Workers' compensation is a form of insurance designed to provide financial assistance to employees who sustain injuries or become ill while performing their job duties. It typically covers related medical expenses, lost income, and rehabilitation costs. In the unfortunate event of an employee's death resulting from work-related injuries, workers' compensation also provides death benefits to their family members.
The primary purpose of the workers' compensation system is to help injured workers quickly receive benefits to cover their lost income and medical care without having to establish fault or go through a lengthy lawsuit. The worker’s comp system is a more streamlined approach that ensures injured or ill employees receive timely financial support, ideally promoting a quicker return to work and overall well-being.
It’s the employer who bears the cost of these benefits. Most employers use a workers' compensation insurance policy to help fulfill these financial obligations when needed for their employees. Workers' comp aims to provide essential financial support, fostering a conducive environment for employees to recover and return to the workforce as soon as possible.
Unfortunately, employees who need to access these benefits are sometimes wrongfully denied. Employers and insurance companies can make successful claims difficult with the goal of not having to pay them. For this reason and many others, any worker who needs to file a workers' compensation claim should seek representation by an experienced workers' compensation attorney.
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What Does a Workers' Compensation Attorney Do?
A workers' compensation lawyer protects the rights and well-being of injured employees, ensuring they receive the full benefits they are entitled to and for as long as they are entitled to receive them. The responsibilities of a workers' compensation attorney are wide-ranging, including providing comprehensive support to their clients.
The main duties and responsibilities of a workers' compensation attorney include the following:
Evidence Gathering
A workers’ comp attorney's initial responsibility is gathering evidence that establishes a work-related injury as such. A careful examination of the circumstances surrounding the incident is necessary to build a strong foundation for the subsequent legal proceedings.
Securing Medical Evidence
A workers' compensation attorney actively collaborates with medical professionals to secure evidence proving the nature and extent of the injury. A comprehensive understanding of the injury's impact on the injured party is essential to strengthen the case for compensation.
Claims Process Guidance
Guiding clients through the often-confusing claims process is another duty of workers’ comp lawyers. They can clearly and concisely explain the workers’ compensation claims procedures so that their clients know what to expect.
Filing Accurate Documentation
Ensuring the accuracy and timely submission of paperwork is also imperative. The attorney takes over accurately filling out all necessary documentation and submitting it within the applicable deadlines. Having an attorney take over this task can eliminate much of the burden of a workers’ comp claim from an injured employee.
Medical Guidance
Workers’ comp attorneys also offer guidance for selecting appropriate medical professionals. They help clients understand which doctors they can see, as some states allow the employer or their insurance company to dictate which medical professionals injured workers can seek care from. In some instances, seeing a medical provider outside of the approved list can create financial burdens that the employee will have to deal with on their own.
Client Education
The attorney acts as an information resource, answering clients' questions about the often-complex workers' compensation process. This includes clarifying legal jargon, outlining potential challenges, and providing realistic expectations throughout the proceedings.
Representation in Discussions and Negotiations
Advocacy is a core function of a workers’ comp attorney’s job, with the attorney representing clients in discussions or negotiations with employers or insurers. The lawyer protects the injured party's interests and conducts negotiations on fair and equitable terms.
Claims Denial Advocacy
In the unfortunate event of a claim's denial, the workers' compensation attorney is your advocate, challenging the denial and presenting compelling arguments to reverse the decision. The lawyer will thoroughly review the denial grounds and address any deficiencies in the original claim.
Legal Proceedings Representation
Should legal proceedings become necessary, the attorney provides courtroom representation, ensuring the client's interests are defended throughout the entire legal process. They will prepare a thorough case, fighting for their client’s rights to receive worker’s compensation.
Settlement Evaluation
A workers’ comp lawyer also evaluates settlement offers. They carefully assess the terms and adequacy of settlement offers to ensure their clients receive the fairest and most comprehensive compensation possible for their injuries.
In reality, the role of a workers' compensation attorney extends far beyond legal representation; it includes a holistic commitment to the well-being and rights of the injured employee, ensuring they navigate the complexities of the workers' compensation system with diligence and skill.
Determining When to Hire a Workers' Compensation Lawyer
Professional legal intervention is often necessary in both routine and complex workers’ comp cases. You should consider seeking the assistance of a workers' compensation lawyer when your workers’ compensation claim involves any of the following:
Claim Rejection or Dispute
Legal intervention becomes imperative if your employer rejects or disputes your workers' compensation claim. A workers' compensation attorney can assess the situation, identify potential weaknesses in the claim, and develop a robust strategy for appeal or resolution.
Delayed Benefit Payouts:
Timely access to benefits is essential for injured workers. When an employer unnecessarily delays or avoids the payout of benefits, a workers' compensation lawyer can step in to expedite the process and ensure you promptly receive the financial support you are entitled to receive.
Inadequate Settlement Offer
If the settlement offer presented doesn’t comprehensively cover your medical bills or lost income, hiring an experienced lawyer becomes essential for a successful claim. They can assess the adequacy of the offer, negotiate on your behalf, and work towards a settlement that adequately addresses your current and future needs.
Partial or Total Permanent Disability
In cases where an injury results in partial or total permanent disability, limiting your ability to work, the representation of a workers' compensation lawyer is especially critical. They can advocate for your rights, ensuring you receive the appropriate compensation for the altered scope of work or the inability to return to your previous job.
