Soon after an injury, workers often struggle with the idea of whether to hire a lawyer, or alternatively, to advocate on their own behalf (“pro-se”). This dilemma arises from two competing interests: the worker’s strong desire to maintain a harmonious relationship with his/her employer versus the worker’s strong desire to protect family.
Here are a few of the reasons why you need a lawyer:
Background:
Since 1985, we have received countless calls from frustrated workers repeating the same story. After cooperating with the insurance company 100%, their benefits were suddenly terminated without good cause or justification. Upon further inquiry, we find that many of these workers made critical mistakes in the handling of their own claims. After realizing their mistake, workers often felt foolish for having thought that they could handle such a complicated matter on their own.
The fact is that many workers fail to understand the sensitive nature of a worker’s compensation claim. The claim demands the utmost care and preparation. Unfortunately, a damaged worker’s compensation claim is not something that can be readily fixed. At a cases’ inception, workers will face critical decisions, which will lay the foundation for a strong case. An experienced lawyer will devote a significant amount of pre-trial preparation to build a strong case to insure the best possible outcome.
While it is true that a worker can always hire a lawyer when things start spiraling out of control, why would anyone want to wait for that to happen? It would be akin to purchasing insurance coverage immediately following a car accident; too little, too late. Indeed, the negligent delay in seeking attorney representation could result in significant delays of months or years due to protracted litigation. While a case is on appeal, the insurance company is often not required to pay any benefit whatsoever. Unless a worker possesses a sizeable savings account or some other source of income, he/she will experience financial hardship and emotional strain. Yet, the truth is that workers often treat their cases like a real estate closing, signing everything that is placed before them, hoping that somehow everything will work itself out. It only takes one critical error to lose thousands of dollars. An experienced lawyer intuitively recognizes a damaged case when he sees it, and will stay clear of it. Such cases typically wind up at law firm “mills” where it is assigned to an inexperienced associate.
There is no substitute for having legal representation at the inception of your claim, when you are most prone to make mistakes that could dramatically devalue your claim.
Medical:
Credible medical evidence is the heart and soul of a strong worker’s compensation case. It will override almost any defense that can be mounted by the insurance company concerning whether an injury is actually connected to work activities. Knowing how and when to obtain proper medical care will have a direct impact on the strength of your case. An experienced lawyer will help you avoid the numerous pitfalls that can adversely affect your case, and show you how to disseminate information about your medical condition in a truthful and accurate manner. The attorney will also offer invaluable advice concerning the type of specialist required for your type of injury, when to change doctors, and whether a second medical opinion is needed.
Regrettably, many workers diminish the value of their claims by failing to provide their doctors with critical information concerning their jobs, changes in health, and violations of medical restrictions by the employer. A worker who fails to observe these guidelines should expect nothing but poor results.
Your Opponent:
The insurance company is not a charitable institution, but rather a for-profit business, which adheres to strict cost-containment policies. A successful insurance company pays out far less than what it receives. To protect their business, they hire hundreds of lawyers to advise them how to handle your claim in the most cost-efficient manner. Your opponent possess in-depth knowledge of the law, and will aggressively fight to pay you the least amount of money you may be entitled to. Unless you have an experienced lawyer protecting your interests, there is nothing counter-balancing this strong influence. For obvious reasons, insurance companies prefer to deal with injured workers directly.
With few exceptions, it is never advisable to advocate on your own behalf. The old adage, “He who is his own lawyer has a fool for a client,” should serve as a warning to all.
Vocational Rehabilitation:
If a worker is unable to return to their former occupation due to some medical limitation, he/she may experience a significant reduction in wages, thus triggering the need for vocational rehabilitation. Vocational rehabilitation is a complicated process that requires a worker to actively participate in a job search program designed to find suitable employment. There is perhaps no other area where the minefields are so numerous. Workers who participate in an insurance sponsored vocational program, whose goals are neither fair, reasonable, or realistic are doomed to failure. An ill-designed program could potentially bar the right to enhanced benefits under the law.
An experienced lawyer will guide you through the steps necessary to successfully complete a vocational rehabilitation plan.
Settlement Negotiations:
Injured workers generally have no experience to know when and how to settle their claim. Soliciting a settlement offer at the wrong time will telegraph weakness to the other side; something your opponent is certain to exploit.
Additionally, the worker needs to protect himself/herself against claims by third parties (doctors, hospitals, Medicare, etc.). Workers often fail to recognize that the settlement process is more than just about money, it is the time when the parties reduce their promises into a legally binding contract. The contract will include the terms by which the parties wish to become legally bound forever. Insurance companies love to limit their exposure by using sophisticated settlement language. Unless you have a lawyer reviewing the settlement terms, you may be leaving yourself financially vulnerable beyond the date of settlement approval.
Because receiving a just and fair compensation is the ultimate goal, the worker needs a legal advocate who can help him/her understand the nuances of reaching a fair settlement.
CLOSING REMARKS:
Hiring a lawyer to represent you in your worker’s compensation claim will probably be one of the most important decisions you will ever make in your life. Unfortunately, workers often fail to see what is at stake until it is too late. We hope you will take the time to arm yourself with the necessary information to insure the best possible outcome for you and your family.
DISCLAIMER:
The information contained in this website is intended as general information only, and is not to be construed as rendering legal advice for any specific loss, issue, or concern.
