Your employer or their insurance company may claim you can return to work with modified work duties. If you disagree or think you cannot return to work because of the severity of your injury, a workers’ compensation attorney can review your situation and can present evidence of your serious medical condition. In some cases, employers and insurers will try to claim you can return to the workplace in some capacity so they can minimize, reduce or suspend your benefits. A workers’ compensation attorney can work to ensure you are not left without a job and without benefits.
- Your employer claims you’re not covered by workers’ compensation. A small number of workers do not qualify for workers’ compensation. If your employer claims you work as an independent contractor and otherwise do not qualify for workers’ compensation, even though you perform the job duties of a full-time employee, contact an attorney. An attorney can look at your employment agreement and can determine whether you qualify for benefits.
- Your employer has not paid for workers’ compensation insurance. By law, employers are required to pay for workers’ compensation coverage for all qualified workers. This is the case even in small and non-profit organizations. Employers may offer insurance either through self-insurance or by going through an insurance company, but they are required to offer coverage. If your employer has allowed the insurance to lapse or has never secured insurance for you, as acquired by law, you may still qualify for benefits. Consult with an attorney to find out what options exist for you.
- You do not understand the workers’ compensation process. You may have questions about ways to fill out forms, your rights, what you can and can’t say, your settlement and more. A qualified attorney can help you with all of these concerns.
- You’re being accused of fraud. While workers’ compensation fraud is a real concern, you shouldn’t be denied benefits if you are legitimately injured. If your employer or their insurance company alleges you aren’t really injured or you are trying to defraud the system, it’s important to consult with an attorney.
- Your employer disagrees with or disputes a decision made by the state workers’ compensation division. If your employer and insurer are trying to avoid honoring a decision made by workers’ compensation division or by a judge, you need an attorney to ensure you will get your benefits.
- After receiving benefits for some time, your employer or its insurance company requests an IME (independent medical evaluation) or other evaluation. Even if you have been approved for benefits, after some time, your employer or its insurance company may contact you and may try to get you reevaluated to see whether your injury has become less severe. Often, this is a precursor to terminating, reducing or eliminating your benefits. If you are being asked to submit to additional tests or to a labor market survey, get legal advice to ensure your benefits aren’t reduced or cut off unfairly.
- The first doctor you see has cleared you for work quickly or did not refer you to a specialist. Sometimes, if you see an employer-approved physician, they will clear you for work quickly, even if you don’t agree you can return to work. They may also not refer you to a specialist, even if you request it. If you have been cleared for work surprisingly quickly or if you disagree with the initial consultation with an approved physician, contact a workers’ compensation attorney.
- You don’t understand what could hurt your claim. Many small things can hurt your claim. For example, posting innocuous pictures on social media can be used against you. If you show yourself at a special event on your social media, insurance companies can use this to claim you are not as injured as you reported. A workers’ compensation attorney can advise you of the seemingly minor incidents that could hurt your claim and can coach you on how to strengthen your claim instead. In many cases, these are issues injured workers don’t even think about.
- You’re not sure which doctor you need to see. In Pennsylvania, for the first 90 days after an injury you must see a doctor approved by your employer or its insurance company. However, this is only the case if your employer posts a list of at least six approved medical providers and meets other requirements. Often, there is confusion about whether you do need to see an approved medical provider or whether you have more options.
If you are required to see an approved medical provider, workers’ compensation may not cover the costs if you see your own doctor. On the other hand, if your employer does not meet the requirements, you may have the option of seeing your own medical provider, which may be more beneficial. A workers’ compensation attorney can ensure you understand which doctor you need to see and when.
- You develop symptoms gradually over time. Sometimes, workplace injuries don’t create symptoms right away. For example, if you suffer a herniated disc or a soft tissue injury, you may develop symptoms over a period of days or weeks. Even if you suffer a serious head injury, symptoms may not become apparent for hours or days. This can make it harder to prove a specific injury is related to work. It can also mean an initial medical consultation will determine you were not seriously injured.
A workers’ compensation lawyer understands not all injuries present symptoms right away and can help you get a thorough medical evaluation to ensure your complete physical situation is clear when it’s time to evaluate your settlement offer.
- You are eligible for Medicare or will become eligible within 30 months. If this is the case, your settlement may be submitted to Medicare, and Medicare may deny some of your medical costs unless you proceed carefully. An attorney can work with you so your medical costs are covered.
