Table of Contents
- Why Workers’ Compensation Claims Are Denied
- Working With A Lawyer
- What A Workers’ Compensation Lawyer Can Do
- Advantages Of Hiring A Workers Compensation Lawyer
- Meeting All Legal Requirements
- Seeking The Right And Enough Benefits
- Dealing With The Insurance Company
- Handling The Legal Proceedings
- Filing An Appeal
A work-related injury can lead to high medical costs, lengthy physical therapy sessions, expensive rehabilitation, and lost time at work. Workplace accidents can be fatal or very serious. According to the Bureau of Labor Statistics, in 2020 alone, work-related injuries and occupational illnesses affected 2.7 million people.
Medical bills and lost wages incurred by injured employees are covered by workers' compensation benefits. The families of employees who pass away on the job are also compensated by these benefits.
A highly competent and qualified workers’ compensation lawyer can help you receive the compensation and benefits you deserve. If you wish to learn more about the pros of hiring a workers’ compensation lawyer, continue reading this article below.
Why Workers’ Compensation Claims Are Denied
When you are injured at work, workers' compensation benefits are meant to pay for your medical expenses and lost wages while you are unable to work. Additionally, it offers further compensation if your work aggravates an existing medical condition you already have.
Unfortunately, many workers’ compensation insurance firms deny claims of injured employees and prevent them from receiving the treatment and compensation they deserve. Many reasons may contribute to the denial or underpayment of your claims.
Some of the most common reasons why workers' compensation claims are denied or under-compensated are listed below:
- There is inaccurate information in the incident report you submitted to your employer or insurance provider;
- You failed to submit the workers’ compensation claim form within the specified deadline (usually 120 days after the incident in most states);
- Your employer disputes whether you were actually injured;
- Your employer or insurance provider downplays your injury by arguing that your condition or illness is not as severe as you reported;
- Your employer argues that your injury or condition is not work-related or occupational;
- Your employer accuses you of alcohol intake during work;
- Your employer accuses you of violating written company policy which resulted in your injury;
- Your employer accuses you of using illegal drugs while working; and
- Your company’s insurance provider says that your injury or illness is not covered by your employer’s insurance policy.
As an employee, you have the right to file an appeal if your workers’ comp claim is rejected for any of these or any other grounds. The appeals procedure can be difficult and time-consuming. You don't want to deal with the complicated appeals procedure while you are struggling with an injury and attempting to recover.
In order to protect your rights and manage the appeals process on your behalf, it is crucial to have a knowledgeable and experienced workers' compensation lawyer.
Working With A Lawyer
For an injured employee, there are many advantages that come with workers’ compensation insurance. However, sometimes it takes a lot of time and effort to fight for a workers' compensation claim. A lawyer can help you file an appeal if your claims are rejected for whatever reason possible. Additionally, a workers’ compensation lawyer can help ensure that you are receiving the right benefits and the exact amount of compensation you are entitled to.
What A Workers’ Compensation Lawyer Can Do
If you decide to work with a workers’ comp lawyer, they can negotiate on your behalf with the insurance provider. Your attorney will also be able to assist you in suing the insurance company if a settlement agreement cannot be reached. Your workers' compensation claims can be appealed if they are rejected.
Your lawyer will keep you informed at each stage of the claims procedure. The process of filing paperwork, obtaining proof, and negotiating can be quite time-consuming. Particularly, if you are healing from significant injuries, this can be a source of tremendous stress. Working with an attorney can remove some of that stress and help improve the outcome of your case.
Advantages Of Hiring A Workers Compensation Lawyer
Choosing to work with an attorney rather than representing yourself in a workers' compensation claim can be the difference between winning your claim and being denied the benefits and compensation to which you may be entitled.
Here are the top five benefits of hiring a workers' compensation lawyer.
Meeting All Legal Requirements
To properly submit a claim for the benefits under workers' compensation, you must comply with all legal standards set forth by your state. Common legal requirements include:
- Proof or evidence that your injury is work-related;
- Submitting all documents and requirements to your employer or insurance provider within a specific deadline; and
- Seeking medical care from a licensed doctor (or your company’s authorized healthcare provider)
However, as state laws vary, there may be additional requirements you must meet in order to be eligible for workers' compensation benefits for your work-related injuries. Hiring an experienced attorney can assist you in meeting all of your legal requirements, and help you collect the benefits you deserve.
Seeking The Right And Enough Benefits
You cannot expect to submit a claim for workers' compensation and then immediately begin receiving payments in the mail. You must determine the benefits for which you are qualified.
Most states allow eligible employees to obtain medical benefits right away, and if they miss work for a predetermined number of days, they can receive wage replacement benefits. Your workers' compensation attorney can assist you in identifying the benefits for which you are eligible and ensure that you don't unintentionally forgo any benefits and compensation.
In addition to knowing which benefits you can collect, you also need to know how much you are entitled to receive. This is where a workers' comp attorney can best assist you. An attorney can help make sure that you are collecting the maximum benefits available under your state’s laws if your work-related injury caused you to miss a significant amount of time at work.
Dealing With The Insurance Company
It is not guaranteed that you will receive compensation just because you have submitted a claim. Since most businesses have workers' compensation insurance, requesting benefits usually involves contacting the company's insurer.
While this can go smoothly, it often doesn’t. It is in your best interest to hire a workers' compensation attorney to negotiate with the insurance company on your behalf as the claims procedure can provide a variety of challenges for injured workers.
Handling The Legal Proceedings
Workers' compensation issues aren't always resolved in an office conference room. Some proceed to court proceedings before a judge. For a self-represented and injured employee, this can be expensive, time-consuming, and extremely difficult to manage. If you don't understand workers' compensation laws, you may have difficulty presenting your claim argument effectively.
Additionally, if you’re still in the process of recovering from your injury, interviewing witnesses, compiling medical records, and filing petitions or motions would be excessively demanding. It might just worsen your injury or condition.
A skilled and experienced workers' compensation attorney can assist you in navigating the legal system and obtaining the settlement you deserve.
Filing An Appeal
Some employees believe it will be simple to obtain workers' compensation benefits. After all, they had an excellent work history, the injury was witnessed by their colleagues, and they even underwent treatment from their authorized healthcare provider.
Nevertheless, many of these workers will experience their workers' compensation claims being rejected for a variety of reasons. A workers' compensation attorney can assist with filing an appeal at that point.
A skilled lawyer can present a much stronger argument for your compensation than you can. This is due to the fact that they are aware of the specific proof that must be obtained to force the insurance company to offer a favorable settlement. Additionally, we do not recommend going up against the experienced insurance company's defense lawyers alone.
Are you interested in learning more about workers’ compensation? Check out this article by Disability Help on the conditions that entitle injured employees to receive workers’ comp benefits.