When a worker gets hurt on the job, they could qualify for benefits that include treatment costs and lost income payments. However, getting approved for these benefits is often more difficult than it has to be. A workers’ compensation attorney helps injured workers navigate the claims process and pursue the benefits promised to them under their state’s workers’ comp laws or their employment agreement.
When you hire a workers’ compensation lawyer to manage your case, they can handle all aspects of the claim. The necessary steps will depend on the circumstances. You can learn more from a local law firm. Most law firms will listen to the details of your case in an initial consultation over the phone. Also, they typically provide free case assessments for injured workers in their service area. Reach out to a worker's compensation lawyer.
Workers’ Comp Attorneys Help Injured Workers Get the Benefits They Deserve
Workers’ compensation lawyers handle claims and help injured workers get approved for the benefits they deserve. There are several reasons why an injured or sick worker might opt to hire an attorney and many ways the attorney could help address their issues. Some of the most common ways a workers’ comp lawyer helps their clients include:
Handling Issues With the Claim
When there is a problem with the workers’ compensation claim, such as denial, the attorney represents the worker’s best interests and fights for the benefits promised. This task could require them to investigate the incident and resulting injury, submit all necessary paperwork, and navigate the official process to challenge a decision.
Many issues occur with workers’ compensation claims that affect the injured party’s benefits. A workers’ comp attorney understands these issues, how to address them, and the steps to take to correct them. They advocate for their client and fight for the benefits they need and deserve.
Protecting Their Rights
When state law or a company’s employment policies provide workers’ compensation insurance coverage, a covered employee hurt on the job has a right to the included benefits. When a problem arises with their employer, insurer, or another party, it could delay these important payments or prevent them from receiving them.
A workers’ compensation attorney analyzes the circumstances and aggressively pursues the benefits due to their client. They also manage all communication about the claim to ensure the insurance company does not use the worker’s own words against them.
Ensuring They Receive Fair Compensation
Sometimes, workers’ compensation insurance companies approve benefits but not at the level promised in the policy. Because these benefits are already significantly less than the worker’s usual take-home pay, a reduced benefit could cause additional financial hardship. Workers’ compensation attorneys challenge these decisions, calculating the appropriate rate and demanding the insurer offer the correct benefits. Sometimes, they might negotiate for a lump-sum payout even after the worker returns to work.
Depending on the circumstances, they might need to challenge coverage of certain treatments or the handling of other benefits, too.
When Should I Consult a Workers’ Compensation Attorney?
A workers’ compensation attorney can go to work on your claim at any time. Sometimes, this process goes smoothly, and injured workers, with the cooperation of their employer, file the necessary paperwork and get approved for benefits as expected. In this case, a lawyer might not be necessary. Many workers manage this process on their own.
However, calling a law firm at the first sign of trouble is a good idea. They can assess your case and could take over from there if necessary.
Some examples include:
- An employer that is uncooperative or does not believe you were hurt at work
- Unnecessary delays in processing your claim
- Pressure to return to work without your doctor’s permission
- A denial letter from the insurance company
An attorney is a great resource when there is a problem with a workers’ compensation claim. They know the applicable laws, can evaluate the policy, and probably have experience handling similar situations in your state.
Even if you believe you will return to work soon, discuss your options with a lawyer. It might be possible to recover the benefits you missed even after healing and returning to work. Depending on the laws and circumstances, your attorney might negotiate a lump sum payment for your missed benefits on your behalf.
If your injuries are still healing or you are unlikely to return to work, a lawyer can fight for approval of the medical care coverage and income replacement benefits you need to make ends meet and get the necessary treatment today.
What Are the Most Common Issues With Workers’ Comp Claims?
Several things go wrong with workers’ compensation cases. In that event, an attorney should know what to do. While some injured employees have an easy time getting their benefits and run into a problem later, some have to fight for their benefits from the start.
Some of the most common calls attorneys get about workers’ compensation cases include these issues:Claims Denials
The most significant problems workers run into with getting their workers’ comp benefits started relate to claim denials or other issues dealing with the approval of their claim.
Insurance companies could deny a claim because they do not believe you are hurt or the injuries are work-related. They could also deny a claim related to the policy or paperwork for administrative or technical reasons.
Underpayments
Sometimes, the insurer approves the claim, but the income loss benefits are significantly different than expected. An attorney can review the policy and your income paperwork to calculate the proper rate. If they find you are underpaid, they can take the necessary steps to challenge the rate and seek the correct compensation and back pay.
Cutting Off Payments Too Soon
Insurers sometimes decide workers are ready to return to work before their doctor approves or they are physically able. They could cut off payments or take other detrimental actions when this occurs. Having an attorney on your side when this problem arises ensures you do not risk your health and healing because of a bad decision the insurer made.
