Injured workers may be able to receive compensation for medical expenses and reimbursement for lost wages through a workers compensation claim. You receive these benefits if you suffer an injury or illness at work or while performing job-related duties. You do not have to prove fault or establish liability to receive workers comp benefits. Even if you are to blame for your accident, if you are injured at work, you have a right to file a workers compensation claim. While this may seem easy and straightforward, insurance companies and employers are often reluctant to pay out these benefits as long as needed. They may push workers to return to work too soon or look for any evidence to reduce the length of time they would be obligated to pay these benefits. For these reasons, it may be necessary to hire an experienced workers compensation lawyer to assist you throughout the process.
What Does a Workers Compensation Lawyer Do?
A worker’s compensation lawyer provides important legal assistance when you seek compensation for a work injury. After you get hurt on the job, if you file a workers comp claim you generally cannot sue your employer (though there are some exceptions). Instead, your employer’s workers compensation insurer should offer you compensation for the medical care you received for your injuries and reimbursement of lost wages. You are generally eligible for this compensation for any injuries resulting from work duties, even if your employer was not negligent. Ideally, you and the workers compensation insurer will be able to negotiate a settlement. If you cannot reach a settlement, your claim can proceed to a hearing before a workers compensation administrative law judge. A lawyer assists you with both the settlement negotiation process, as well as with a hearing if one becomes necessary.
Can I Sue My Employer if I Am Hurt at Work?
The tradeoff for employers providing workers compensation insurance to pay for employee’s injuries is that generally employees are barred from suing their employer. There are two primary exceptions:
- You Can Sue Your Employer if You Are Not Covered by Workers Compensation
If you fall into one of the exceptions to workers compensation in your state, the shield protecting employers from being sued does not apply and you can file a civil action to seek financial restitution for your harms and losses. Exemptions include farm workers, government workers, and domestic workers. Since you would not be eligible for workers compensation in your state, the only way you could be compensated for your workplace injury would be through a personal injury suit against the employer.
- You Can Also Sue Your Employer if You Are Wrongfully Denied Workers Compensation
You have a right to compensation for your work-related injuries, and if you have properly filed a claim for workers compensation, your employer has a duty to pay it – usually through their insurance carrier. If your valid claim is still denied, you can then sue your employer for the financial restitution you should have received through your workers compensation claim. Bear in mind that, in some states, you must first go through other steps before you can sue. You may, for example, need to appeal the denial of your claim.
Examples of Situations That May Call for a Lawyer’s Intervention:
- When Your Employer Is Threatening To Retaliate Against You if You File a Workers Compensation Claim. It is unlawful for an employer to fire you solely because you file a worker’s compensation claim or seek the benefits you are entitled to. Unfortunately, this does not stop some employers from threatening to terminate an injured workers employment or cut his or her hours. If your employer has terminated you, is trying to intimidate you, demote you, cut your hours, reduce your pay, or any other form of discrimination because you filed a worker’s compensation claim, you may need a lawyer to protect your legal rights.
- When Your Claim Is Denied. Insurance carriers deny workers compensation claims for many reasons. Some are valid. Others are not. You do not have to accept the insurance carrier’s decision. You may appeal the denial through the workers compensation claims process. The appeals process requires you to file formal paperwork, gather and develop evidence to meet your burden of proof, and present your case at hearing. A lawyer can help you with these steps.
- When a Third Party Caused Your Work Injury. Though workers compensation is often the exclusive remedy for work-related accidents, you may have a civil action if a third party’s negligence caused your work injury. For example, if another driver struck your car, you may have both a worker’s compensation claim and a personal injury lawsuit. Maximizing the value of both claims is complicated. A lawyer can help guide you through both legal systems.
- You Are Receiving Other Disability Benefits. If you are receiving Long Term Disability or Social Security Disability Insurance (SSDI) benefits, these payments may be reduced if you receive workers compensation wage loss benefits. A lawyer can help you minimize both the long-term disability-workers compensation offset and the SSDI offset, and also help you negotiate a workers compensation settlement that includes a Medicare Set-Aside Arrangement and is structured to put more money in your pocket.
- When You Have Suffered Catastrophic Injuries. Some accidents are so severe that they may prevent you from returning to work. If the insurance carrier is concerned that you will have partial or total disability, then they will fight harder to delay, deny, or dispute your case. A lawyer can help you get the compensation you deserve.
- When Your Employer’s Settlement Offer Does Not Cover All Your Lost Wages or Medical Bills. If you are not sure if a settlement offer is good enough, do not rely on the workers compensation judge to make sure that you are getting a fair deal. Although workers compensation settlements must have judicial approval, judges will usually sign off on any agreement if it is not grossly unfair. A lawyer can help you negotiate a higher settlement.
Pros of Hiring a Workers Compensation Lawyer
- Experienced help with navigating workers compensation paperwork can prevent errors that might otherwise invalidate your claim.
- You do not have to deal with insurance companies or issues that might arise with your employer in a contested claim.
- Meeting workers compensation deadlines can be challenging depending on your home state.
- Typically, injured workers who hire experienced workers compensation lawyers receive more money from their claim.
- If your claim is denied, workers compensation lawyers are best suited to handle the appeal.
- Your workers compensation lawyer has your best interest in mind. Your employer may not.
Cons of Hiring a Workers Compensation Lawyer
- If injuries are minor, no workdays are lost, and your company is cooperating, you may benefit handling the claim on your own and avoid the cost of hiring a worker’s compensation lawyer.
- If the injury is minor and you do not project it will cause long-term issues, hiring a lawyer could drag out the process.
- If money is an issue for you – especially if your injury involves lost wages – you might want to avoid the cost. Workers compensation lawyers generally do not charge their clients an hourly fee. Rather, they get paid a percentage of your claim when a settlement is reached (the percentage paid to your lawyer will need to be approved by your state’s workers compensation commission).
