If you have a workplace injury, you need to file a worker’s comp claim. People may think they can handle the case settlement themselves. But you could leave a pile of money on the table without a worker’s compensation attorney in many situations, as we highlight below.
Claim Is Denied
If the insurance company denies your claim, you’re almost certainly going to need to bring in a lawyer. Insurance companies reject worker’s comp claims for many reasons.
For example, it may say that your injuries didn’t happen at work. Or, you filed the claim too long after the accident occurred.
Your attorney can appeal the company’s denial through the worker’s comp system. The process to appeal a denial varies by state. Generally, you need to file official paperwork, use various legal tools to collect evidence, and show your proof at a hearing.
Insurance Company Disputes Your Disability Rating
Most of the settlements and awards for worker’s comp cases involve permanent disability benefits. The benefits are determined by the permanent disability rating you receive. If the worker’s comp insurance firm disagrees with your rating given by your doctor, you could need to go to an independent medical examination or IME. Note: In some states, IME is referred to as Employer’s Medical Exam or EME.
A physician performs the IME or EME that the insurance company chooses. The doctor represents the company’s interests, not yours. So, it’s probably common they’ll give you a lower rating. The company will take that rating and use it to pay you lower benefits.
A worker’s compensation attorney is usually needed to obtain a just settlement or convince the judge that you should have a higher rating.
Someone who has a preexisting condition that involves the same area of the body could be in for a fight with the worker’s company insurance company. It will almost certainly attempt to blame the workplace injury on the preexisting condition. This nearly always happens if the workplace injury occurred over time, such as carpal tunnel syndrome.
You Already Get Government Benefits
If you get Social Security Disability benefits, they could be lowered when you get worker’s comp benefits. Your attorney can help ensure that your Social Security benefits are reduced as little as possible.
If you can get Medicare, you may need to put aside some worker’s compensation benefits for medical treatments in the future. An attorney can help make this happen most beneficially.
You Can’t Work
If working is impossible after your injury, you need as much in worker’s comp as you can get. Also, it needs to be structured to last as long as possible. If a career change is necessary, you’ll require training to prepare for a new job. Your attorney will be indispensable in these situations.
You Have A Hearing Coming Up
If the worker’s comp insurance company is fighting you or offers a small settlement offer, a hearing is in your future. This is similar to a mini-trial, so an attorney is almost always needed.
A worker’s compensation attorney doesn’t charge by the hour, as many people think. They charge you a contingency fee at the end of the case. This fee is a percentage of the benefits they get for you.
Also, many states have limits on contingency fees in workplace injury cases. This number varies by state, but it’s usually between 15-25%. The cost, however, might be just 10% or as high as 30% in a few states.
Most clients get a higher settlement when they get an attorney involved. Even when you account for the legal fees, you’ll usually come out ahead. Attorneys know the law, negotiate with insurance companies almost every day, and have many legal tools available to construct your case.