The workers’ comp system is set up to make sure injured workers get fair and prompt compensation. Since most workplace accidents only cause minor injuries without life-changing effects, not everyone has to hire a workers’ comp lawyer.
However, workers’ comp claims can be complex. In cases of serious injuries from complicated incidents, hiring an attorney might be the best option.
This guide from Insurance Business looks into situations where you might need a workers’ comp lawyer and where you might not. We’ll also explain how these legal experts help injured workers get the right benefits and what they earn in the process.
Keep reading to discover the pros and cons of Hiring a workers’ comp lawyer.
What are the pros and cons of hiring a workers’ compensation lawyer?
Deciding whether to hire a workers’ compensation lawyer depends on the specific details of your claim. Bringing in a specialized attorney to manage your case has both advantages and disadvantages. Let’s explore each of them.
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Advantages of hiring a workers’ compensation lawyer
1) Proper filing of paperwork: A workers’ compensation lawyer ensures that all the necessary paperwork is filled out correctly and submitted on time. Although it might seem minor, clerical errors and missed deadlines are common reasons why workers’ comp claims get denied.
2) Better chance of a higher settlement: While success is not guaranteed, having an experienced attorney increases your likelihood of receiving all entitled benefits for an extended period. According to a 2018 study by insurtech Clara Analytics, injured employees who hire a workers’ compensation lawyer receive five times more payout than those who don’t.
3) Equal representation: Employers and insurers have their own lawyers for workers’ comp claims. By hiring your own attorney, you have someone to negotiate on your behalf. In case your claim is denied, your workers’ compensation lawyer can also appeal your case.
4) Access to additional resources: Enlisting a lawyer provides you access to resources you might not have otherwise. For example, if your claim requires proving the full extent of your injury, your attorney may help connect you with their network of medical experts.
5) Peace of mind: If you get injured on the job, the last thing you need is to worry about navigating the system. With a workers’ compensation lawyer, you can be confident that someone is safeguarding your best interests and working diligently to secure the benefits you deserve. This allows you to concentrate on your recovery.
| Advantages | Explanation |
|---|---|
| Proper filing of paperwork | Ensures correct and timely completion of necessary paperwork, reducing the risk of denial due to clerical errors or missed deadlines. |
| Better chance of a higher settlement | Increases the likelihood of receiving entitled benefits for a longer period, with a potential fivefold increase in payouts according to a 2018 study. |
| Equal representation | Provides a representative to negotiate on your behalf and appeal your case if needed, balancing the legal playing field with employers and insurers. |
| Access to additional resources | Grants access to resources, such as a network of medical experts, which may be crucial in proving the full extent of your injury. |
| Peace of mind | Allows you to focus on recovery by ensuring someone is dedicated to protecting your interests throughout the workers’ compensation process. |
Disadvantages of hiring a workers’ compensation lawyer
1) Process becomes complex and time-consuming: If you’re seeking a quick resolution to your claim, hiring an attorney might not be the best choice. Legal proceedings inherently take time, and even with a lawyer doing most of the work, your commitment and cooperation are still needed for effectiveness.
2) Success is not guaranteed: While having a specialized lawyer can enhance the chances of your claim being accepted and securing a higher settlement, it’s not always guaranteed. Each workers’ comp claim is unique, and success largely depends on the validity of the evidence presented.
3) Strained relationship with your employer: Involving an attorney may negatively impact your relationship with your employer. While legal protections prevent retaliation, the positive rapport you once had with your employer may be irreparably damaged, even if you manage to keep your job.
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| Disadvantages | Explanation |
|---|---|
| Process becomes complex and time-consuming | Legal proceedings take time, and even with an attorney, resolution may not be quick. Your commitment and cooperation are required for effective proceedings. |
| Success is not guaranteed | While a lawyer can improve your chances, the outcome depends on the uniqueness of each claim and the strength of the evidence presented. |
| Strained relationship with your employer | Involvement of an attorney might negatively impact your relationship with your employer, potentially damaging any positive rapport you had, even if job retention is achieved. |
Is it necessary to hire a workers’ compensation lawyer?
Deciding whether you require the help of a workers’ compensation lawyer depends on several factors, including:
Severity of your injury: How serious and impactful your injury is.
Complexity of the circumstances: The level of complexity in the details surrounding your claims.
Actions taken by your employer or their insurer: The steps your employer or their insurance company has taken in response to your claim.
When you don’t need a workers’ compensation lawyer
Generally, there’s usually no need to hire a workers’ compensation attorney in the following situations:
1) You suffered a minor injury, like a small cut, bruise, scrapes, or a twisted ankle.
2) Your injury resulted in only a few days of missed work.
3) Your employer confirms that your injury is related to your work.
4) You do not have a pre-existing condition that impacts the same part of your body that got injured.
However, even if your case falls into these situations, you can still choose to talk to a workers’ compensation lawyer. Many offer free consultations. An attorney can guide you through the entire insurance claims process and provide an honest assessment of whether your case requires their services or not.
When you need to hire a workers’ compensation lawyer
Complications may arise in your workers’ compensation claim that might necessitate the help of a workers’ compensation lawyer. This includes situations when:
1) An employer rejects or disputes your claim.
2) An employer delays the timely payout of your benefits.
3) The settlement offer doesn’t cover the entire medical bill or lost income.
