Suppose you twist your elbow after slipping on the floor while performing normal duties at the office. The doctor will wrap the elbow with an elastic bandage, give you painkillers, and recommend a few days’ bed rest. Soon, you’ll return to the office and resume work. The workers’ comp will cover medical expenses but not any lost wage since you were out of work for a short period.
You are wondering whether to hire a workers’ compensation lawyer or handle the case alone. Unless you have sustained a minor injury at work, which doesn’t need extensive treatment, you can file a claim without an attorney. The case is also easier to handle if you don’t need a long off period. Different workers’ comp claims are handled differently and there are exceptions in certain occupations. That is where workers compensation advocates come in to tackle challenging cases. It makes sense to hire an advocate in one of the following scenarios.
A Preexisting Medical Condition
So you got injured on your knee which has a preexisting condition. Expect an uphill battle when presenting the claim to the insurance company. Many times, the insurance company blames the preexisting condition for the injury rather than the work activity. It becomes extremely difficult if the illness has been developing over time. So, proving that a single incidence caused the injury can be a tough procedure.
Rejected Claim
There are many reasons the insurer rejects workers comp claims. The most obvious is when the injury is not job-related or if the claim has not been presented within the right timeframe. To appeal the denial, you need an experienced lawyer to navigate the workers’ comp system. The process of a court appeal differs from one state to the next and required formal paperwork and other legal tools. If you’ll have a hearing, the insurance may refuse to settle or will make a lowball settlement. Since this is a mini-trial, having an advocate to represent you is highly recommended.
Government Benefits are Involved
If you are eligible for the Social Security Disability Insurance, your benefits may be turned down if workers’ comp benefits are to be rendered. To avoid a reduction in SSDI, it is advisable to involve workers compensation advocates. Also, with Medicare, you might be forced to surrender a percentage of the workers’ compensation for future treatment. You need an attorney to get the most of this.
A Disputed Permanent Disability Rating
Workers with permanent disabilities often receive the most settlement, which is based on their permanent disability rating. Sometimes, the insurer disagrees with the rating given by your doctor. This means you have to undergo an independent medical exam with a doctor chosen by the insurance company. Then this doctor is likely to assign a lower disability rating which is then used to calculate your reimbursement. That is why you need a lawyer to convince the jury that you deserve a higher rating and consequently, a better workers’ compensation.
Ideally, workers should be compensated fairly when they sustain injuries at work. Nonetheless, the system seems to be in favor of the insurance companies and employers. Don’t forget that the insurers use highly experienced attorneys. Thus, only seasoned workers compensation advocates can help in tilting the case in your favor. Whenever you’re not sure how to deal with the workers’ comp claim or are unable to get the best treatment, you can always count on a good lawyer.
More info can be found at https://arawc.org/innovation-series/part-2-employee-advocacy/.
