Severity
of the Injury
A minor injury with a minimal amount of medical
treatment and no lost time usually can be handled
without a lawyer. Bumps, bruises, contusions,
lacerations, or even a few stitches which are treated in
the emergency room or with a few follow up visits to
Doctor’s Care will probably be processed routinely and
not require you to get a lawyer. On the other hand, if
you have a severe injury you are more likely to benefit
from the services of an attorney. A lawyer can help you
get the proper medical care and compensation so you have
the best outcome from your injury.
Employer
Cooperation
If your employer seems to be angry at you for getting
hurt or refuses to send you to a doctor, this may be a
warning they do not plan to cooperate to get your
benefits started. The employer is supposed to report the
injury to their insurance company right away. The
insurance company then "adjusts" the claim -
investigates to determine if the injury is compensable
and what benefits are owed. If the employer does not
report the claim, the insurance company won’t know about
it and will not be processing the claim for benefits.
This can cause all sorts of problems and delays. With a
non-cooperative employer it is probably a good idea for
an injured worker to consult lawyer.
Referral
to a Specialist
Injured workers with severe injuries can benefit from
having representation. Referral to a specialist, such as
an orthopedic surgeon or neurosurgeon, is generally a
good indication your injury is severe enough to benefit
from retaining a lawyer.
Denial of
Medical Treatment
Sometimes medical treatment is denied from the start.
The employer refuses to send an injured worker to the
doctor or the insurance company refuses to authorize
treatment, often because the employer has not reported
the claim. Other times, an injured worker who has been
receiving ongoing treatment is denied further treatment.
For example, the insurance company refuses to authorize
a referral to a specialist, or for diagnostic testing,
such as an MRI, or physical therapy, or a pain clinic.
Sometimes, the injured worker is released by the
treating physician, but is still having problems and
wants a second opinion, but the insurance company won’t
agree. In all of these situations the injured worker
probably needs a lawyer to help get the needed
treatment.
Refusal to
pay weekly benefits
An injured worker who is unable to work and is not
getting weekly benefits should consult a lawyer.
Important tip: Always get your work status in
writing from the doctor and keep a copy for your
records!
Getting a
fair settlement
It is always a good idea to consult a lawyer before you
settle your case to determine if you are being treated
fairly or if you would benefit from representation. Even
if the employer and the insurance company seem to have
treated you right all along, this does not necessarily
mean you will be offered a fair settlement. You might
also want to discuss with an attorney what your options
are before you make any decisions. If your case does not
settle and you have to go to a hearing, you may benefit
from having an attorney represent you.
Loss of
Earning Capacity or Permanent and Total Disability
If you believe you have suffered a significant loss of
your earning capacity or you are permanently and totally
disabled as a result of your work injury you should
contact a lawyer. Settling or bringing such cases to a
hearing can be complicated. There can be confusing
issues which are best handled by a lawyer. A lawyer can
help you obtain the evidence and documentation necessary
to get the benefits you are entitled to. Also, if you
receive or have applied for other types of disability
benefits, such as Social Security Disability, you would
most likely benefit from the services of an attorney in
concluding your Workers Compensation claim. A lawyer can
help you protect your other disability benefits.
Permanent
Disability, Restrictions, or Inability to Return to
Previous Employment
If you have a permanent problem as a result of your
injury, permanent restrictions or, if you are unable to
return to the type of work you usually do, it is a good
idea to talk to a lawyer and determine if you need
representation. In most of these situations you will be
more likely to get fair compensation if you have an
attorney.
Denied
Case
If you have been hurt on the job but your employer
doesn’t believe you, or if the insurance company denies
your case, you will most likely need a lawyer to help
you prove you case. Some cases are straight forward
enough to handle without a lawyer, but many cases are
denied for legal reasons or on issues that can be
difficult for an injured worker to handle alone.
Injury
caused by a third party or defective machine
If you have been hurt by someone who does not work for
your employer you may be able to bring a separate
lawsuit in addition to your workers compensation claim.
This would include, among other things, on the job auto
accidents and injuries caused by improperly designed or
defective machines. When you may have both a workers
compensation claim and a third party claim it is a good
idea to consult an attorney to determine your rights and
if you would benefit from representation.
Questions, worries, and concerns
If you have never had a workers’ compensation claim
before, don’t know your rights, have questions, doubts,
fears or concerns, or just don’t know what to do, you
should consult a lawyer. A lawyer can answer your
questions, explain your rights, put some of your fears
to rest, and help you decide if you would benefit from
having representation. When in doubt, call a lawyer!