Refusal to Pay for Some Medical Care
Income loss benefits are the part of workers’ compensation that many people think about first, but this insurance also covers the treatment of the work-related injury. There are strict rules about which doctor you need to see, what to do if you want a second opinion, and how to handle instances when your doctors disagree on treatment.
Issues related to any of these topics could lead the insurer to refuse to pay for treatments you need. An attorney can help you navigate challenging this decision.
Who Qualifies for Workers’ Compensation?
Who qualifies for workers’ compensation depends on the applicable state laws. Each state sets laws for who it requires to provide workers’ comp insurance and who meets an exception and does not have to. Often, these factors depend greatly on the number of employees the company has on staff. Many states require all businesses with four or more employees to provide coverage.
When a state requires coverage, they do not limit which employees receive the benefits. Instead, all employees should have workers’ comp coverage from the first time they clock in for work.
They include:
- Full-time, salaried workers
- Full-time hourly workers
- Part-time workers
- Seasonal workers
- Occasional staff
Those who do not qualify for coverage generally include independent contractors and volunteers. The policy should include all employees at a workplace required to provide workers’ comp coverage.
When a covered worker suffers an injury at work or receives a work-related diagnosis of a chronic injury or illness, they should file a claim and receive benefits.
How Do I Know If I Am Getting the Workers’ Compensation Benefits I Deserve?
While the required workers’ compensation coverage differs by state, most policies provide the same general benefits. Ensuring you receive the benefits you deserve based on the applicable workers’ comp policy could require reviewing your employment paperwork or discussing your case with an attorney.
The typical benefits from workers’ comp include:
Medical Care Coverage
Stipulations are common, but workers’ comp generally pays for your medical care related to the workplace injury or illness. This coverage often includes all related medical bills. Generally, workers need to see an approved physician. Because of their agreement with the insurance provider, the employee never needs to deal with the bills.
While this benefit is often overlooked because workers are more concerned about income losses when they cannot work, medical care coverage often pays out more money.
If you are having a hard time getting certain treatments approved or there are issues between your doctor and the insurer, you might not be recovering the benefits you deserve. An attorney can review your options.
Income Loss Benefits
Income loss benefits are what most people think of first when you mention workers’ comp. This benefit pays a portion of the worker’s lost income while they heal. It ensures they have money coming in despite being unable to work. Most policies have complex rules about when you receive your first check, how long you can receive benefits, and how your benefits could change over time.
Income loss benefits do not pay the full compensation you would earn if you were working. They pay a portion, often about two-thirds, up to a maximum. It is common for the payment amount to differ from what the worker expected, and sometimes this is because of a miscalculation. A lawyer can help you determine the income loss payments you deserve.
Death Benefit
Most workers’ compensation policies include a death benefit in the event of a fatal accident. It is generally a lump-sum payment that could cover reasonable funeral and burial costs and other final expenses.
Additional Benefits
Many workers’ compensation policies have additional benefits available. One common example is coverage of certain training programs to help workers with lasting impairments learn a new job or adapt to handle their old tasks with a new disability.
How Much Does It Cost to Hire a Workers’ Compensation Lawyer?
Most workers’ compensation lawyers work based on contingency. They do not charge anything up front. Hiring a workers’ comp lawyer and getting them started on your case costs nothing.
Instead of retainers or other upfront fees, they receive a portion of the money they recover for the client. Some states have laws capping the total the attorney charges or the percentage of the recovery they take. This limit generally keeps these percentages fairly low, although they could differ based on the laws in your area or the individual firm’s policies.
When a lawyer works based on contingency, it ensures anyone who needs legal guidance and representation can afford to hire them. This payment arrangement prevents someone who needs help getting income loss benefits from going further into debt when they’re trying to hire a lawyer to manage their claim.
Discuss Your Workplace Injury Case With a Legal Team Near You for Free
Getting the benefits you deserve following an injury at work should not be difficult, but it can be. Even when you follow all the rules, there are often hiccups in the process: your employer refuses to admit the issue occurred, will not cooperate with their part of the paperwork, or there are issues getting approval from the insurer. In that case, you need to know how to navigate the process, challenge the decision, and fight for the benefits you need. Reach out to a personal injury lawyer.
If you run into any issues filing your claim or getting approved for benefits after a workplace injury, contact a law office today. Most workers’ comp firms provide free consultations for workers hurt on the job. You could have options for getting approved for benefits, overturning a denial, or negotiating a settlement for your missed benefits. An attorney can manage your case from start to finish and protect your best interests.
