Should I Contact an Attorney If Insurance Is Evaluating a Claim?

The workers’ compensation process is a complex one, and if you have been injured and are out of work, you may not be sure what your rights are and how you should proceed. Consulting an attorney is always advisable before submitting your insurance claim. However, are you completely barred from speaking with one after you have already submitted your claim to the workers’ compensation insurance provider, or is it wise to speak with one even after you have submitted the claim?

We have asked attorney Alaina Sullivan, about what you should do. Here is what she had to say:

How Does Workers’ Compensation Work?

The process can vary slightly by state, but for the most part, as soon as you are injured on the job, you must notify your employer and workers’ compensation insurance provider. You will need to give your employer the type of injury, the date and time, as well as location of the injury, detailed information about how the accident occurred, and any medical treatment you may have received following the accident. At this point, your employer will file a claim with the workers’ compensation insurance company, as well as the workers’ compensation board.

After the claim has been reviewed, you will be notified if your claim has been accepted and the amount of benefits you will receive. If your claim is rejected, your state will have guidelines as to how you can appeal your deal both administratively and in the legal system.

Should I Get Help If My Claim is Under Evaluation?

Here's a little more information on how your state's laws will play into a workers' compensation claim.

Is It Too Late to Talk to a Lawyer?

No, it is not too late to speak with an attorney if you have already submitted the actual claim form. It may be too late to have that attorney review your form before you submit it to make sure you are submitting the proper type of evidence and asking for enough in terms of your claim. However, an attorney can assist you if you need to negotiate with the insurance company or if you need to appeal a denial.

Will It Be Enough?

One issue an attorney can review with you is what to expect with your claim. He or she can look over your medical evidence and give you an accurate estimate of what would be a reasonable offer from the insurance company. The attorney will also be able to help you look through whatever offer you are given to see if you have been “low-balled,” meaning you have been knowingly given a lower than normal offer in the hopes you would accept. If the insurance company knows you submitted the claim without the assistance of an attorney, the insurer may try to get you to take a lower offer in an effort to save money. Insurance may rely upon your ignorance of the law in hopes that you will think even a low offer is a good one. An attorney should be able to help you see whether you are being given something reasonable and can then help you go to the negotiation table if needed.

Negotiating a Settlement

An attorney will also be able to help you negotiate a good settlement in the event that you are given an offer that is lower than you deserve. Attorneys are trained in the art of negotiation and know the tricks that may be used to get you to accept something that is not legally reasonable. It is at this point where it would greatly benefit you to have a trained professional handling the back and forth between the insurance company to get you the settlement you deserve.

Appealing a Denial

In the event you receive a denial from the insurance company following the submission of your claim, an attorney can assist you in the process. The first step is normally an administrative appeal, which works similar to a legal appeal but in a less formal manner. It is important that the process be followed properly in order to be successful in the appeal. Therefore, it is helpful to have the assistance of an attorney to help make sure you are successful in your appeal.

Appealing a denial can be challenging and scary, especially when you need the income to stay afloat while you're not working. You'll probably want to know specifics on how to file an appeal.

Contact an Attorney Today

If you have been involved in an accident during the normal course of business and you have questions about your ability to seek workers’ compensation benefits, it is highly recommended that you contact an attorney to answer your questions. A licensed attorney trained in workers’ compensation law will be able to review your case and determine your best course of action. To receive the compensation you deserve, contact an attorney in your area today.