The workers’ compensation system aims to swiftly and equitably compensate employees who sustain injuries on the job. While many workplace accidents result in minor injuries without significant long-term effects, not every case necessitates the involvement of a workers’ compensation attorney.
However, the process can become intricate for incidents involving severe injuries or complex circumstances. In such cases, seeking the assistance of a skilled attorney may be advisable.
In this guide, Insurance Business examines the situations in which employing a workers’ compensation lawyer is warranted and when it may not be necessary. We’ll delve into the pivotal role these legal experts play in assisting injured workers in securing appropriate benefits, as well as shed light on the compensation they typically receive for their services.
What are the pros and cons of hiring a workers’ compensation lawyer?
When considering whether to hire a workers’ compensation lawyer, it’s essential to weigh the advantages and disadvantages based on your specific circumstances. Hiring a specialized attorney to handle your case has its benefits and drawbacks, which we’ll outline below.
1.1. Advantages of hiring a workers’ compensation lawyer:
- Ensured accuracy in paperwork: A workers’ compensation lawyer ensures that all required paperwork is completed accurately and submitted on time. This is crucial because errors or missed deadlines often lead to claim denials.
- Increased likelihood of a higher settlement: Although success isn’t guaranteed, having an experienced attorney improves your chances of receiving the full benefits you’re entitled to and potentially for a longer duration. According to a 2018 study by insurtech Clara Analytics, injured employees who engage a workers’ compensation lawyer typically receive five times more compensation than those who don’t.
- Representation parity: Employers and insurers typically have legal representation for workers’ compensation claims. By hiring your own attorney, you level the playing field and gain someone to advocate on your behalf. In case of claim denial, your attorney can also handle the appeals process.
- Access to additional resources: Engaging a lawyer grants you access to resources that might otherwise be unavailable to you. For instance, if your claim necessitates proving the full extent of your injury, your attorney may leverage their network of medical experts.
- Peace of mind: Dealing with a work-related injury is stressful enough without the added burden of navigating the legal system alone. With a workers’ compensation lawyer, you can have confidence that someone is safeguarding your interests and diligently pursuing the benefits you deserve. This allows you to concentrate on your recovery without worrying about legal complexities.
1.2. Hiring a workers’ compensation lawyer comes with its own set of drawbacks
- Increased complexity and time consumption: Engaging a lawyer can elongate the process of resolving your claim. Legal proceedings inherently take time, and even though your attorney may handle most of the paperwork, your active involvement and cooperation are still necessary for effectiveness.
- No guaranteed success: While a specialized lawyer can enhance the likelihood of your claim being accepted and securing a higher settlement, success is not assured. Each workers’ comp case is distinct, and its outcome heavily relies on the strength of the evidence presented.
- Strained relationship with your employer: Involving an attorney may strain your relationship with your employer. While retaliation is prohibited by law, the dynamics between you and your employer could be negatively impacted, potentially leading to irreparable damage to your rapport, even if you retain your job.
In summary, the decision to hire a workers’ compensation lawyer involves weighing both benefits and drawbacks, as outlined in the table below
Do you really need to enlist a workers’ compensation attorney?
It all boils down to several key factors:
- The severity of your injury.
- The complexity of your claim’s circumstances.
- The actions taken by your employer or their insurer.
2.1. When you don’t need a workers’ compensation lawyer
You typically won’t require the assistance of a workers’ compensation attorney in the following instances:
- If your injury is minor, like a small cut, bruise, scrape, or twisted ankle.
- If your injury only results in a few days of missed work.
- If your employer acknowledges that your injury occurred while on the job.
- If you don’t have a pre-existing condition that impacts the same injured body part.
However, even if your situation aligns with these criteria, it’s still advisable to consult with a workers’ compensation attorney. Many attorneys offer free consultations, during which they can walk you through the insurance claims process and offer an honest assessment of whether legal representation is necessary for your case.
2.2. When you need to hire a workers’ compensation lawyer
When considering the need to enlist the services of a workers’ compensation lawyer, several scenarios warrant attention:
- If your employer rejects or disputes your claim.
