Employers may fight legitimate workers' compensation claims because they are concerned that expensive claims could cause their insurance premiums to skyrocket, they want to discourage other injured employees from filing claims, or they want to protect their company's image.
Workers' comp laws change constantly. Therefore, it can be difficult for the company to track what needs to be done. As laws change, the company must make adjustments to many facets of a claim, from the application process to the confirmation that you are eligible for compensation.
Medical-OnlyMedical-Only This is the type of claim that is the simplest to file and easiest to process.
As a general rule, you may be able to get by without an attorney if all of the following statements are true: 1. You suffered a minor workplace inj...
In addition to making sure you file all the necessary forms and meet the deadlines, an experienced attorney will know how to gather the evidence ne...
The workers' compensation system may have been intended to provide prompt and fair compensation to injured workers. But now, it seems to work mostl...
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.
Reporting regulations and deadlines vary from state to state, but it should typically take no longer than 30 days to complete this process.
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.
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.
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.
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.
They can reject the settlement if they feel it’s not reasonable and the employee is getting a raw deal.
A knowledgeable workers' comp attorney is essential in cases involving permanent injuries or illness. You receive or plan to apply for Social Security disability benefits.
Here are some examples of situations that call for a lawyer's intervention: Your employer denies your claim or doesn't pay your benefits promptly. Employer s and workers' comp insurers routinely reject bona fide workers' comp claims, confident that many workers will fail to appeal. Unfortunately, they're usually correct.
If your employer has fired you, demoted you, slashed your hours, reduced your pay, or engaged in any other form of discrimination because you filed a workers' comp claim, contact a workers' comp attorney immediately to protect your legal rights. You were injured because of a third party's actions or your employer's serious misconduct conduct.
If you can't agree on a good settlement, an attorney can prepare for and represent you at the hearing or trial. Learn more about what a good workers' comp lawyer should do and what to look for in a workers' comp attorney.
Although workers' comp settlements must have judicial approval, judges will usually sign off on any agreement as long as it's not grossly unfair. If you really want someone to get you the best settlement possible, call an attorney.
Hiring a workers' comp attorney costs nothing up front (more on that later), and it gives you the best chance to receive a fair settlement or award for your injuries. Your employer's settlement offer doesn't cover all your lost wages or medical bills.
When You Can Probably Represent Yourself. As a general rule, you may be able to get by without an attorney if all of the following statements are true: You suffered a minor workplace injury, such as a twisted ankle or a cut requiring a few stitches. Your employer admits that the injury happened at work.
By contrast, because there routinely are ongoing disputes over evolving issues — your claim is denied; you’re having trouble getting medical care; you’re unable to return to your previous job; your disabilities are disputed — workers comp cases can last for years, even decades.
In workers compensation law, then, timeliness is pivotal. As every investigator knows, an inverse relationship exists between the value of evidence and the time it is collected. That is, the longer you wait, the less it is worth.
Employers, who despise the knock-on effects of higher premiums associated with claims, will attempt to dissuade workers from filing a workers comp claim “even when they’ve had a legitimate on-the-job accident, ” she says.
You are permanently disabled, either totally or in part, and the insurer resists your rating. Your employer and insurer fail to pay workers compensation benefits promptly, counting on you not to file an appeal.
A lawyer will be able to analyze the details of a particular workers ’ comp case to ensure an employee receives proper benefits. The lawyer might look over medical records to determine the extent of the injury in question and could also examine your business’s records to see if it has had any previous safety violations.
Employees who retain an attorney often do so because: They don’t understand how the claims process works. They want to make sure they are filing the claim correctly.
When employees file a workers’ comp claim, they report the incident to the proper labor authorities in their state. If an injured employee accepts benefits or a settlement package, they usually waive the right to sue your business, but they can reject the settlement outright and pursue litigation.
Lawyers can also advise employees after your business’s insurance provider decides whether or not to grant benefits. If the insurer denies the claim or offers an unsatisfactory payout, the employee’s lawyer may encourage him or her to appeal the decision. As noted above, this is an instance when a small business might consider hiring its own ...
Your business lacks workers’ comp insurance. If your company fails to purchase the required workers’ comp coverage for the states in which you do business, you are likely to hear from the Occupational Safety and Health Administration, in which case it’s wise to speak with an attorney.
Lawyers help employees assess the cost of their injury or illness to determine how much money they should receive. To do so, attorneys consider medical bills, rehabilitation costs, time away from work, and the type of disability that the employee has incurred.
The good news: Small business owners rarely need to hire lawyers for workers’ comp claims because they rarely end in lawsuits. Usually, the injured employee is simply exercising his or her right to compensation, and the employer’s workers’ comp insurance provider will decide whether the worker is eligible for benefits.