Do I Need a Workers’ Comp Lawyer?
Not everyone who applies for workers’ comp needs a lawyer 100% of the time. So the question is, when is it a good idea to have an attorney and when can you get away without one? Simply speaking, the more serious your injuries are and the more time you are likely to miss from work, the more important it is to have a workers’ comp lawyer manage your claim.
Workers’ comp is an insurance policy that your employer is (by law) required to purchase. It is the insurance company that signs off on the claim, not your employer. You and your employer submit information to the insurance company and then the insurance company pores through your medical records, investigates what happened, and does everything in their power to find a legal reason to deny the claim.
At Dewberry Law, we have helped a number of our clients in disputes with overzealous insurance companies. Insurance companies have a right to investigate, but they cannot deny a claim in bad faith and they must pay out when the evidence is here. Our job is to ensure that the evidence is there. If you’ve been denied, it may be a good idea to seek out a skilled California workers’ comp attorney. We can help.
When Can I Represent Myself?
There are a number of reasons why an attorney may not be necessary for your claim. When your injuries are relatively minor and you can be patched up quickly, and only missed a few days of work, there’s no sense in hiring an attorney to manage that claim. However, if your employer denies that the injury occurred on the job, then you might want to seek out an attorney.
In some cases, employers have been known to fire or reprimand employees after injuries on the job. This absolves them of responsibility and keeps their premiums low. In that case, no matter how harmless your injuries are, you may want to seek out an attorney.
The majority of workers’ compensation attorneys offer free consultations. Even in a situation where your employer admits the injury happened on the job and the injury is minor, there’s no good reason not to talk to a workers’ comp attorney just to get a feel for how the process should go.
When Will I Need to Hire a Lawyer?
There are a number of situations in which you’ll want to hire an attorney to manage your claim. These include:
When your injuries are severe.
If your injuries are severe enough to require surgery, a period of rehabilitation, or require that you miss work for longer than a week, you want to have an attorney manage that claim. It doesn’t matter if the employer admits that accident occurred on the job or not. The insurance company is going to scrutinize a more expensive claim more thoroughly than they would a claim that pays for minor medical expenses. This means not only putting the incident under investigation, but you too. They may ask for drug tests, medical histories, and want to know how you spend your free time. This is where an attorney can be a major advantage.
Your employer or their insurance company denies the claim.
Insurance companies will deny valid workers’ compensation claims all the time. They’re hoping you’ll throw your hands up in the air and say “oh well”. They’re also forcing the situation into the appeals process which costs them very little. You, on the other hand, may find yourself without a steady source of income. In other words, they’re applying pressure. A workers’ comp attorney will ensure you get the best possible settlement and they don’t require that you pay them money you don’t have up front.
The insurance company offers a lowball offer.
If the insurance company’s offer does not cover all of your medical expenses and compensate you from missed time from work, it’s time to get an attorney. The insurance company is required to respond within 14 days of the date on which you filed. If they don’t they can be fined 10% of your claim. A lowball offer is a response. It may not be the one you’re looking for, but meets the criteria. If they’re not offering to compensate you for all of your medical expenses and missed time from work, it’s time to get an attorney.
In addition, if your employer retaliates against you or attempts to blame the accident on you, you’re going to need an attorney. Workers’ comp is a no-fault claim. It doesn’t matter if your employer was negligent or not. Some employers think that by pinning the accident on you, they can keep their insurance companies happy. It doesn’t work that way. A lawyer can protect you.
How Can a Workers’ Compensation Lawyer Help?
You will need to develop an array of evidence in order to file a workers’ comp claim, submit an appeal, or prove the necessity of medical treatment. This evidence will include medical information, vocational documentation, and more. By providing insufficient evidence, your claim may be denied. You will have a second chance to submit evidence during an appeal, but your evidence must be carefully constructed and stated with legal arguments.
An attorney can help you gather medical records that are complete, but that do not provide more information than is necessary. For example, you only need to submit medical evidence from the date of your injury at work forward. However, your employer may request medical records from the past in order to prove that you had a preexisting condition that is causing your conditions. The medical records you provide in your claim are important.
Obtaining Medical Treatment
You may also need help from a good workers’ compensation lawyer to set up medical treatment from various physicians. Attorneys know which physicians frequently help workers’ comp clients, so it can be helpful to associate with an attorney who can guide you through the doctor selection process.
You may opt to submit to an independent medical examination (IME) from a third party doctor who does not regularly treat you. This can be helpful because an IME is heavily weighted by the workers’ compensation commission and by other parties. You should gather all medical information and submit it to the doctor in advance. Then, the doctor will perform an IME and make an opinion about your condition and necessary medical treatment. Your employer may also ask you for an IME with one of their doctors.
Providing Medical and Vocational Experts
If your case is particularly complex, then your attorney may opt to provide the opinions of experts. You may utilize a medical expert or a vocational expert, both of who can provide insight about your conditions and ability to work. An attorney can help you provide necessary information to these experts and interview them at a hearing. Your employer will also likely want to interview your experts; however, they may provide their own experts. Medical and vocational experts work closely with attorneys to develop evidence in a case.
An Attorney Can Prepare You for Hearings
Although your workers’ compensation case is not an actual lawsuit, you will have to attend hearings. Hearings take place in front of one or more hearing officers. Your employer’s attorney will also be present at hearings. You will have an opportunity to testify at hearings and present evidence. All of these activities can be best prepared by an attorney who is familiar with legal procedure.
If you are to testify at a hearing, your attorney can help you get prepared. This may involve reviewing incident reports, medical records, and other documents related to your claim. You should also review questions that may be asked during the hearing.
Talk to a Pasadena CA Workers’ Comp Attorney
If you’ve been injured at work, an experienced Pasadena CA workers’ comp attorney Dewberry Law can help. Contact us today.