- You may need medical treatment much later after your injury. Some injuries will result in a lifetime of care. For example, if you have suffered an amputation at work, you may need to replace your prosthetic regularly for the rest of your life. You need to ensure your settlement covers these additional costs. An attorney can review your case and your injuries to help you understand how much money you need to cover all of your current and future medical costs.
- Your injury is hard to quantify medically. Some injuries are very clear. If you have suffered a crushing injury, a serious laceration or you require surgery, it may be easy to prove you have been seriously injured. Some injuries, however, are harder to prove. If you have suffered severe mental trauma as a result of your injury, for example, this may prevent you from working, but it can be difficult to prove using medical tests.
Soft tissue injuries can be difficult to prove as well because they do not always show up on X-rays. A workers’ compensation attorney can ensure you are evaluated by qualified specialists who can submit compelling medical evidence about your injury.
The reality is that the workers’ compensation process is highly complex. It’s important to speak with a qualified attorney who can offer reassurance and can bring you peace of mind. With a good attorney by your side, you can focus on getting better and on taking care of your injury. An attorney will take care of the workers’ compensation process and will guide you through the application, appeal and other processes you may need to secure compensation.
When Should I Hire a Workman’s Comp Lawyer?
If anything goes wrong with your workers’ compensation claim or if you have any concerns about your claim, contact a workers’ compensation attorney immediately. However, it is best to consult with a workers’ compensation attorney immediately after you have been injured. If you have sustained a serious injury and don’t expect any problems, it can still be beneficial to talk with an attorney to have your case evaluated. An initial consultation with My Comp Lawyers, for example, is free and gives you a chance to ask about your claim.
What Does a Workers’ Compensation Attorney Do?
A workers’ compensation attorney can:
- Secure evidence that your injury or condition is caused by your work
- Secure medical documentation to prove your injury
- Help you understand what you need to do to file a claim
- Ensure you fill out paperwork correctly and on time to qualify for benefits
- Help you understand which doctors you need to visit and when
- Answer any questions you have about the workers’ compensation process
- Advocate for you if your claim is denied or delayed
- Prepare you for any discussions with an insurer or any appearance before a judge
- Help you understand how much your claim is worth and help you evaluate any settlement offers so you get the fairest compensation possible
- Help offset any evidence presented by “independent” medical professionals approved by your employer or their insurance company
In short, a workers’ compensation attorney represents you and your best interests. He or she can ensure you avoid some of the most common pitfalls associated with a workers’ compensation claim and can improve your chances of securing fair compensation. While everyone in your life may have opinions about your injury and your claim, an attorney is a legal professional who has experience with these cases and understands what it takes to secure fair compensation.
Without an attorney, you are relying on your employer and its insurer to give you information, and they have their own interests in mind. You are also relying on your own understanding of workers’ compensation to file your claim. Without an attorney, you are vulnerable if you run into any challenges. With an attorney, you have the professional representation and protection you need, so you are poised to get the best results possible in your case.
When should you hire a workers’ comp attorney? The answer to that question is likely “now.” If you are reading this, you may have questions about your claim or you may have been injured and are wondering how to proceed. Speaking with a certified worker’s compensation expert at My Comp Lawyers can help you get personalized answers.
Keep in mind that your employer and its insurance company has attorneys on their side. In fact, in insurance companies have teams of skilled attorneys to ensure they do not have to pay compensation claims unless absolutely necessary. If you’re an injured worker, don’t you also deserve legal representation and support? When you consult with a workers’ compensation attorney, you can level the playing field and ensure you get the legal advice you need, when you need it.
There are many good reasons to get a workers’ comp lawyer, but one reason why many injured workers turn to My Comp Lawyers is because our workers’ compensation experts and attorneys understand what it takes to win a fair settlement. In addition, our firm does not charge case management costs, and we can easily be reached — even on weekends and evenings.
Our commitment to stand by you is evident in our client approach and in the way we structure our fees to ensure you get legal support without having to pay case management fees or upfront costs. If you are concerned about legal costs, rest assured My Comp Lawyers services are free for clients.
If you have questions about your workers’ compensation case or are trying to determine when to a hire a workers compensation lawyer and need to speak to someone now, contact us for your free consultation.