Originally posted on https://www.injuredcalltoday.com/what-does-workers-comp-attorney-do/
There is a saying: “Everybody hates lawyers—until they need one.” If you get hurt on the job, you need a competent workers’ compensation attorney. But why? The insurance company tells you they will “take good care of you,” and if you hire an attorney, “that will just take money from your settlement.” Don’t let them fool you. If you suffer an injury on the job, you need a competent New York workers’ compensation attorney.
Why You Need a Worker’s Comp Attorney
Imagine you’ve heard of football, but you don’t know any of the rules. Now imagine you’re suddenly on the field about to play the Cowboys, and you still don’t know the rules. Don’t worry, says Zeke Elliot, “I’ll make sure you know the rules.” Yeah right!
Okay, so the above scenario is a bit over the top. But it’s not much worse than trusting the insurance company to tell you what you should get out of your workers’ compensation claim. Who has the most to gain from your ignorance about your workers’ compensation rights? The insurance company. Duh! Why would you trust the one who benefits the most from your ignorance?
The opposite is true of your New York workers’ compensation attorney. The more money your attorney gets for you—the more your attorney makes, too. So unlike the insurance company, your attorney has the incentive to get you more money, not less.
To read our comprehensive New York Workers’ Compensation Guide, click here.
Can an Attorney Make a Difference?
Okay. So, your attorney should know the rules. But can an attorney get you more money? Most of the time, the answer is yes. Here is why: If you have a workers’ compensation claim, the insurance company will, at some point, try to limit or stop your benefits. A competent attorney can (1) spot when the insurance company is taking advantage of you, and (2) put a stop to insurance company shenanigans.
Workers’ compensation is a highly specialized area of law. Even though workers’ compensation laws are statutory (based on written laws), those statutes have to get interpreted. The worker’s comp insurance companies always adopt the most conservative interpretation possible. They do that to save money. Your competent workers’ compensation lawyer will know how the courts interpret the statutes and how to get the most out of your claim.
Here are a couple of examples where the insurance company can take advantage of legal “interpretation”:
- The general rule is you are not on the job (or “in the course of employment”) when “coming and going” to work. But that rule doesn’t apply if your employer provides a parking lot or tells you where to park. It doesn’t apply if you have to travel between jobs. It doesn’t apply if you get sent on a “special mission” (like dropping the company mail at the post office on your way home). And, it doesn’t apply if you get sent on a business trip. The insurance company isn’t going to dig down to see if the rule applies, though. They will just deny. Deny. Deny. Your good lawyer will ask the right questions to make sure the rule really applies.
- Suppose your company hires you “as a contractor” but tells you when and how to do the job, and even provides the tools and materials to get the job done. That’s not really a “contractor.” Under those circumstances, you’re an employee entitled to workers’ compensation coverage. But if you get hurt under that arrangement, the insurance will deny your claim. A good workers’ compensation attorney will prove that you are a covered employee. Your attorney can show that the company hired you as a bogus contractor to avoid paying workers’ compensation premiums.
- Want another? Suppose you hurt your back through years of use and abuse on the job. These claims (called repetitive stress injuries) get denied routinely. But if you can tie the injury to your job activities, that is a covered claim. That’s where a good workers’ compensation lawyer comes in.
The above scenarios are the tip of the iceberg. Maybe the best way to “prove” you need an attorney is to list the many things that can go wrong with your claim:
- Failure to comply with deadlines;
- The company says you faked your injury;
- The company says your job is not “covered” by the workers’ compensation laws;
- The insurance company says your injury isn’t “job-related”;
- Presence of alcohol or drugs in your system;
- Inconsistent statements in medical records;
- The insurance company wants a recorded statement (don’t EVER agree to that without consulting an attorney);
- Failure to provide proper medical documentation of your claim;
- Insurance wants you to see their doctors (click here to see why that is a bad idea);
- The insurance company wants an “Independent Medical Examination (IME)”(click here for our Independent Medical Examination guidebook to protect yourself at the IME);
- The insurance doctors claim you have reached “Maximum Medical Improvement” (read the MMI sections in our Workers’ Compensation Guidebook for more about this);
- The insurance IME doctors say you aren’t entitled to permanent total or partial disability benefits (read “PPD” and “PTD” sections in our Workers’ Compensation Guidebook for more about this);
- Insurance denies or limits your wage replacement benefits;
- Insurance claims your injury was “pre-existing”;
- Company claims injury was the result of “horseplay”;
- The insurance company does not want to pay for an MRI or other diagnostic tests;
- The insurance company does not want to pay for orthopedic surgery, physical therapy, pain management procedures, or chiropractic care;
- Insurance doesn’t tell you about free rehabilitation options;
- Insurance says you are ready to return to work even though you haven’t fully recovered;
- Your claim got denied, and you want to appeal;
- Your employer retaliates against you for filing a claim;
The above should tell you why you need an attorney to protect your interests. A lot can go wrong with a workers’ compensation claim. These things will limit or eliminate your claim — the insurance company benefits when things go wrong. You don’t. Your competent workers’ compensation lawyer has seen all the tricks. He or she knows how to slap the hand of the insurance company to get you all you should.
But, don’t wait to talk to an attorney until one of these problems arises. It may be too late by then to undo the denial.
How Do I Find an Experienced Workers’ Comp Attorney in New York?
Click for the following from our New Workers’ Compensation Guidebook to learn how to find a good New York Workers’ Compensation Attorney:
If you don’t get anything else out of this article, get this—Don’t delay. Find a good lawyer now. Legal claims are not like fine wine. They don’t get better the longer they age. The best way to protect your rights is to start right now to find someone who knows the system and will work hard on your claim.
Click here to read our comprehensive New York Workers’ Compensation Guidebook.