Getting injured at work sucks.
Dealing with your injuries is bad enough, without having to put up a fight to get the benefits you deserve.
The workers’ comp system can be complicated, frustrating, and downright confusing. Insurance companies have teams of lawyers working overtime to get your claim denied or settled for as little as possible.
And they’re good at it too.
A workers’ comp lawyer can even the playing field.
A good attorney will fight tooth and nail to get you every last dollar of compensation you are owed. Why? Because the average payout for all workers’ comp claims combined is $47,316.
Workers that don’t know the law are routinely getting screwed over by insurance companies. Settling for far less than they deserve. Or worse — giving up completely when their claim gets denied.
You don’t have to be one of them.
This guide covers everything you need to know about workers’ comp lawyers.
From what they do, to when to hire one, to how to handle a denied claim. Let’s get to it…
What Does a Workers’ Comp Lawyer Actually Do?
Workers’ compensation lawyers help injured workers get the benefits they deserve.
Sounds simple, but what does that really mean?
Workers’ comp attorneys have the legal expertise and experience to navigate the claims process. They understand all the relevant laws and know the tricks insurance companies use to deny legitimate claims. A good lawyer will handle your case from start to finish. This includes:
- Filing all the paperwork
- Gathering medical evidence
- Negotiating with the insurance company
- Appealing denied claims
- Representing you at hearings
Best of all, most workers’ comp lawyers work on a contingency basis. That means you don’t pay a fee unless they win the case.
Yeah… Pretty sweet deal if you ask me.
When Should Someone Hire a Workers’ Comp Lawyer?
OK, so getting a workers’ comp lawyer sounds like a no brainer. But should everyone hire one?
The truth is, not every workers’ compensation claim needs an attorney.
For example, if you have a minor injury that was clearly work-related and your claim gets approved quickly. Legal representation probably isn’t necessary.
But there are some situations where getting an attorney is critical.
I’d recommend hiring a workers comp lawyer out of Fresno or any qualified local workers’ comp attorney if:
- Your claim gets denied or disputed
- You have preexisting conditions that could complicate the case
- Your injury is severe or results in permanent disability
- Your employer retaliates against you or threatens to fire you
- The settlement offer is far too low
- Your medical benefits get terminated prematurely
Complications like these happen all the time. When things go south on a claim, legal expertise can make all the difference.
How Lawyers Handle Denied Claims
Did you know…
Almost half of workers who received settlements had their claims initially denied?
That’s an absurdly high percentage of legitimate work injuries insurance companies are finding ways to reject.
But that’s where lawyers really shine.
When a workers’ comp claim gets denied, the attorney immediately investigates the reasons. Some common reasons claims get denied include:
- Missed deadlines – Employers aggressively push strict time limits
- Preexisting conditions – Insurers blame old injuries
- Insufficient medical evidence – Claims need to be properly documented
- Disputes about work-relatedness – The company argues the injury happened off the job
A good lawyer aggressively fights each of these denials. Gathering additional medical evidence, interviewing witnesses, and building a strong case that addresses the insurer’s objections point by point.
And it works. Statistics show that injured workers with legal representation receive 47% more benefits than those that go it alone.
No small chunk of change there.
The Appeals Process: What to Expect
The appeals process sounds intimidating when you don’t know the system.
Each state has its own procedures and deadlines that must be followed precisely. Miss a deadline and your claim could be denied outright. File the wrong paperwork and you have to start over again.
The reality is this is exactly why legal representation matters.
Workers’ comp lawyers know the appeals process backwards and forwards. Representation from a qualified attorney during an appeal includes:
- Filing the appeal within strict deadlines
- Requesting and attending settlement conferences
- Gathering expert medical testimony
- Presenting evidence at formal hearings
- Cross-examining insurance company witnesses
In the vast majority of denied claims, the case will get resolved through negotiation rather than a formal hearing. About 82% of cases settle before a hearing is needed.
A skilled attorney knows when to push for a better settlement and when to take the case all the way to a hearing. They understand the true value of the claim and won’t let insurance companies lowball their clients.
What Makes a Good Workers’ Comp Lawyer?
Some lawyers are better than others.
When it comes to choosing a workers’ compensation lawyer, certain traits make a world of difference. A great attorney has the following qualities:
Specialized experience — Focuses solely on workers’ comp claims
Local knowledge — Thoroughly understands state-specific workers’ comp laws
Proven track record — History of successful results
Clear communication — Explains legal issues in a way clients understand
Worker advocacy — Represents only injured workers, not employers
Some workers’ comp attorneys take both employer and employee clients. This is a big red flag. Injured workers need attorneys who have their back.
The Real Cost of Going It Alone
Something most people don’t realize…
Trying to fight a workers’ comp claim on your own usually ends up costing you more in the long run.
Insurance companies have armies of lawyers and adjusters whose job it is to pay out as little as possible.
Going up against them by yourself? Not a smart idea.
Injured workers that don’t have legal representation routinely make mistakes that hurt their claims including:
- Missing critical deadlines
- Inconsistencies in their statements
- Accepting lowball settlement offers
- Failing to gather proper evidence
- Misunderstanding full benefits
These mistakes add up and can cost thousands of dollars in lost benefits. Or worse — lead to a completely denied claim that could have been approved if handled correctly.
Building a Strong Case From Day One
The strongest cases are built on solid foundations.
Good lawyers start working on your case from the very beginning. They begin documenting every aspect of the claim including:
- The exact details of the injury
- All medical treatments and diagnoses
- Lost wages and earning capacity
- Employer and insurance company communication
- Witness statements and evidence
The more thorough and detailed this foundation, the more bulletproof the case becomes. It’s far harder for insurance companies to deny or minimize well-documented workers’ comp claims.
Plus…
Good documentation often leads to faster settlements. Insurance companies know when they are up against a well prepared case with solid evidence.
Moving Forward: Taking Action
Workers’ compensation is designed to protect injured workers.
But the system doesn’t always work as it should.
Insurance companies are constantly searching for reasons to deny valid claims or pay out as little as possible. Employers sometimes retaliate against workers who file legitimate claims.
This is the brutal reality.
The good news is, there are skilled workers’ comp lawyers out there fighting to protect injured workers’ rights every single day. Lawyers that understand the system. Know the tricks insurance companies use. And have the experience to win.
Injured workers don’t have to fight these battles alone. Getting the right legal representation as soon as possible dramatically improves the chances of a successful outcome.
Final Thoughts: Getting the Benefits Deserved
Workers’ comp lawyers are vital in helping injured workers navigate a broken system.
Without legal help, many legitimate claims get denied or settled for a fraction of what they’re worth. This is unacceptable.
The right attorney can make all the difference. By:
- Filing claims correctly from the start
- Gathering strong medical evidence
- Negotiating a fair settlement
- Fighting denied claims aggressively
- Representing workers at hearings
Most importantly, they level the playing field against huge insurance companies that want to pay as little as possible.
Getting injured at work is traumatic enough. Workers shouldn’t have to fight for benefits they are legally entitled to receive. That’s what workers’ comp lawyers are there for — to fight those battles and make sure injured workers get every dollar they deserve.
