When Should You Call a Lawyer for Your Workers’ Comp Claim?
Being injured at work can cause more than just physical pain. It can force you to take unpaid time off work, require medical treatment, and disrupt your personal life. The workers’ compensation system in your state is designed to replace lost wages and cover your medical bills regardless of fault.
However, the process is complex and insurance companies try to get away with paying as little as possible. Knowing when to bring in an attorney can significantly impact the compensation you receive and how fast your claim is resolved.
While not all workers’ comp claims need to involve an attorney, here’s how to know if your situation would benefit from legal representation.
- Your claim has been denied or delayed
Handling a denied or delayed claim is difficult when you’re not a lawyer with the legal knowledge that forces insurance companies to play fair. Workers’ comp claims are outright denied at an alarming rate, and many injured workers receive less than their case is actually worth.
If your claim gets denied, you’re legally owed a reason. Common reasons for denial include disputes over whether the injury was work-related or reported on time. A lawyer can analyze your denial letter, gather your documentation, and file an appeal. A lawyer will also represent you during the evidentiary hearing – something that isn’t easy to handle on your own.
Although it’s smart to hire a workers’ comp attorney if your claim is denied, having a lawyer from the beginning can help you avoid unnecessary delays and get you the maximum benefits available under state law. A lawyer can also help you pursue a third-party claim against a negligent contractor or manufacturer to recover additional compensation.
- Your injury is severe and/or permanent
While most workplace injuries tend to be sprains, strains, and other minor injuries, many are serious and permanent. If your doctor has indicated your injury constitutes permanent impairment, it can increase the value of your claim. However, you can’t rely on the insurance company to properly evaluate your situation on their own. Having an attorney will force them to play by the rules, so they can’t ignore your disability classification and issue you a low payout.
If your injuries require ongoing medical care, physical therapy, additional surgeries, or pain management, the insurance company is likely to dispute these needs. Your lawyer will advocate for you and prevent your benefits from being cut short. Having an attorney is especially important if you can’t go back to work in the same position and need to take a pay cut or completely change your profession. A lawyer will make sure you don’t accept a settlement that undermines your long-term needs.
- Your employer or the insurance company disputes your medical treatment
Medical disputes are common. If the insurance company refuses to approve recommended treatments, you’ll need a lawyer to challenge that denial. Unfortunately, many insurance carries require you to be examined by one of their doctors. Many injured workers report that insurance company doctors minimize the severity of their injuries. A workers’ comp attorney can prepare you for this exam and contest biased conclusions if needed.
- You’re offered a settlement
Settlement offers seem straightforward but are rarely fair. Workers’ comp insurance companies will do everything in their power to pay you as little as possible. The first offer they make is virtually guaranteed to be too low. If you accept it, you can’t ask for more later when you find out you need additional medical care.
The smart move is to wait until you reach Maximum Medical Improvement (MMI) before accepting a settlement. An experienced lawyer can tell you if your future medical needs have been accounted for in the settlement offer.
- A third party is liable
Workers’ comp typically doesn’t allow injured workers to sue their employer directly. However, lawsuits against third parties might be possible if someone other than your employer contributed to your injury. For example, if faulty equipment caused your injury, you might be able to sue the manufacturer.
- You’re facing retaliation or termination
Employers are legally prohibited from retaliating against workers who pursue workers’ com claims, but it still happens. If you get fired shortly after you report an injury, get demoted, or are reassigned to an undesirable role, talk to a lawyer right away.
Legal help can protect your claim
Workers’ compensation is supposed to provide you with a financial safety net that covers medical bills and lost wages. However, some cases are unfairly denied and devalued. Having legal representation from the start will help you get every dollar you deserve.
