When to Hire a Workers Comp Lawyer
Imagine you are at work and have to move a stack of boxes. Halfway through lifting one, your boss shoots you with a bow and arrow.
He doesn’t really, but pain shooting through your shoulder and neck makes you think he did.
Whether it turns out to be a pulled muscle or a slipped disc, you’re going to need medical help. That means you’re about to enter the workers compensation maze.
Who you gonna call?
The first call some people make is to a workers comp lawyer. That’s a great idea, except when it’s not.
Allow us to explain the difference and help you decide when to lawyer up.
Signs You Should Get a Workers Comp Lawyer
How your company, or more importantly, its insurance carrier, handles your case will determine whether it’s in your best interest to get a lawyer. Here are 10 signs you need a workers comp attorney on your case.
- Your employer or insurance carrier denies it happened at work – This is often the case when a slight injury happens at work and goes unreported. That injury is aggravated further at work, suddenly becomes serious and the employer/carrier says the original injury didn’t occur at work. This also happens when the long-term effects of exposure to something at work result in a disease.
- Your employer drags its feet with your claim – If you’re injured on the job, you should immediately notify your employer and start the reporting process. The company must provide you with the proper paperwork, report your case to the state workers comp board and file a claim with its insurance carrier. Reporting regulations and deadlines vary from state to state, but it should typically take no longer than 30 days to complete this process.
- If you suffer permanent disability, either partial or total, that will prevent you from ever fully returning to work – Insurance companies are more likely to contest such claims because they are the most expensive.
- Your doctor recommends treatment and the insurance company won’t pay for it – This too is a common practice when an injured workers recovery means rehabilitation visits that an insurance company doesn’t think are necessary.
- If the insurance company denies your claim – If you appeal that decision – and you should if you feel your claim is legitimate – this is where things can get complicated and expert advice is needed. “If it gets contentious, if there’s a disagreement, then it’s time to get a lawyer,” Branham said.
- If the settlement offer doesn’t cover all lost wages and medical bills – Most worker comp settlements are for permanent disability benefits, which are based on a rating system determined by examining doctors. 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.
- You have a preexisting condition – If you already had neck problems before lifting that heavy box, the insurance company will likely blame your new pain on that. You’ll need evidence to prove otherwise.
- You plan file for Social Security disability benefits – Those benefits, known as SSDI, may be reduced by workers comp benefits. A lawyer can structure your settlement to minimize or eliminate the offset.
- Your employer retaliates against you – If you are fired, demoted, have your hours cut or are pressured to return to work too soon, a lawyer can argue the penalties are unwarranted.
- 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.
Signs You Should Not Get a Workers Comp Lawyer
- Your injury is minor and doesn’t require much medical treatment –The workers comp system is specifically designed to handle these types of cases.
- You don’t have a preexisting condition that was aggravated by the accident –Preexisting conditions can complicate your claim, like a neck injury from car wreck that is inflamed by a fall at work.
- You miss little or no work –This type of claim should be straightforward.
Should I Get a Lawyer for Workers Comp?
Hiring a lawyer for a workers comp claim is a question every injured worker faces and the truth is that most situations – injured ankle, cut on the arm, sore back – are easily treated and won’t require more than a bag of ice, a trip to the doctor, a few aspirin and some rest.
However, if your work injury is serious and things get contentious between you and your employer or the insurance carrier handling the case, there is no question that it’s in your best interests to at least talk to a workers comp lawyer. A twisted knee or strained back can turn into knee or back surgery and things get serious very quickly.
“You don’t have to hire an attorney every time you have a claim,” said Tom Holder, a prominent workers comp lawyer in Atlanta, “but you should at least call one and let them explain how the process works and what benefits you are entitled to receive.”
Just don’t automatically assume your case is going to turn into a legal food fight.
“Too many claimants get a lawyer the day after the accident,” said Jeff Branham, a workers compensation attorney in Florida.
Conversely, if you’re worried about rocking the boat at work or the expense of hiring a lawyer, not calling one could end up costing you a lot more.
“The perception of the public is that I can’t afford a lawyer, or it’s going to cause unnecessary delays or the lawyer is going to take too much of my award,” said Judge Neal Pitts, a Judge of Compensation Claims in Florida. “If the case settles for $100,000 with a lawyer or $10,000 without, that’s a no-brainer. And that happens.”
Handling a Case on Your Own
We’ve mentioned SSDI and IME, but do terms like AOE/CEO, cumulative trauma, DEU, IIPP, PDRS and WCAB mean anything to you?
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.
Even when employees win their appeals, most would have done better with a lawyer arguing their case.
“Way more than half, way more,” Judge Pitts said. “Probably closer to 80%. It’s rare that you get a situation where the employee likes the insurance rep and the insurance rep likes the employee and things work out.”
When You Should Get a Lawyer for Workers Compensation
As soon as you decide to contest the settlement decision.
At that point, workers compensation can quickly turn into a legal jungle of paperwork, deadlines, depositions and evidence gathering. It’s easy to get lost if you don’t know what you’re doing.
What an Attorney Will Do for You
There will be court proceedings before your case is heard by a workers comp judge. 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. It’s High Noon, and everything will depend on how effective your side makes its case.
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. When an employee represents himself or herself, the settlement is not final until the judge approves it.
They can reject the settlement if they feel it’s not reasonable and the employee is getting a raw deal. But the settlement usually has to be grossly unfair for a judge to reject it.
To avoid that predicament, get a lawyer at the first sign of trouble. You’ve already been injured on the job. You don’t need what follows to turn into a pain in the neck.