Lack of Strong Medical Evidence
A lack of strong medical evidence supporting your injury can weaken your claim. A workers' compensation lawyer can collaborate with medical professionals to strengthen your case, ensuring your injury and its implications are well-documented. Your lawyer can prove that your injuries were related to your job and that you deserve compensation.
Retaliation by the Employer
If your employer retaliates against you for filing a workers' compensation claim, legal protection is crucial. A workers' compensation lawyer can take action against any discriminatory or retaliatory measures, protecting your rights as an injured worker.
Employer's Grave Misconduct
In situations where the injury results from your employer's severe or intentional misconduct, a workers' compensation lawyer can build a case against your employer, seeking compensation for the consequences of the employer's actions.
Third-Party Negligence
Pursuing a workers' compensation claim requires particular legal knowledge if a third party's negligence contributed to your workplace injury. A lawyer can assess liability, explore third-party claims, and ensure that all responsible parties are accountable so that you can maximize your compensation.
Social Security Disability Insurance (SSDI) Benefits
If you plan to apply for or are already receiving SSDI benefits, an improperly structured settlement in your workers' compensation case can impact your SSDI benefits. A workers' compensation lawyer can assess this complex interaction, protecting your financial well-being.
Settlement Uncertainty
Consulting a workers' compensation lawyer should be the next step when offered a settlement. Your attorney can evaluate the terms of the settlement, assess its fairness, and provide guidance on whether the proposed settlement aligns with your best interests under the circumstances you face.
In these scenarios, the assistance of a seasoned workers' compensation lawyer ensures that your rights are protected and that you receive the rightful compensation and support you deserve during your recovery.
The Benefits of Hiring a Workers' Compensation Attorney
There are several advantages of hiring a workers' compensation lawyer, including the following:
- Proper Paperwork Filing: A workers' compensation lawyer ensures the accurate completion and timely submission of all necessary paperwork. An attorney's careful approach minimizes the risk of administrative mistakes because clerical errors and missed deadlines are common reasons for claim denials.
- Increased Chance of Higher Settlement: While success is never guaranteed, hiring an experienced attorney significantly increases the likelihood of securing all entitled benefits for an extended duration. A study revealed that injured employees represented by a workers' compensation lawyer receive five times more payout than those without legal representation.
- Equal Representation: Employers and insurers often have legal representation for workers' compensation claims. By hiring your own attorney, you level the playing field, ensuring that you have someone advocating for your rights. In case of a claim denial, your workers' compensation lawyer can navigate the appeals process on your behalf.
- Access to Additional Resources: Legal representation grants access to resources that may otherwise be unavailable. For instance, if your claim requires substantiating the full extent of your injury, your attorney's network may include medical experts who can provide valuable support in strengthening your case.
- Peace of Mind: Suffering an injury while on the job is stressful enough. With a workers' compensation lawyer, you gain assurance that someone is diligently protecting your best interests and working hard to secure the benefits you deserve. This allows you to focus on your recovery without the added burden of personally dealing with the complex workers’ comp legal system.
What if Another Party Is Responsible for My Workplace Injuries?
Even if you have suffered a workplace injury, it's important to consider the possibility of other responsible parties beyond your employer. Workers' compensation insurance your employer provides typically covers their potential liability, precluding you from suing them directly. However, consulting with a workers' compensation lawyer is crucial to exploring the potential liability of other parties. You may have grounds for a third-party liability claim if someone else is at fault.
Third-party liability arises when someone not directly employed by or affiliated with your employer directly causes your injuries. For instance, imagine you're a construction worker on a shared worksite with various contractors. An electrician, who is not your employer's employee, leaves a live wire exposed without warning signs. Unaware of the hazard, you come into contact with the live wire, resulting in severe burns, muscle damage, and heart problems. The electrician or their employer can be liable for your injuries in a third-party claim.
Other examples of third-party liability include the following:
- Auto Accidents during Work-Related Travel: If an auto accident occurs while you are in a company vehicle or while being compensated for work-related travel, the liable third party is the individual who caused the accident.
- Defective Tools or Devices: If a tool or device used at work is defective due to manufacturing faults, the manufacturer is liable for resulting injuries.
- Accidents Involving Delivery Truck Drivers: In scenarios where a delivery truck driver causes an accident affecting warehouse workers, both the driver and their employer can be liable.
- Distribution of Hazardous Substances: If a third-party company distributes a potentially toxic substance without the required warnings, leading to injuries or occupational diseases among workers, they may be held responsible.
- Deliberate Harm or Gross Negligence: In cases where a worker intentionally causes harm or acts with gross negligence, they can be accountable for the damages inflicted, such as co-worker assault.
- Numerous other situations illustrate how an employee may pursue a third-party liability lawsuit against an individual or entity. In such cases, you can file both a workers' compensation claim and a personal injury lawsuit. A reputable workers' compensation attorney will be crucial in identifying all parties potentially responsible for your injuries and guiding you through the legal process.
Injured on the Job? Contact a Skilled Worker's Compensation Attorney Today
Dealing with the complexities of a workers' compensation claim alone can be quite taxing, especially while recovering from an injury. It can also be risky, as many claims filed by employees are denied—often for frivolous reasons. Your best chance at getting reimbursed for your work-related medical expenses and lost income through a workers' compensation claim is hiring a skilled workers' compensation attorney who can help. If you've suffered an injury on the job, don't delay contacting New Jersey personal injury lawyer today.
