Facing a work-related injury can be an extremely stressful situation for any individual. Should a claim be filed? Does the person need an attorney? While an attorney is not always needed, many times, it is wise to hire a workers’ compensation attorney.
When a Lawyer Is Not Needed
Not all situations require the assistance of an attorney. For instance, if the employee suffered a minor injury that healed quickly and did not require extensive treatment, he or she will likely not need to hire an attorney. In situations where the workers’ compensation insurance provider determines:
- 1. The injury was clearly work-related;
- 2. The injury does not require expensive, extensive medical treatment;
- 3. The employee will not need a significant time off work; and
- 4. No permanent injury or disability resulted from the injury;
The insurance company will likely agree with the claim and process it quickly. In fact, many workers’ compensation claims are open-and-shut cases and do not require litigation or the assistance of a hired attorney.
Proceeding without an Attorney
It is possible that the person injured can represent himself or herself in a workers’ compensation matter. If the above qualifications apply to the person’s case: the injury was minor, little to no time was missed because of the injury, the employer readily admits that the injury occurred at work, and the employee does not have a pre-existing condition, he or she should be able to navigate the claims process without attorney intervention. However, if any question exists in any of these factors, it is recommended that the employee at least contacts an attorney for a consultation on the matter before filing a claim.
When to Hire an Attorney
It is recommended that the employee seek the assistance of an attorney if any of the following situations occur.
- 1. The Workers’ Compensation Claim Was Denied.
If a workers’ compensation claim was filed and denied, it is recommended that the employee hire an attorney. A denial can be appealed through an administrative appeals system. The process is not an easy one and requires that a close step-by-step procedure be followed, and evidence be gathered and submitted. Many times, it requires a hearing, and an attorney can be best at navigating this system easily and properly.
- 2. The Insurance Company Disputes the Permanent Disability Designation.
Most workers compensation claims are for permanent disability benefits, which are calculated on a rating system. If the insurance company reviews the employee’s rating and does not agree with the one given, they can require that the employee undergo an independent medical examination (IME) with a doctor chosen by the insurance company. It does not take a rocket scientist to guess that this physician will side with the insurance company. An attorney can stand up for the employee and advocate for the rating given or at least ensure that the employee is not given an unfair rating after a re-evaluation.
- 3. The Employee Has a Preexisting Condition.
If the employee making the workers’ compensation claim has a preexisting condition, it can be safely assumed that he or she will have a fight getting the claim approved by the insurance company. The claim may be denied on the basis that the employee’s injury was from his or her preexisting condition instead of the work-related activity. It can be proven but often requires the employee produce medical records to prove the case.
- 4. The Employee Is Facing a Workers’ Compensation Hearing.
If the insurance company has insisted upon a hearing or if settlement negotiations are not going well, employees are encouraged to contact an attorney. These hearings tend to be like mini-trials and require use of rules of evidence, information the average person may not fully understand.
Do Not Wait Too Long
It is highly recommended that, if the employee believes an attorney is needed, he or she does not wait too long. Certain statutory requirements are set, giving specific deadlines on how soon an employee needs to give notice to an employer of an injury and intent to file a workers’ compensation claim. Waiting too long can bar him or her from being able to seek a claim at all. Further, if a denial was given, deadlines are also provided for how long the employee has to file an appeal.
Contact an Attorney Today
If you have been involved in an accident during the normal course of business and are unsure about how to proceed with a workers’ compensation claim, 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.