When an employee has suffered a work-related injury, state law says they are entitled to receive workers’ compensation benefits to pay for all their medical treatment and lost wages as they recover. Many people wonder if they need a workers’ comp attorney in order to obtain the benefits they are entitled to. The answer to this question usually depends on how complex the case may be, including how serious the injury or illness is and how the injured worker’s employer and/or insurance company is handling the claim.
When an Attorney May Not Be Needed
There are certain types of injuries that an injured worker may not need an attorney. If all of the following apply to the injury, the process will likely be a simplified one without any issues:
- The injury itself was a minor one, such as a cut that required only a couple of stitches.
- The employer verifies the injury was work-related.
- The injured worker missed no work (or barely any) due to the injury.
- The injured worker had no pre-existing condition in the same area as the injury that could be aggravated by the work injury.
Even if a work-related injury meets all the above criteria, it is always a good idea to at least consult with an attorney to discuss the specifics of the case and what potential issues may arise. Most workers’ compensation attorneys do offer free and confidential case evaluations.
When an Attorney Is Needed
The majority of work injury cases do require the assistance of an attorney because of the issues that are involved. These issues can include:
- The employer and/or insurance company denies the injured worker’s claim or there is a delay in paying the worker their benefits. It is not uncommon for an employer or their insurance company to deny a legitimate work injury claim. When this happens to a worker who does not have an attorney, it is rare they will file an appeal on their own. The insurance company counts on this. Another common situation is for the company to accept the claim, but there is always a delay in paying the worker their benefits, such as wage replacement and medical treatment. This is often a tactic to get the worker to return to work before they are medically able to. Workers who do not have an attorney protecting their rights often find themselves in this situation.
- The settlement offered by the insurance company does not cover the medical bills or the wages the injured worker has lost. State workers’ compensation boards – which are usually the agencies that oversees claims and settlements – will likely approve any settlement offer the two parties agree on. It is not their job to ensure that the settlement amount is fair and just for the injured worker. That is what a workers’ compensation attorney will do. Therefore, the injured worker should consult with an attorney to ensure they are receiving what they deserve.
- The injury has left the worker with a disability that either limits or prevents them from returning to their prior job. If the worker has suffered a partial or total disability, they are entitled to financial compensation for the losses they will now suffer. It is critical to have a seasoned attorney negotiating and protecting the injured worker’s rights during the settlement offer process.
There are a variety of other reasons why an injured worker should consult with an attorney, including retaliation by the employer against the injured worker, the worker will be applying for Social Security disability benefits, or the injury involved a third-party or serious misconduct. In the event you need legal guidance, do not hesitate to reach out to a professional, like a trusted Nassau County Workers Comp Attorney, to assist you with your case.
Thank you to Polsky, Shouldice, & Rosen P.C for providing their insight and authoring this piece on workers compensation.