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Published on September 19, 2023

Workers’ Compensation Benefits – The Role of Attorneys

Have you been injured while working and are now facing challenges getting fair compensation? Understanding your rights and navigating the workers’ compensation system can be confusing and frustrating. So, when should you contact an attorney? What exactly will they do for your claim? And, how much will legal representation cost? 

This article answers common questions about the role attorneys play in obtaining workers’ compensation benefits. You’ll learn the advantages of retaining counsel, their responsibilities in handling claims, when to seek their advice, how contingency fees work, and more. With insight on how lawyers can help maximize your compensation, you can make an informed decision to protect your rights and get the benefits you deserve.

The Crucial Role of Attorneys in Workers’ Compensation Claims

When an employee is injured on the job, they have the right to file a workers’ compensation claim to receive benefits. However, the process of obtaining these benefits can be complex and adversarial. Insurance companies and their attorneys often try to minimize or deny valid claims. 

For instance, If you’re working in LA, and facing issues at work, looking at Workers Compensation Lawyers Los Angeles, in your search queries can be a good place to start. These lawyers generally have a proven track record fighting for injured workers, and they being on your side can make all the difference.

Attorneys who specialize in workers’ compensation understand all the intricate laws and regulations surrounding these cases. They know how to properly document and value injury claims. 

Insurance company adjusters frequently pressure unrepresented claimants to accept lump sum settlements that do not adequately compensate them for their injuries and losses. An attorney will advise the claimant on whether a settlement offer is fair or fight to obtain full benefits.

By hiring a workers’ compensation attorney, the playing field is leveled. Claimants have an advocate to act on their behalf and deal directly with the insurance company. 

The attorney’s expertise and negotiating skills can result in substantially higher settlements and awards. They ensure clients are aware of all their entitled benefits so they can focus on recovery, not fighting with the insurer.

Mitigating Denials and Delays

Insurers often deny legitimate claims or delay benefit payments using questionable rationale. Without legal guidance, claimants may become discouraged and fail to appeal wrongful denials. An attorney thoroughly investigates denials, requests hearings, and builds evidence to prove your claim’s validity. 

They understand what constitutes misconduct by insurers and will file complaints with the state agency if warranted. With representation, unwarranted delays or denials are aggressively challenged to obtain owed benefits faster. Having an advocate saves claimants months or years of fighting with insurers alone.

The Attorney’s Responsibilities in Handling Claims

Once retained, a workers’ compensation attorney takes over handling all aspects of the claim. This includes:

  • Submitting the initial claim paperwork and accident reports
  • Gathering medical evidence and records
  • Communicating with treating physicians
  • Determining the full extent of disability and appropriate benefits
  • Negotiating with insurance company adjusters
  • Appearing at workers’ compensation hearings

Unlike an unrepresented claimant, the attorney is familiar with the litigation process and knows how to build the strongest case. They undertake the time-consuming task of collecting documentation and testimony to prove the claim’s validity.

The attorney’s main role is to ensure clients recover appropriate benefits under the state’s Workers’ Compensation Act. This requires in-depth knowledge of permissible benefits like lost wages, permanent disability status, retraining programs, and future medical costs. A good attorney relentlessly pursues maximum compensation for the claimant.

When to Retain an Attorney

It is highly advisable to consult an attorney before ever speaking to the insurance company about an accident. The workers’ compensation claims process is inherently adversarial. Insurance companies want to pay as little as possible on claims. They will use adjusters and defense attorneys to poke holes in a claimant’s story and procure evidence to deny or reduce benefits.

Speaking with an attorney helps claimants understand their rights and build the optimal case from the outset. The attorney can manage communications and negotiate with the insurer. Most claimant attorneys work on contingency fees, meaning no upfront costs. Their fee comes out of any eventual settlement or award. This removes barriers for injured workers who could not otherwise afford legal representation.

Retaining counsel quickly also allows the attorney to start gathering evidence, interviewing witnesses, and documenting the full impact of the disability. The sooner they can build a convincing claim, the sooner they can fight for fair compensation. Do not wait until you hit roadblocks with the insurer – that may negatively impact your claim.

The Financial Aspect of Hiring an Attorney

Most workers’ compensation attorneys work on a contingency fee basis. This means the attorney only collects a fee if they succeed in obtaining benefits. If they cannot secure any compensation, the claimant owes nothing.

The attorney’s fee generally ranges from 10% to 30% of the total settlement amount, with the percentage declining for higher settlements. While legal representation takes a portion of the benefits, most claimants still end up with significantly higher compensation compared to going it alone.

It is a common misconception that retaining a lawyer means you will end up suing your employer. Workers’ compensation cases are meant to be “no-fault”, meaning blame is irrelevant. The attorney’s goal is to work constructively with the insurer to reach a reasonable settlement. However, they will not hesitate to take aggressive legal action if the insurer refuses to provide fair benefits.

The Possibility of a Third-Party Lawsuit

While you cannot sue your employer for negligence, workers’ compensation law does not prohibit filing a separate third-party liability lawsuit. If someone other than your employer or a co-worker caused or contributed to your work injury, you may have grounds to sue them for damages.

For instance, if faulty equipment caused your injury, the equipment manufacturer could be held liable. Your attorney can determine if a third-party claim is warranted and handle the litigation process. Any settlement or award from a third-party case is in addition to your workers’ compensation benefits.

Frequently Asked Questions

  • What benefits can I receive from a workers’ compensation claim?

Workers’ compensation laws permit workers who are hurt on the job to receive a number of benefits, depending on the injury. They can include permanent total disability benefits, permanent partial disability benefits, temporary partial disability benefits, medical benefits, wage reimbursement benefits, and vocational rehabilitation benefits.

  • Who is covered under workers’ compensation laws?

Workers’ compensation laws are governed by each state’s legislation and by federal statutes. Both provide fixed awards to employees or their dependents in the event of employment-related accidents and diseases. Independent contractors are not covered under most workers’ compensation laws.

  • Can I sue my employer for negligence that caused my accident?

The Illinois Workers’ Compensation Act specifically provides that you cannot file a lawsuit against your employer, regardless of some action or negligent conduct of your employer that clearly caused or contributed to your accident.

In Conclusion

Obtaining fair workers’ compensation benefits can be an uphill battle, especially against experienced insurance company attorneys. Hiring your own knowledgeable workers’ compensation attorney levels the playing field and significantly improves the odds of receiving maximum compensation for your injuries, lost income, and rehabilitation. 

Their expertise guides you through the complex claims process and protects your rights. With strong legal representation, you can focus on recovery rather than fighting with insurers. If you were injured on the job, contact a reputable workers’ compensation attorney before signing anything or speaking to the insurer. With an attorney’s counsel, you can pursue the benefits you rightly deserve.

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