If you are an employee who has been injured or sick at work, you may be eligible for workers’ compensation payments. Unfortunately, employers or their insurance companies regularly refuse genuine workers’ compensation claims, leaving injured employees to navigate a convoluted system of appeals. Many candidates just quit at that point, while others attempt to negotiate the system on their own.
Hiring a professional workers’ compensation attorney can significantly improve your chances of receiving the benefits you deserve. An attorney will contact the workers’ compensation insurer on your behalf, acquire medical evidence to support your claim, negotiate a favorable settlement, and represent you at your workers’ compensation hearing.
The insurance company’s claims adjusters and lawyers are not looking out for you, and they will not hesitate to deny your legitimate claim for questionable reasons. Fortunately, a workers’ compensation attorney can help you tip the balances in your favor.
Develop evidence from medical, vocational, and other sources
The most frequent reason workers’ compensation applications are refused is a lack of medical proof. Even if your claim is granted, you are more likely to obtain all of the medical care you require—as well as all of the other benefits you are entitled to—if you have solid medical proof to back up your claim. An attorney can assist in the development of medical evidence by gathering medical records; arranging or recommending treatment with specific physicians; obtaining medical opinions from your treating physicians and through an independent medical examination; representing you when you are called to appear and answer questions at a deposition; and conducting depositions of medical experts.
Other sorts of evidence that might help your case include:
• Testimony from a vocational expert on the physical needs of your work
• Testimonials regarding your everyday activities from friends and family members; or
• Documentation demonstrating your employer’s history of inadequate workplace safety or lack of training.
Based on the strengths and weaknesses of your case, an experienced workers’ compensation attorney will know what evidence is required to optimize the chances of a favorable conclusion.
Settlement agreements must be negotiated
When it comes time to negotiate a settlement with your employer’s insurance company, a workers’ comp attorney has the advantage of being able to estimate how much your case is worth—that is, the number of benefits you should receive, based on a number of factors such as:
• The extent of your injuries and resulting limitations in what you can do
• Your past medical expenses, as well as the cost of medical treatment you’ll need in the future
• If your employer owes you money for prior temporary incapacity (wage loss) benefits and late payment penalties; and
• Your previous salary.
Lawyers are familiar with insurance companies’ negotiation strategies, which range from low-ball proposals to phoney “final offers” that aren’t. With rare exceptions, workers’ compensation lawyers are more likely than applicants working alone to participate in fruitful talks with insurers.
Your attorney may help ensure that your settlement agreement is correctly worded to prevent future problems. For example, if you are receiving or filing for social security disability payments, a poorly constructed settlement agreement might cost you hundreds of dollars in benefits each month owing to the workers’ compensation offset.
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