What Does a Workers’ Compensation Attorney Do?

July 10, 2024 | Steve Fields
What Does a Workers’ Compensation Attorney Do?
What Does a Workers’ Compensation Attorney Do

Workers’ compensation is a system that will protect you if you have suffered an injury or developed a work-related illness and cannot work. Each state has its own workers’ compensation system and laws with the same general purpose. Workers’ compensation is a legal process involving insurance companies with a profit motive. While you have certain fundamental rights under the law, the insurance company and your employer may want your claim denied or minimized.

Hiring an experienced Minnetonka workers' compensation attorney can help protect your legal rights to the fullest extent possible. A workers' compensation attorney is a legal professional who can help employees navigate the complex world of workers' compensation claims.

Schedule a Free Consultation

If your workers’ compensation claim is successful, you will receive payments for the expenses associated with your workplace injury. Specifically, the insurance company or your employer (if they self-insure) will need to pay the following:

  • Reasonable and necessary medical expenses to treat your injury;
  • A portion of your lost income, up to the amount of the statutory cap in your state; and
  • Vocational training, if you need to learn to do a new job;
  • If a loved one died on the job, the family will get paid a death benefit, and funeral and burial expenses (up to a specific statutory limit)

There are no assurances of a successful outcome to your workers’ compensation claim. Even if your claim is initially successful, the insurance company can complicate things. Thus, hiring a workers’ compensation lawyer is helpful to protect your legal rights.

In the meantime, to understand why you should consider hiring a workers’ compensation attorney, you should know the role that they may play in helping with your claim. Here is what a workers’ compensation lawyer can do for you.

When you have suffered an injury on the job, there is an entire process that you must follow before you can receive your first workers’ compensation benefits check that can cover your medical expenses. The law imposes deadlines and other requirements, and failure to meet these deadlines can mean that you miss out on benefits entirely. For example, you must notify your employer of your injury within a specific time. Then, there is a deadline for submitting your workers’ compensation benefits application.

Workers’ Compensation Claim Form

You may think that applying for workers’ compensation claim benefits is as simple as filling out the claim form, submitting it, and then waiting for your check. Unfortunately, that is not the way that things work in practice. You need to understand the process and how it works to give you the best chance of success in your claim. Your benefits are never assured because you are dealing with an insurance company that does not want to pay, and an employer whose insurance rates may increase when more workers file claims.

An experienced workers’ compensation attorney will explain how the process works and what you may expect. Then, they can handle the details of your claim so you can focus on your health and recovery. The more that you can hand off to someone else, the better you can deal with the effects of your work-related injury or illness.

You should consider hiring a workers’ compensation attorney right after your injury. Their pay comes from a percentage of your benefits, so you will want to receive the most possible services in exchange for what you are paying.

Prepare the Claim on Your Behalf

An experienced attorney can also help prepare your claim. This process includes gathering all the necessary evidence, filling out the required paperwork, and filing your claim within the specified deadlines. They understand the intricate details of workers' compensation laws and can guide you through any legal hurdles that may arise.

Your medical issue may be complex, and the insurance company may be more likely to refuse your claim. For example, your workers’ compensation claim may include emotional distress and PTSD, which is something that may not show up on an “objective exam.” You need to know how to properly document your claim to give you the best chance of success.

When your claim is complicated, you will want an attorney’s help at the outset of your case. The last thing you want is for the insurance company to deny your claim at the outset, forcing you to fight for the benefits you deserve. It may be months before you can get a workers’ compensation hearing. Even if you win your appeal, you will have an extended period of uncertainty and difficulty, with trouble paying your bills.

Hiring an attorney reduces the chances of making an error that can endanger your claim. Insurance companies can be very technical, denying claims because you did not follow every possible formatting requirement. Even if you can eventually correct any mistakes, errors will delay receiving your benefits.

Represent You in an Appeal

One of the key ways that a lawyer can help is if the insurance company denies your initial claim. Insurance companies may refuse to pay you benefits for several reasons, including:

  • They do not think your condition requires medical treatment or will keep you from working.
  • They do not believe that your injury or illness was work-related.
  • Your condition was pre-existing and did not come from your job.
  • They accuse you of recklessness or intentional misconduct that resulted in your injury.

Some claim denials result from a misunderstanding between you and the insurance company. When you hire an attorney, they can speak directly to the insurance company to resolve the issue. Insurance companies may be willing to talk because litigation can drive up their costs. Lawyers can win many cases on appeal, and you may get an even better financial result than if they granted your claim in the first place.

You have legal options if the insurance company stands by its initial determination and refuses to cover your injury. State law allows you to file an appeal with an administrative body, where an objective professional with judicial powers will hear your claim. Your attorney will present evidence on your behalf, and they can question witnesses at a hearing.

