The administrative process of worker’s compensation is designed for making navigation relatively easy for the workers. So, we can say that usually, a worker does not need to hire an attorney to get his or her worker’s compensation.
When you have a straightforward claim which is not at all being argued by your employer, you can handle your claim all by yourself.
However, the process is not that simple all the time. A lot of workers might benefit from hiring a Worker’s compensation attorney. In a number of instances, the employee who is suffering or has suffered from an injury can make a claim outside the worker’s compensation.
In this case, a personal injury lawyer will be able to help them. So, in case you are thinking about making a claim, it is crucial to know when you need to hire an attorney and when not.
- 1 When A Worker’s Compensation Lawyer Is Not Necessary
- 2 When A Worker’s Compensation Lawyer Is A Must
- 3 Hire A Lawyer!
When A Worker’s Compensation Lawyer Is Not Necessary
In case you are suffering or have suffered a relatively minor injury at work, which is completely treatable and will be healed with the proper treatment, you might not need to hire a worker’s compensation lawyer.
Here are some of the claims that your insurance company is unlikely to dispute.
- Do not result in permanent injuries.
- Do not include long periods of time off work.
- Do not need extensive medical treatment.
- Include injuries that are work-related.
Let’s say you slipped on some water in the break room and sprained your ankle. Now, your doctor asked you to ice your ankle, stay in bed for a few days and take pain relievers. As you are doing a desk job, you will be able to resume work as soon as your ankle heals within a few weeks.
If this is the case, your medical costs will be covered under the worker’s compensation. But you might not get wage loss benefits as you were only out of work for a few days. This is the possibility for most of the states.
When A Worker’s Compensation Lawyer Is A Must
Whenever you are in dispute with the insurance company, you must consider hiring a worker’s compensation lawyer to present you. In order to challenge the position of an insurance company, you need to gather as much evidence as you can.
That might include taking depositions along with requesting a completely independent medical examination and hiring expert witnesses. For all of these, you must have the proper legal knowledge and also a skill.
To help you with much clearer information, here we are providing some examples of when you need to hire an attorney.
#1 Claim Is Denied
There are a lot of reasons why insurance companies deny worker’s compensation claims. Like the insurance company can claim anytime that the injury you are suffering from is not work-related or you have filed the claim too late.
Through the worker’s compensation system, you definitely can plead the denial. From state to state, the appeal process varies. Usually, it involves filing formal paperwork, using legal tools or gathering evidence, and presenting your case at a hearing.
#2 Having A Preexisting Condition
In case you have a condition or injury in the same part of your body injured at work, you are definitely going to fight a battle with the insurance company. In most cases, the insurance company blames the previous condition instead of your work activities.
It is most likely to happen in case your injury has developed slowly over time instead of occurring during a single work accident.
#3 Disputed Permanent Disability Rating
Most of the worker’s compensation awards and settlements are for permanent disability benefits. On the basis of your permanent disability rating, all these benefits are calculated.
In case the insurance company denies the disability rating provided by your doctor, it can deny it and ask you to attend an IME or independent medical examination with a doctor who will be chosen by the insurance company.
Isn’t it obvious that the IME doctor will assign you a much lower disability rating?
And the insurance company will use that to justify you fewer benefits offered by them. Only a lawyer will be able to get you a fair settlement or at least convince a judge that you are entitled to a higher rating.
#4 WorkAbility Has Been Affected
In case your condition is so severe that you will never be able to work again, you will be required to maximize your worker’s compensation benefits along with structuring them in a way to last that well into the future.
In case you are required to change careers, it is quite expectable that you need to secure training in a new line of work. An attorney will be able to help you in both these cases.
#5 Having Trouble In Getting The Treatment
Often insurance companies reject or delay approving medical treatments that are a little expensive, like surgery. Only your lawyer will be able to take the insurance company under pressure and get the necessary medical treatments approved in a timely manner.
#6 Receiving Other Government benefits
In case you are getting SSDI or Social Security Disability Insurance, these types of benefits might be reduced in case you are also getting worker’s compensation benefits.
Only an experienced legal professional will be able to assist you in minimizing the amount of SSDI benefits that will be reduced.
In case you are also eligible for medicare, you might also be required to set aside a particular part of your worker’s compensation benefits for paying for future medical treatments. A lawyer can assist you in all these things.
#7 Having Worker’s Compensation hearing
Suppose your insurance company is refusing to settle or only creating lowball settlements; you have to prove your case at the gearing. As it is some kind of a mini-trial, you must have a lawyer in order to present you and handle all the legalities.
Hire A Lawyer!
After going through this article, we believe you understood that whenever you are having any type of issue or not getting fair compensation, you must hire a lawyer. A worker’s compensation lawyer handles these types of matters every day. The professional will be able to guide you properly.