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Do I need a workers' compensation lawyer?

There are certain situations in which hiring a workers’ compensation lawyer can be crucial to help you get the benefits you deserve. Here are some of the factors which affect whether it makes sense to hire a workers’ comp attorney.

evident Editorial Team
published
July 30, 2021
Hardhat on concrete at construction site

If you have a workers’ comp claim, you may be wondering whether you need to hire a lawyer. Some workers’ comp claims are straightforward and do not require hiring a lawyer. For instance, if no one disputes your claim and you receive your benefits promptly, then you probably don’t need to hire an attorney.

But many people hire lawyers for their workers’ compensation claims every year. And there are certain situations in which hiring a workers’ comp attorney can be crucial to help you get the benefits you deserve.

Those situations include: if your employer or their insurance company reject or dispute an aspect of your claim; if you have certain issues related to your medical circumstances; or if certain legal scenarios apply to your case. We'll address each of these in turn.

Key Takeaways

If your employer or their insurance company reject or dispute an aspect of your claim

This one is pretty straightforward -- if your claim is accepted and processed without a fuss, then you probably don’t need to hire a lawyer. But if not, you may need someone to help you navigate the workers’ compensation system and advocate on your behalf.

There are various ways that your employer or their insurance company might dispute your claim, ranging from rejecting the claim outright to disputing certain parts of it. For instance, some of the ways the insurance company might dispute your claim include:

  • Disputing whether your injury was work-related
  • Disputing how your injury is “rated” for calculating your benefits (more on this below)
  • Attributing your injury to a preexisting condition instead of your work injury

Anytime the insurance company disputes your claim, you should consider hiring a lawyer. In this scenario, you will be able to appeal a denial through the workers’ comp system, but you will generally need to gather evidence and make your case at a hearing. Gathering evidence can include:

  • Taking depositions (essential sworn interviews of witnesses)
  • Requesting an independent medical examination
  • Hiring expert witnesses

An experienced workers’ comp lawyer will be familiar with this process and can put you in a position to succeed.

Here are a couple of ways specific disputes might arise:

Disputes about permanent disability ratings

Your employer or their insurance company might dispute your claim by disputing your permanent disability rating. Your disability rating could impact how many weeks of benefits you are eligible to receive, the actual amount of those benefits, or both.

And because most benefits are awarded for permanent disabilities, if there is a dispute about your permanent disability ranking, it can significantly impact your benefits. A lawyer can be a critical resource in your efforts to convince a judge or the insurance company that you are entitled to benefits under the higher designation.

Disputes about preexisting conditions, particularly if the condition relates to whatever you injured at work

The insurance company may try to argue that your injury is the result of your underlying condition as opposed to your “work activities.” This issue often comes up if the injury occurred over time as opposed to in a single accident.

If you have certain issues related to your medical circumstances

Issues related to your medical treatment or medical circumstances are another set of factors that can make it more important to hire a lawyer. Examples can include:

  • You are having trouble getting the medical help you need -- Insurance companies sometimes delay or deny your efforts to seek medical treatments if they are expensive. (One example might be approving surgeries). A lawyer can help fight for your rights and prompt the insurance company to act more quickly instead of making you wait for the medical care you need.
  • Your ability to work has been affected -- If your injury has impacted your ability to continue working your old job, it is particularly important that you get the maximum benefits allowed or the most assistance possible with vocational retraining.
  • You have a preexisting condition -- As discussed above, if you have a preexisting condition related to your workplace injury, this can complicate your recovery efforts.

If certain legal scenarios apply to your case

If you are receiving other government benefits such as SSDI

Workers’ comp benefits could reduce the amount of SSDI benefits you can receive. A lawyer can help ensure you get the maximum combined benefits from workers’ comp and SSDI based on the structure of your workers’ comp benefits.

If you have grounds for a separate lawsuit

Workers’ comp programs generally prevent you from suing your employer except in certain situations -- for instance, if a third party’s actions or your employer’s intentional conduct caused your injuries. In such situations, you are allowed to sue outside of workers’ comp regimes.

A workers’ comp lawyer can help you understand if you can sue under the applicable law.

If your employer has retaliated against you for filing your claim

If your employer has retaliated against you for filing your workers’ comp claim, you may be able to file a separate employment law claim. Your employer may not fire you, demote you, or decrease your hours or pay in response to a workers’ comp claim. You should consider hiring a lawyer if you think you have been subject to retaliation by your employer.

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Two important practical considerations

First: it is important to understand how much a workers’ compensation lawyer costs. Check out our article here, but as an overview, you should know that they generally charge contingency fees. That means your workers’ comp lawyer only gets paid if you win.

Second: workers’ comp settlements must be approved by a judge, but this only provides limited protection for claimants. Usually, a settlement must be grossly unfair for the judge to reject it, which is a far cry from ensuring that you are getting the benefits you deserve. The only way to ensure that is to hire a workers’ comp lawyer who will fight for the maximum benefits you are entitled to.

The final word on whether to hire a workers’ comp lawyer

If your injuries are minor and your case is straightforward, you probably don’t need to hire an attorney. And many people can handle their own workers’ comp claims in such situations.

But there are certain situations in which hiring a workers’ comp attorney can be crucial in getting you the benefits you deserve. Generally, you should consider hiring a workers’ comp lawyer if:

  • Your employer or their insurance company disputes or rejects your claim
  • You have certain issues related to your medical circumstances, such as trouble returning to work or difficulty getting the medical help you need
  • Certain legal conditions exist, such as you already receive SSDI benefits or your employer has retaliated against you for filing your claim

In these circumstances, a workers’ comp lawyer can help you navigate the system and make sure you get the benefits you deserve. And because workers' compensation attorneys work on a contingency basis, you don't pay your lawyer unless your claim is successful.