It is vital to get a workers’ compensation lawyer if there is a dispute or lack of clarity surrounding a workplace injury. An employee can handle a claim on his or her own if the injury is minor and without dispute. Unfortunately, the process is not always straightforward, with employers and their insurers denying claims for several reasons. To challenge the companies’ position, employees must gather sufficient evidence, a process that requires legal skills and knowledge.
When Employees Can Potentially Represent Themselves
Workers’ compensation insurers are unlikely to deny or dispute claims that:
- Involve clearly work-related injuries
- Do not involve extensive treatment or time away from work
- Do not lead to permanent injuries
A workers’ compensation lawyer may not be needed if the workplace injury suffered is minor — like a cut needing a few stitches or a sprained ankle — and it heals quickly and completely with treatment. Nevertheless, even in uncomplicated situations, it is advisable to consult with a lawyer. Workers’ compensation lawyers usually offer free consultations, during which an employee can learn more about his or her case, including the potential pitfalls.
When It Is Necessary to Hire a Lawyer
There are several situations that require a lawyer’s intervention. These include:
A claim has been denied
Insurance companies and employers often reject legitimate claims knowing that the affected workers are highly unlikely to appeal. Appealing a denied claim usually requires filing formal paperwork, gathering evidence, and presenting a case at a workers’ compensation hearing. A lawyer will guide a worker through the process and help secure the documents that can help prove the case.
Working capacity has been significantly affected
An employee that suffers partial or total disability will have his or her ability to work seriously affected. In such cases, insurance companies are likely to contest the claims because the worker will require long-term benefits. An attorney will help a seriously injured employee maximize the benefits and structure them to last long into the future.
The settlement offer is not good enough
Insurers can lowball injured employees and pressure them to accept insufficient settlement offers. Workers’ compensation judges can sign off on agreements provided they do not consider them grossly unfair. An employee can end up getting a smaller settlement than what he or she feels should be received. If an injured employee wants to get the settlement that best covers lost wages or medical bills, it is best for him or her to hire a workers’ compensation attorney.
Preexisting health condition
Employers and insurance companies may try to use the preexisting conditions of employees to deny compensation benefits. An attorney can help prevent an injured employee’s preexisting condition from being used to disqualify him or her from receiving benefits.
An employee is receiving or planning to apply for SSDI benefits
Workers’ compensation benefits can significantly reduce Social Security disability benefits if they are not structured properly. An attorney can help draft a settlement agreement in such a manner to eliminate or minimize this offset.
Employers and insurance companies have highly trained lawyers, so working with a workers’ compensation lawyer helps tilt the scales in an injured employee’s favor.