- If your employer delays or avoids timely payment of your benefits.
- If the settlement offer doesn’t adequately cover your medical expenses or lost wages.
- If your injury leads to partial or total permanent disability, restricting your ability to work or preventing a return to your previous job or any type of work.
- If there’s insufficient supporting medical evidence for your injury.
- If you face retaliation from your employer for filing a claim.
- If the injury stems from serious misconduct by your employer.
- If the injury resulted from negligence by a third party.
- If you intend to apply for or are already receiving Social Security Disability Insurance (SSDI) benefits, which may be affected by a poorly structured settlement.
- If you’ve been offered a settlement but are uncertain whether to accept it.
While the average workers’ compensation settlement in the US falls within the range of $2,000 to $40,000, as per recent data from the Bureau of Labor Statistics (BLS), it’s important to note that many workplace accidents result in minor injuries without significant long-term consequences.
However, there are instances where settlements reach substantial sums, even reaching seven or eight figures. If you’re curious about the factors contributing to these outcomes, you can explore our rankings of the highest workers’ compensation settlements in the US.
What does a workers’ compensation lawyer do?
A workers’ compensation lawyer ensures injured employees receive their entitled benefits and support for as long as necessary. Below are key duties and responsibilities of such attorneys.
How much do workers’ compensation lawyers get paid?
Workers’ compensation lawyers’ payment structures vary by state, with each state setting its own regulations. Typically, these attorneys receive a percentage of the final settlement amount, often ranging between 10% and 20%, depending on factors such as the complexity of the case.
Before receiving payment, the attorney’s fee must be approved by the judge, taking into account various aspects such as the time and effort expended, as well as the benefits awarded.
It’s important to note that workers’ compensation lawyers usually work on a contingency fee basis. This means that if they don’t win the case, they don’t receive payment. This arrangement enables injured workers with limited financial means to access legal representation. Additionally, it motivates attorneys to strive for the highest possible settlements on behalf of their clients.
What benefits are covered by workers’ compensation?
Workers’ compensation insurance typically covers a range of benefits, which can differ based on the insurance provider. Generally, these policies provide coverage for medical expenses and a portion of lost wages for employees who experience work-related injuries or illnesses. The specific benefits that employees are eligible for under a workers’ compensation policy are outlined in the table below.
In the United States, nearly all states mandate businesses to obtain workers’ compensation insurance. This requirement aims to safeguard both employers and employees financially in the event of severe workplace accidents. To gain a deeper understanding of how workers’ compensation insurance operates, explore our detailed guide on the subject.
How much do workers’ compensation claims cost?
The compensation you’ll receive hinges on various factors:
- The nature of your injury or illness
- The severity of the injury or illness
- The required treatment
- Your salary
You have the option of a lump sum or structured periodic payments. However, opting for a lump sum means forfeiting the ability to reopen your claim in the future. Consequently, if your condition worsens over time, you’ll be responsible for your medical expenses. If uncertain about the long-term impact of your injury, structured payments may be preferable.
Employers, insurers, and attorneys often refer to a workers’ compensation settlement chart to determine appropriate benefits for injured employees. For further insights into this tool, refer to our detailed guide accessible through the provided link.
How do workers’ compensation settlements work?
Workers’ compensation settlements function in the following manner: When an injury occurs at work, the employer is obligated to report it to their insurance provider. Subsequently, the insurer covers the employee’s medical bills and compensates for lost wages.
Should an employee find the payouts insufficient, negotiations for a workers’ compensation settlement commence. This is where workers’ compensation attorneys step in to ensure their clients receive appropriate benefits.
Every state has its regulations regarding the types of compensation available to injured workers. Typically, the settlement should encompass:
- Past and future medical expenses resulting from the work-related injury.
- Loss of income both past and future due to the injury.
Once both parties agree on an amount, the claim is considered settled. The insurer then disburses the payment either as a lump sum or through structured installments. Following the completion of payments, the claim cannot be reopened.
Securing rightful benefits necessitates a comprehensive grasp of the workers’ compensation industry. Stay informed by regularly visiting our Workers Comp News page for up-to-date news and industry insights.