Workers often struggle with the decision of whether to hire a lawyer or attempt to advocate on their own behalf. This conflict arises from two competing interests: the worker’s desire to maintain a harmonious relationship with their employer, versus the equally strong desire to protect family and self.
Here are a few reasons why a lawyer is necessary:
Background:
Since 1985, we have received countless calls from frustrated workers repeating the same story. After fully cooperating with the insurance company, compensation benefits were terminated with little warning. However, upon further inquiry, we find that many of these unrepresented workers made critical mistakes in the handling of their own claims. Failing to understand the sensitive nature of a legal matter can be costly. A worker’s compensation claim demands the utmost care and preparation. From the inception of the case, the worker will be required to make important decisions that will lay the foundation for either a strong or weak case. A lawyer will devote a significant amount of time guiding their client through these decisions, 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 wait for that to happen? The deeper the hole, the harder it will be for the attorney to dig his client out. And unlike the depiction we see on TV, lawyers are not magicians; we need credible evidence to build a successful case. Suffice it to say, any unreasonable delay in seeking legal help could result in protracted litigation involving several years, not to mention the potential loss of thousands of dollars. While the case is on appeal, the insurance company is usually not required to pay any benefit whatsoever. Unless the worker possesses a significant amount of savings, he/she will suffer financial and emotional hardship. An experienced lawyer intuitively recognizes a damaged case when he sees it, and will stay clear of it. These cases cases typically wind up at law firm “mills” where they are assigned to unseasoned associates.
There is no substitute for having legal representation at the start of the claim, when the worker is most prone to make a mistake.
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 a case. An experienced lawyer will help his client avoid the pitfalls that can adversely affect a claim, and show the worker how to disseminate medical information about themselves in a truthful and accurate manner. The attorney will also offer invaluable advice concerning the type of specialist required for a specific injury, when to change doctors, and whether to solicit a second medical opinion.
Regrettably, many workers diminish the value of their claims by failing to provide accurate information to their doctors about their occupation, health, and employer accommodations in response to physicians’ orders. Workers who fail to protect themselves in these areas should not expect anything more than average to poor results.
The 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 and managers to advise them on how to handle each claim in the most cost-efficient manner. The opponent possesses in-depth knowledge of the law, and will aggressively fight to pay the claimant the least amount of money. Without an experienced lawyer protecting client interests, there is nothing counteracting this strong influence. For obvious reasons, insurance companies prefer to deal with unrepresented workers.
With few exceptions, it is never advisable to advocate on one’s 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 reemployment. 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. Moreover, an ill-designed program could potentially bar the right to enhanced benefits under the law.
An experienced lawyer will guide the client every step of the way to insure the successful completion of 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 the opponent is certain to exploit.
Additionally, workers need to protect themselves against claims by third parties (doctors, hospitals, Medicare, etc.). Workers often fail to recognize that the settlement process is about more than just money; it is the time when the parties reduce their promises into a legally binding contract. The contract will include the legal terms by which the parties wish to become permanently bound. Insurance companies love to limit their exposure by using sophisticated settlement language. Unless a lawyer reviews the settlement terms, the claimant may be left 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:
With the passage of the new worker’s compensation reform law, there is perhaps no greater time to hire a lawyer than now. Insurance companies are aggressively using American Medical Association impairment ratings to drive down the value of awards. Regrettably, judges are starting to approve these unfairly low settlements for workers who knowingly fail to protect themselves. It is imperative that workers learn to stand up for their rights.
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.
