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If you got injured at work, you are surely wondering if you need a lawyer. This is a complicated question to answer, as cases are different and involve multiple factors. You will have to deal with a complex and bureaucratic system, and most of the time with unfair insurance companies.
Pacific Workers’, The Lawyers for Injured Workers, wants you to have all the information you need to make the right choice. Workers’ Compensation is an area of law with its own codes, cases, and even court and judges. It involves a lot of paperwork and specialized knowledge. It takes a lot of time to follow up with doctors and insurance adjusters, in addition to keeping your case moving.
Law firms that specialize in Workers’ Compensation Claims fight employers and the insurance industry for a living. They can tell you if your case is on track, if you are being treated unfairly, and if the settlement is right for you. Experienced and respected attorneys can often maximize a case through careful preparation and good negotiation.
We have prepared a list of 5 questions that will help you decide whether you need a Workers' Compensation attorney.
1. What is your case status?
Workers' Compensation is supposed to provide your medical treatment and related expenses, loss of wages, and an amount towards any resulting Permanent Disability.
If your case has been denied or delayed, which insurance carriers do regularly, you require an attorney—no ifs or buts. This can be an incredibly difficult time for an injured worker. Frequently, we must refer our clients to the Employment Development Department (EDD) or Social Security to help them take care of themselves and their family.
Lawyers, paralegals, and legal assistants also spend an enormous amount of their time fighting to get medical treatment authorized. The fight to get medical treatment can be strenuous, as insurance companies have the right to deny medical treatment. If they do—which happens all the time—you have limited options for appealing their decision.
2. What type of workplace injury did you suffer?
Your employer is required to pay for Workers’ Compensation benefits if you were injured at work. Whether your injury is caused by a single event, such as falling down at work, or a repeated exposure, which the State of California recognizes as Cumulative Trauma that will come from years of working. For example, the carpal tunnel syndrome, tendinitis, or hearing loss.
If you have a cumulative trauma, you need an attorney. If you have a specific injury, as long as it is mild and your case is accepted, you might be able to handle your Workers' Compensation case yourself.
3. How severe is your injury?
If you have a permanent disability because you were injured at work, you probably require a Workers' Compensation attorney, unless you are prepared to negotiate with the insurance company's adjusters and attorneys to get the settlement you deserve.
Keep in mind that they do this for a living. Making sure the insurance company pays out as little as possible is their job. Do you think you can negotiate on that level? A Workers' Compensation attorney can.
4. What medical treatment do you need if you were injured at work?
Minor injuries can turn into major injuries without prompt necessary treatment. Most Workers' Compensation insurance companies will send you to facilities like Concentra or other work injury clinics. Doctors at these facilities are employed by the insurance companies, not by the injured worker.
Do you have the time and knowledge to find yourself a better Workers' Compensation doctor? Remember, you cannot treat with your regular doctor for a Workers' Compensation injury. Treatment for your Workers' Compensation injury will also have to be approved by Utilization Review. Do you know how to handle a denial?
5. Is the settlement right for you?
According to the California Department of Industrial Relations, your case is resolved when there is an agreement between you and the claims' administrator. Or a judge issues an order about your Workers' Compensation payments and future medical care that will be provided to you.
Workers’ Compensation claims settle in two main ways: Compromise and Release (C&R) or by Stipulation with Request for Award (Stips). There is a big difference when it comes to get injured at work.
A C&R is for the settlement of your Permanent Disability, future medical treatment, and for anything else that might be owed to you. This is paid in one lump sum directly from the insurance company, minus any attorneys' fees (generally 15%). If the lump sum includes the estimated cost of future medical care, the claims' administrator will no longer pay your doctor, this becomes your responsibility.
With Stips, you get paid for your Temporary or Permanent Disability—usually paid in weekly payments—, but your medical treatment stays open for life for the injury. That money is paid directly to the medical providers for your additional treatment.
It is rare that people see large monetary awards from Workers’ Compensation courts, which is why settlements occur so often. Although attorneys can never guarantee an outcome, their experience can give them insight into what may happen.
If your attorney believes there is a lot more available, trust his/her expertise. Experienced and respected attorneys can typically maximize a case through careful preparation and good negotiation. The offer your lawyer gets you can regularly be higher than what you get from a trial.
About the author
Bilal Kassem President and Co-founder
Bilal Kassem, is the co-founder of Pacific Workers. Bilal has been nominated for Applicant Attorney of the Year. His passion for helping injured workers brings his leadership with his team to lead with empathy and world-class customer service. He fosters a supportive atmosphere, which is why each one of his team member feels empowered to excel. With a 98% success rate at Pacific Workers, Bilal is on a mission to continue to educate and serve any injured worker in CA.