The judge does not have the same financial self-interest as the insurance company. They will use a fresh, independent set of eyes to review your case and often side with claimants against insurance companies. Many workers’ compensation appeals will eventually result in some form of benefits getting paid. Your attorney can take your case into the state court system if you do not win your initial appeal before the workers’ compensation judge.

You stand a much better chance of winning an appeal when you have an attorney who can present your case. They have the knowledge and experience to handle appeals and can provide representation during hearings and court proceedings. They will work diligently to present a strong case on your behalf and fight for the benefits you deserve.

Advocate for You When You Are Receiving Benefits

Just because the insurance company has approved your initial claim does not mean it will act favorably to you throughout the process. Insurance companies may have had no choice but to approve your claim because you had strong evidence of a work-related injury, or the court ordered them to do so. However, they can continue throwing sand into the gears while paying you benefits.

You may face numerous issues when you are receiving benefits. One of the most common difficulties claimants face is when the insurance company tells them they have healed enough to return to work. Insurance companies may have asked (or directed) you to attend an independent medical examination with a doctor they are paying. The doctor may have said you have recovered enough to return to work, fully or on light duty, and you may lose some workers’ compensation benefits if you do not follow these orders. You may also have to appeal if the termination of your benefits is because of the wrongful notion that you are healthy enough to work.

Then, the insurance company may try to avoid paying for certain medical costs associated with caring for your injury. There are continuing doctor’s charges; insurance companies may also need to cover expensive prescriptions and medical equipment. If the costs rise enough, they may refuse to pay for your care, claiming that the fees are too high or that what you need is not necessary. Your lawyer may need to push insurance companies to pay for what they are required to by law.

You may also receive a disability rating that does not reflect your reality. Remember that the doctor who assigns your rating is at least partially reliant on the insurance company for their livelihood. You may need to challenge the rating they gave you because it will reduce the size of your settlement. A lawyer will advise you to get a second opinion, and they will fight to get you an accurate rating related to your condition.

Finally, your employer may try to retaliate against you when you have filed a workers’ compensation claim, even though state law forbids it. They may have terminated you for dubious reasons, and their justification does not hold water. An attorney can file a lawsuit on your behalf when your employer is taking action against you for exercising your rights under workers’ compensation law.

Negotiate a Settlement on Your Behalf

If you have suffered a permanent disability, you may deserve workers’ compensation benefits for an extended period. Some states fix the amount of benefits that you can receive, assigning a specific number of weeks of benefits based on the body part that suffered an injury and how disabled you are.

Settlement Negotiation

Insurance companies may not automatically offer you all the compensation you deserve, and you may need to negotiate a settlement that provides you with the total amount you should get paid under the law. Then, you may decide to negotiate a settlement that pays your medical treatment costs upfront. Settlement agreements are crucial because you are signing away your right to future compensation for your injuries. You need to know that you have maximized your compensation, and hiring an attorney can help do that. Insurance companies will take advantage of claimants representing themselves when negotiating a final settlement of the workers’ compensation claim.

As you can see, most of what an attorney does are things you may be unable to do alone. After all, you may have no idea how to present a case to a judge or assemble the evidence you need to back up your claim. Insurance companies have a built-in advantage over you because they have an apparatus they can quickly put to work to defeat your claim. Hiring a workers’ compensation attorney levels the playing field and removes the insurance company’s home-field advantage. They will negotiate on your behalf and fight for your best interests, whether securing the necessary medical treatment, reimbursement for lost income, or a fair settlement.

How Much Does a Workers’ Compensation Attorney Cost Me?

You do not pay any money upfront for a workers’ compensation attorney, which is helpful considering the reason for applying for benefits in the first place is that you cannot work. You only pay your attorney if your claim is successful and you receive benefits. Your attorney gets paid a percentage of your benefits, and you will not have to pay your attorney anything if you do not win your case. It may be in your interest to pay an attorney because a lawyer can help you achieve a better financial outcome in your case.

A workers' compensation attorney is your trusted partner throughout the entire workers' compensation process. From filing your claim to negotiating with insurance companies and advocating for your rights, they ensure you receive the compensation and support you deserve. So, if you need legal assistance after a work-related injury or illness, don't hesitate to reach out to a Minnetonka Personal Injury Lawyer who can guide you through the system's complexities and help you achieve a positive resolution.

Schedule a Free Consultation

Steve Fields Author Image

Steve Fields

Founder | CEO | Principal | Attorney

Steve Fields founded Fields Law in 2001 and quickly established a reputation with his Personal Injury clients for being a lawyer who truly cares. After more than 20 years, those clients continue to refer their friends and family whenever they have been injured or become disabled.

Author's Bio