Someone who gets injured at work and needs to file a workers’ compensation claim hopefully can rely on the system working smoothly to provide complete care and other benefits. One hopes that injured workers have access to good advice through their employers or a third-party claims administrator, and that everyone involved will try hard to ensure that the worker receives all the benefits that are owed under state law. Unfortunately, this isn’t always how things go. Like every kind of insurance, workers’ compensation often raises conflicts of interest, disputes about medical diagnoses or treatment plans, and other problems that a worker who isn’t represented by an attorney may struggle to overcome.
How an attorney facilitates workers’ comp claims
The role of a workers’ compensation attorney is to protect the client’s interests and ensure that all the benefits to which the worker is entitled are properly paid. Within the scope of that work there are a number of important things an attorney can do for the client:
- Ensure that claims paperwork is completed correctly and on time.
- Monitor the medical evaluation process to verify that the client isn’t railroaded into accepting an incorrect or incomplete diagnosis.
- Raise and resolve concerns with how coverage is being provided.
- Keep track of important records that may be vital if the claims process needs to be taken into a dispute resolution proceeding or litigation.
- Advise the client on when and how to dispute insurer decisions.
When should you hire an attorney?
Whether an individual needs the help of an attorney is really a question that needs to be answered after taking stock of all the facts of the individual’s case. It never hurts to reach out to an attorney who offers free consultations to determine if representation is necessary. Broadly speaking, the help of an attorney is more important if complicating factors are present. Some examples of these include:
- Severe injuries. An attorney’s help can make a huge difference for someone who has suffered a serious injury that will involve significant health care expenses, long periods off work, or some form of disability. Such injuries cost workers a lot of time, money, and stress. Ensuring that workers’ compensation benefits cover everything the worker needs takes planning and close oversight. In part this is because high-cost claims often end up in disputes as insurers look for ways to limit their financial exposure.
- Wrongfully denied claims. Someone who feels they’ve had their claim wrongfully turned down may need to file an appeal. Although an attorney isn’t necessarily required to make an appeal, the chances of an appeal succeeding gets significantly better if an attorney is involved, especially if the attorney has been involved from early in the process.
- Medical disputes. Many types of injury are subject to a wide variety of medical diagnoses. A strained back could be diagnosed as a muscular problem or as a slipped disc. A headache might be diagnosed as a concussion or as a more severe type of head trauma. Insurers know this and will use the medical examination process to find ways to restrict their exposure. An attorney can make sure the client knows how to exercise important rights like the option for seeking a second opinion.
The law firm of Greenman Goldberg Raby Martinez has represented clients in workers’ compensation cases for over 45 years. We provide personal, caring service to each and every client. For a free attorney consultation about your case call us at 702-388-4476 or through our contacts page