When filing for worker’s compensation, it’s good to have a lawyer on hand. Do you need a workers’ comp lawyer just to file a claim?
Every year, tens of billions of dollars are paid out in workers’ compensation claim cases.
The policies and procedures that govern these cases can vary quite a bit. Each situation is different, and each state sets its own workers’ comp regulations. These cases can become complicated and convoluted, and often require the help of a workers’ comp lawyer.
Timelines for workers’ comp cases will vary by state. For example, in the Commonwealth of Massachusetts, you have four years from the time of injury to file a claim. Though you are provided with wide latitude to file your claim, the sooner you act, the better.
Keep reading to learn more about how to file a workers’ comp claim and when to hire an attorney.
What Is Workers’ Comp?
Workers’ compensation is a form of insurance that protects employees who develop illness or injury on the job. The actual payout can vary based on many factors—like medical fees, lost wages, and rehabilitation costs.
Generally speaking, it is social insurance that covers these associated injury costs. It also pays out a tax-free wage-replacement—though policies and procedures can vary widely.
Workers’ comp insurance is required by most states. Actual policy requirements will vary by state law, as well as the type of work performed and the size of the company.
This is one of the major factors that influence some businesses to relocate or expand operations in another state.
With such high costs to these claims, executives are incentivized to look for states with workers’ comp laws that fit their needs. In turn, this relocation/expansion generates jobs in those locations.
States with laws like those in Massachusetts are considered a “no-fault state.” This means you can still qualify for benefits, even if the injury is a direct result of your own actions at work.
Most companies purchase this insurance from private providers. However, there are some state-funded programs available. Some states require the exclusive use of state-provided insurance.
Texas is the exception. This is the only state in which employers are not required to purchase workers’ comp insurance.
Workers’ Comp vs. Disability
Workers’ comp can sometimes be confused with disability insurance. Both offer insurance to protect employees who are unable to work due to some sort of injury or illness.
However, the difference comes in the nature of the ailment.
Workers’ compensation insurance covers those injured as a direct result of workplace activities. This can cover something like a slip and fall, being struck by materials, or equipment failure resulting in injury. It does not cover something like getting into a car accident on your daily commute to work.
On the other hand, disability is designed to cover injuries that were not sustained as a direct result of working conditions, though they still prevent you from working. In this case, the car accident situation could be cause for temporary disability insurance.
Of course, not all injuries or illnesses are black-and-white. If you are unsure of where your claim falls under the range of insurance options, contact a workers’ comp lawyer. They can help you navigate the system, and determine which path is the best fit for your case.
How to File a Workers’ Comp Claim
There are a variety of ways that workers’ comp injuries can happen.
They are not exclusive to one industry. While construction and other related jobs can pose a higher risk, someone working at a desk can still suffer a workplace illness or injury.
When actually processing a workers’ comp claim, there are important steps to keep in mind.
Seek Medical Attention
Primarily, after a workplace incident, you should consult a medical professional as soon as possible.
Of course, this will make sure you are okay and do not suffer lasting damage. But also, this establishes a medical record that will be a key piece of evidence in the case. Be sure to obtain a copy of this detailed report for workplace illness or injury.
Report the Incident
As soon as realistically possible after seeking medical attention, report this incident to your employer. Following the guidelines of your state and their own insurance policy, they should provide you with the appropriate paperwork to process the claim.
Of course, serious injuries may push this timeline back.
But generally speaking, it is best to file the claim as soon as possible. This ensures you have plenty of time to seek litigation if it comes to that. Each state has a statute of limitations that prevents action on cases past that point.
Gather Important Documents
Be sure to gather important documents that can serve as proof of the illness or injury. Especially if your claim is denied and you choose to appeal it, these documents will help your case.
These documents include:
- Medical reports
- Doctor’s notes
- Medical bills
- Physical therapy reports
- Any other illness/injury paperwork
Keeping careful records can make or break your case moving forward.
Keep in Contact
When filing, keep in constant communication with your employer. This keeps everyone on the same page and can make the process run much smoother.
Plus, this can help you stay out of court. It’s true there is potential for large awards in a workers’ comp lawsuit. However, these are extreme cases.
For smaller illness or injury cases, there is the possibility you could lose the suit and walk away with nothing. To avoid the legal fees associated with these cases that may not produce a return, it may be best to avoid entering the courtroom unless totally necessary.
Again, consulting with a workers’ comp attorney can help you determine the best path to seek to maximize your claim.
File all the necessary paperwork, and follow up with your company to be sure they have completed their end.
Follow Up With Your Doctor
After the initial illness or injury, it is critical to closely follow the advice of your doctor.
This way, there is no potential for questions about your injury. Your employer could allege that you aggravated the injury with your own actions (or inactions).
Be sure to closely follow the doctor’s advice, as well as keep up with any follow-up appointments. This includes finishing any prescriptions and attending physical therapy sessions as directed.
Do I Need a Workers’ Comp Lawyer?
For smaller, more straight-forward cases you may be able to successfully represent yourself. But for more complicated cases, consulting a workers’ comp lawyer is the key to protecting your benefits.
Any legal process can be confusing for a layperson to navigate. It is no different from workers’ compensation claims.
Primarily, they will review the facts of your case in the initial consultation, and evaluate the situation. This includes many factors, including:
- The nature of the incident
- Circumstances surrounding the incident
- Workplace conditions
- Employment history
- Witness testimony
After filing a claim, your company has the right to dispute it. This serves their own interests, as lower incident rates result in lower insurance premiums.
If the claim is disputed, it is then passed along to the state workers’ compensation board for investigation. From there, a state-designated doctor will evaluate the injured employee. They are impartial and are held to strict standards to ensure no bias is formed.
However, normal doctor-patient confidentiality is not present in these situations.
This means that anything you say to the doctor that suggests the injury is exaggerated, faked, or not work-related can be used against you. Not only can your claim be denied, but your employer can sue you for filing a false claim.
Remember that your employer will almost always be working to protect their own interests. Unfortunately, this does not always align with your own—even if you are on good terms with your employer.
Plus, if these cases do end up in litigation, they can often be very emotionally-charged. This is why it is critical to work with a workers’ comp lawyer to protect your interests and make the most of your claim.
Choosing the Best Fit
The workers’ comp laws can be very complex. Plus, they can vary quite a bit by state. As such, it is critical to hire a trusted workers’ comp lawyer who is experienced in the laws of your state.
They should have a good reputation and be dedicated to protecting your interests.
Find a Workers’ Comp Lawyer that Works for You
Every state has its own workers’ compensation laws. Most companies have their own insurance and their own internal policies.
Be sure to carefully review all of the regulations pertaining to your claim. This way, you can be prepared in the event of a dispute.
The best way to adequately prepare yourself and be sure to protect your interests is by hiring a workers’ comp lawyer.
In Massachusetts, there is no better source than Fitzpatrick & Associates. Contact their office today to schedule a consultation and make the most of your workers’ compensation claim.