4) The injury results in partial or total permanent disability, limiting the type of work you can do or preventing you from returning to your old job.
5) There’s a lack of strong supporting medical evidence for your injury.
6) The employer retaliates against you for filing a claim.
7) The injury was caused by your employer’s serious misconduct.
8) The injury was caused by third-party negligence.
9) You plan to apply for or are receiving Social Security Disability Insurance (SSDI) benefits, which can be reduced by an improperly structured settlement.
10) You’ve been offered a settlement but are unsure whether to accept it.
Workers’ compensation settlements in the US typically range from $2,000 to $40,000, with recent data from the Bureau of Labor Statistics (BLS) suggesting an average amount of around $20,000. While this might seem relatively modest, it’s crucial to note that many workplace accidents result in minor injuries without significant life-altering effects.
However, there are instances where settlements have reached seven or even eight figures. If you’re interested in understanding the factors behind these higher resolutions, you can explore our rankings of the highest workers’ compensation settlements in the US.
What does a workers’ compensation lawyer do?
A workers’ compensation attorney assists in securing all entitled benefits for an injured employee and ensures they receive these benefits for the necessary duration. The table below outlines key duties and responsibilities of a workers’ compensation lawyer.
| Main Duties and Responsibilities of a Workers’ Compensation Attorney |
|---|
| Ensure Injured Employee Receives Entitled Benefits |
| Advocate for Prolonged Benefit Duration |
| Assess and Investigate the Claim |
| Collect and Review Medical Evidence |
| Communicate and Negotiate with Employers and Insurers |
| Prepare and File Necessary Legal Documents |
| Represent the Injured Employee in Legal Proceedings |
| Provide Legal Advice and Guidance Throughout the Process |
How much do workers’ compensation lawyers get paid?
Each state enforces different rules regarding attorney’s fees in workers’ compensation cases, often capping the maximum amount between 10% and 20% of the total settlement. This cap depends on the complexity of the case.
Generally, the judge must approve the fee before the workers’ compensation lawyer receives payment, considering factors like the time invested, efforts made, and benefits awarded, among others.
It’s important to note that workers’ compensation lawyers typically work on a “contingency fee” basis. This means that if they lose the case, they do not receive any payment. This arrangement enables injured workers with limited financial resources to access quality legal representation. Simultaneously, it provides a strong incentive for attorneys to secure the highest possible settlements for their clients.
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What benefits are covered by workers’ compensation?
The benefits offered by workers’ compensation insurance can differ based on the insurance provider. Typically, these policies provide coverage for medical expenses and offer a percentage of lost income for employees facing job-related injuries or illnesses. The table below outlines the specific benefits that employees are eligible for under a workers’ compensation policy.
| Type of Benefit | Description |
|---|---|
| Medical Care | Covers the expenses of necessary medical treatment, including hospital stays, doctor visits, surgeries, and prescription medications. |
| Lost Income | Provides a percentage of employees’ salaries if they are unable to work due to job-related injuries or illnesses. |
| Ongoing Care | Covers treatment expenses for extended medical care, such as occupational, physical, and speech therapy, as well as other rehabilitation costs. |
| Disability Benefit | Offers full or partial disability benefits if a work-related accident results in the employee becoming disabled. |
| Death Benefit | Includes coverage for funeral and burial expenses, along with financial support for the beneficiaries if an employee dies due to a job-related incident. |
Almost all states in the US mandate businesses to obtain workers’ compensation insurance to provide financial protection for both themselves and their employees in case of severe accidents at the workplace. To gain a deeper understanding of how this type of coverage operates, you can explore our comprehensive guide to workers’ compensation insurance.
How much do workers’ compensation claims cost?
The compensation you receive for your claim depends on various factors, including:
- The type of illness or injury.
- The extent or seriousness of the illness or injury you experienced.
- The type of treatment you need.
- Your salary amount.
You have the option to receive either a lump sum or structured weekly or bi-weekly payouts for your workers’ compensation. However, choosing a one-time payment means you’re giving up the right to reopen your claims in the future. This implies that if your illness or injury worsens later on, you’ll be responsible for covering the medical expenses. If you’re uncertain about how your injury may impact your future, it’s advisable to opt for structured payments.
Employers, insurance providers, and even lawyers often use a workers’ compensation settlement chart to determine the entitled benefits for an injured employee. You can learn more about this industry tool by following the link to our comprehensive guide.
How do workers’ compensation settlements work?
Once a work-related injury occurs, employers are obligated to report the incident to their insurance provider. The insurer will then cover the employee’s medical expenses and salaries for the time lost at work.
If a worker finds the payouts inadequate and unacceptable, this is when negotiations for a workers’ compensation settlement commence. Workers’ compensation lawyers can assist clients in securing the benefits they deserve.
Each state has its own regulations regarding the types of compensation entitled to injured workers. In general, it’s crucial to ensure that the settlement amount is adequate to cover:
1) Previous and future medical expenses: These include costs incurred due to the work-related injury.
2) Past and future loss of income: This accounts for the income lost as a result of the injury, both in the past and anticipated in the future.
Once both the worker and the insurer reach an agreement on the amount, the workers’ compensation claim is considered settled. The insurer will then make payments to the employee, either as a lump sum or through structured payments. Once all the funds have been disbursed, the worker loses the ability to reopen their claims in the future.