Worker's Compensation Case

What Does a Worker’s Compensation Case Actually Look Like in Practice?

Worker’s compensation insurance is mandatory in all states. But how and when does it help? Everyone hopes for a great and fulfilling day at work. Unfortunately, not every day turns as you hoped it would.

Perhaps you started your day at work well as usual. You feel motivated and productive. Then, as you head to the manager’s office to submit your end-of-the-day report, you accidentally slip and fall on wet pavement.

What seemed like a perfect day turns into chaos, and you are immediately rushed to the nearest health facility.

Your hip bone is dislocated, and you have to go on bed rest for some days. What’s next? You must be feeling frustrated. You have a hospital bill to pay and cannot make it to work for a few days, weeks, or even months.

While nothing can be done to take things back to how they were before the accident, worker’s compensation can make you feel better, emotionally and financially.

If you find yourself in such a situation or suffer any workplace injuries, this guide is for you. Keep scrolling to learn everything you should know about worker’s compensation.

What Is Worker’s Compensation?

When injured while at work, you are eligible for compensation offered by the employer’s insurance. The insurance covers the incurred hospital bills and lost wages during the recovery period.

Worker’s compensation insurance aims to help injured workers to recover from injury without stressing about the piling medical bills. It also makes things easier for the employer and gives them peace of mind knowing that they are financially protected if the unexpected happens.

Nonetheless, the compensation process is not always as easy as it sounds. Sometimes, the victim may not accept the amount offered by the insurer. They may feel like the compensation amount is unfair based on the extent of injuries.

In such cases, the injured employee is eligible to file a claim against the employer’s insurer and fight for what they believe is the best compensation value.

How Does the Claim Compensation Settlement Work?

As an employee, if your employer fails to accept your compensation claim, you should hire a workers compensation attorney to help you push for the deserved payment.

The attorney has experience, and you, therefore, get a professional perspective. The law expert will review your case to establish if you should accept the offer or push for a higher amount. To do so, the lawyer considers;

  • The incurred medical costs
  • The possible future medical costs related to the sustained injuries
  • The lost wage during the recovery process
  • Disability compensation, if applicable
  • Retraining fee if necessary
  • Legal fees

These aspects will help the attorney come up with a reasonable average compensation amount when summed up. The amount can be slightly higher to give room for negotiations.

How Do You Prove that the Accident Happened at the Workplace?

Where there is a lack of clarity, or your employer feels that you are not honest about the incident, it is up to you to prove that, indeed, the accident occurred while on the line of duty.

Again, hiring a law expert will come in handy in gathering substantial evidence to prove your case. With their skills and expertise, the best attorney can quickly establish a connection between your work and injury.

The expert has handled similar cases before and knows how and where to look for evidence. Without proof, you might deny you the benefits.

The Discovery Process

To avoid complicating the evidence-gathering process, you may undergo a pretrial legal discovery, where you share evidence with the other party before the actual trial.

The discovery process prevents trial by ambush. Your employer will have an idea of what happened, and you also get their side of view. In return, this helps you to weigh the strengths and weaknesses of your case before trial.

The best way to undergo discovery is through interrogations, medical examinations, and depositions. The insurance company will send questions to you as the injured worker that you must answer to help them find out more about what happened.

Your attorney will help you prepare to answer those questions in a way that does not contradict your case. The lawyer will also be with you through the deposition.

When Does the Legal Discovery Happen?

Upon requesting a hearing session, a hearing date is set, which will be within 30 days. During this period, you have enough time to collect evidence and conduct discovery until about two weeks before the hearing date.

When Should You Lawyer Up?

Pushing for higher compensation should not be the only reason to hire a law expert. Some other instances that will make you consider hiring an attorney include:

If the Employer Denies that Your Injury Is Work-Related

You should also consider hiring a lawyer if there are misunderstandings on what caused the injury.

In some instances, the employer will try to evade the compensation claim. You may be accused that the injury happened outside the workplace or you had a preexisting condition that caused the illness.

Hiring a reliable attorney will ensure that your rights are protected and get the compensation amount you deserve.

The Insurer Disputes Your Permanent Disability Ratings

The worker’s compensation insurance mainly goes to permanent disability benefits. The benefits are massive but are calculated depending on your permanent disability rating offered by your doctor.

If your employer disregards the results, you should undoubtedly consider a lawyer. The insurer will require you to go to an independent medical examination with a doctor of their choice. The doctor will most likely offer you a lower permanent disability rating, which could disqualify you from the benefits. If you are not careful enough, you may end up falling for this trick.

The lawyer understands the game better and will use their knowledge and power to rebuke the ratings until you get what you deserve.

You Have a Preexisting Illness

If you have a preexisting condition in the same area where you got injured, you should be prepared to go on an uphill battle with the insurance company.

The insurance will deny that your injury is work-related and will blame the preexisting illness for it. An attorney comes through to help you prove the insurance company wrong.

You Cannot Go Back to Work Soon

If the is extreme to the extent of compromising your ability to work, that means you deserve more lost wage compensation.

It might take you years or forever to go back to the office. The compensation should be structured in a way that will make your life without a job easier to manage.

You might also need to change your career now that your previous one is shuttered. A career change calls for training, which is equivalent to more money required. The lawyer will apply their negotiation skills to see all these factors observed.

Essential Things to Note Before Filing a Worker’s Compensation Claim

The period after a workplace injury or illness can be confusing. You are not only in physical pain but also feeling emotionally drained. The thought of not going back to work soon is awful, not to forget that you are in dire need of fast cash to settle the incurred bills.

With all these going through your mind, you may find yourself making hasty decisions. But here is an overview of essential things to note before you rush to file a claim.

You Cannot Sue Your Employer for a Workplace Injury or Illness

Worker’s compensation is like a benefit or tradeoff for employers and employees. When injured, you receive compensation for the lost wages and incurred bills. You, therefore, cannot sue your employer after receiving the benefits.

However, you can sue them if you realize that they intentionally hurt you. This can only be established after conducting a thorough investigation to prove that your employer was reckless or did the action intentionally to hurt you.

Not All Injury Cases Qualify for Compensation

If you get ill at work due to a preexisting issue or suffer an injury due to your negligence, you are not eligible for compensation. Worker’s compensation is only granted to employees that are injured due to the employer’s negligence.

Also, if you only suffered a minor injury, such as a cut that does not affect your working capability, there is no point in filing a claim.

Seek Legal Assistance to Maximize Your Compensation Benefits

Now that you know what to expect during a worker’s compensation case, you are better positioned to make wise decisions that will not contradict your case. The best and most crucial step is to hire a lawyer to take you through the legal process.

The law expert will not rest until you get the best value compensation. In a case of denial, the attorney can quickly prove that you qualify for compensation.

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