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Can You Win a Workers’ Comp Settlement Without a Lawyer?

Understand the factors in deciding to get a workers’ comp attorney

In addition to needing medical care, injured employees often lose wages due to extended time away from work. If you’ve suffered a work-related injury, you may be wondering how to be compensated for medical treatment or lost wages.  

In most states, workers’ compensation is a system designed to compensate injured employees. Workers’ comp functions as an alternative to a lawsuit, allowing workers to get the money they need without going through litigation. 

If workers’ comp doesn’t involve litigation, do you need a lawyer to get your benefits? The short answer to this question is no. However, the workers’ comp process can be very complicated. Especially if you’ve suffered severe injuries or a disability, having a lawyer ensures your employer gives you a fair settlement. 

In addition, lawyers often work on a contingency fee basis for workers’ comp cases, meaning that you don’t have to pay the lawyer unless you win your case.  Legal representation doesn’t come with financial downsides, while ensuring you get the money you’re entitled to. 

This article will overview what’s involved in a workers’ comp claim and why it’s often a good idea to seek legal help for your case.  

What Is Workers’ Comp? 

“Workers’ compensation is a law that allows for people who are employees to receive benefits when they’ve been injured at work,” says Pennsylvania workers’ compensation attorney Alfred J. Carlson

Workers’ compensation laws vary from state to state and are fact specific. A workers’ comp lawyer can help you navigate your state’s requirements.  

In general, most states require employers to have workers’ compensation insurance to cover employee injuries on the job.  

Workers’ comp is a no-fault system, meaning that injured workers don’t have to prove that their employer was at fault for their injuries. They just have to report that an injury occurred during work. 

When an injury occurs, the employer’s insurance company will investigate the incident to determine whether the employee has a compensable claim. At the end of the investigation, the insurance company will either approve or deny the worker’s claim. In many states, if your claim is denied, there is a process for appealing the decision. 

Workers’ compensation benefits generally cover: 

  • Medical bills. Workers’ comp usually covers all medical expenses resulting from a workplace injury, including future medical treatment. In some cases, employees reach a point called “maximum medical improvement” (MMI), meaning that further treatment won’t improve their medical condition. The employee may be able to return to work only in a limited capacity. Workers’ comp can make up for lower pay due to a reduced level of work. 
  • Lost wages. In many states, workers’ comp benefits for lost wages are equivalent to two-thirds of your average weekly wages before the injury. In some states, the percentage is higher. 
  • Disability benefits. Work injuries sometimes result in permanent disabilities, making it impossible for the employee to return to work. Disability benefits help compensate for these long-term expenses. 

The amount of your workers’ compensation settlement will depend on several factors, including: 

  • What are your medical expenses?  
  • How long were you out of work? 

You can generally take a lump sum settlement or get smaller monthly or weekly payments. Deciding what kind of settlement to take is another area where legal advice is often helpful. A lawyer can discuss your options and what type of settlement makes the most sense in your situation. 

Things To Consider Before Hiring a Workers’ Compensation Lawyer 

Whether you should get a lawyer for your workers’ comp claim depends on your situation. There are many factors to consider:  

  • The complexity of the process 
  • The severity of your injuries 
  • How long you will be out of work 
  • If you have a pre-existing condition 
  • If your employer or insurance carrier disputes your claim 
  • If there are delays in receiving compensation 
  • If the settlement is insufficient for your medical or living expenses 
  • If your employer has retaliated against you for filing a claim 
  • The possibility of appeal and litigation if your claim is denied 

Obtaining legal representation in your workers’ comp case can become important if complex situations arise. 

“Getting an attorney puts the injured worker on equal footing with their employer and the insurance company. Certainly, the insurance company will have their own attorneys on retainer,” says Carlson.  

These attorneys will give the insurance company “legal advice throughout the process.” The insurance company will receive sound legal advice while handling your workers’ comp claim.  

“I think it’s very important for an injured worker, regardless of the severity of the injury or size of the case, to consult with a lawyer as soon as possible,” says Carlson.  

If an injured employee is worried about the cost of meeting with a lawyer, “initial consultations are free, and it really does put the injured worker on equal footing with the employer and insurance company,” he says.  

Questions for a Workers’ Comp Attorney 

Even if you decide to pursue your workers’ comp claim without legal representation, it can be beneficial to speak with an experienced workers’ compensation attorney about your case.  

An attorney will be able to explain your state’s workers’ comp laws, the process of filing a claim, and how to get a fair settlement. 

Many workers’ comp attorneys provide free consultations, meaning the initial meeting won’t cost you anything. These meetings allow you to get legal advice and make an informed decision about whether the attorney or law firm meets your needs. 

To get the most out of a consultation, ask informed questions such as: 

  • Do you charge your attorney’s fees on a contingency basis? 
  • What expenses can be covered by my workers’ comp case? 
  • How much can I get in my workers’ comp settlement? 
  • What is the workers’ comp claim process in my state? 
  • Is a settlement likely, or will litigation be involved? 

Look for a workers’ compensation attorney in the Super Lawyers directory to help with workers’ comp issues. 

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