While an attorney is not necessary for every workers’ compensation claim, there are many cases in which having one is recommended. You should hire an attorney if you do not understand the workers’ compensation process, your injury or disability is being disputed, your injury is serious or complex in nature, or you are concerned about benefit and settlement specifics. The role of a workers’ compensation attorney is to protect your rights and enable you to focus on recovering from your injuries.
Pennsylvania Workers’ Compensation is Complicated
Because Pennsylvania workers’ compensation law is always changing, it is complicated. For example, there was a roughly 18-month period in which IREs were deemed unconstitutional, but they are now back in an altered capacity; however, the constitutionality of the new provisions is still being challenged as is the impact of the new law on old cases.
You will also be sent many forms to fill out. Some of these forms are not necessary and others will cause your benefits to stop if they are not completed correctly and in a timely manner. An attorney can help you sift through these forms and the information you receive from your employer. You may be given incorrect or outdated information regarding your case, either by accident or on purpose, by your employer or the insurance company. Some common misinformation includes:
- That you must treat with the company doctor or that the company can disregard the opinions of your own treating doctors;
- That you do not qualify for workers’ compensation because you are not a full-time employee;
- That your injury is not covered by workers’ compensation for some reason;
- Incorrect deadlines for when certain forms must be filed;
- An unapproved list of physicians to treat with;
- That your employer has workers’ compensation coverage, when in fact, they do not; and
- Threats of retaliation if you file a claim.
Your Workplace Injury or Disability is Disputed
In many cases, your workplace injury or disability may be disputed. These disputes will come from either your employer or their insurance company and can take a few different forms. Depending on the nature of your injury, one form these disputes can take is when it is denied that your injury happened in the course and scope of your employment. If you fall from a ladder at work and injure your back, especially if there are witnesses, it is unlikely for this type of denial to happen. But if there were no witnesses, you are suffering from a repetitive stress injury, or you partake in potentially dangerous physical activities in your spare time, it may be argued that your injury did not occur at work.
Another common dispute arises from a disagreement regarding the extent of your injury. Your employer, their insurer, or the treating physician may claim that you are ready to return to work even if you do not think that to be the case. If they believe you have sufficiently healed, they may request an independent medical examination (IME) or attempt to stop your benefits.
Your Injury is Serious or Complex
Serious injuries often result in extended periods of time off work, or in more extreme cases, permanent withdrawal from the workforce. These injuries also generally require extensive medical coverage that lasts far into the future — something employers and insurers are not keen on paying for. Because of this, they may try various ways of getting your benefits stopped, including by pressuring you into taking a settlement.
Some less severe injuries can be just as difficult to receive compensation for if the circumstances surrounding them are complex. Any time a pre-existing injury or condition is present, it is something that the insurance company will jump on in an attempt to downplay your new injury. Additionally, if you develop symptoms over time, such as through a repetitive stress injury or a head injury with delayed symptoms, the insurer will attempt to distance those symptoms from your claimed workplace injury. Because of this, it can be tricky for an individual to prove that their symptoms are related to their work injury without help gathering evidence.
And in some cases, the complexity may arise from a third party being involved in your injury. This may mean that you have additional claims you can make against the third party. But on the other hand, it could also mean that both the third party and the insurance company are claiming that the other party is responsible for paying your compensation, making it more difficult for you to receive it in a timely manner.
You Are Concerned About Benefits or a Settlement
Aside from recovering from your injuries, the one thing that is most likely going to be at the front of your mind is your financial situation. Your benefits may not be enough to cover your bills. Or, perhaps your benefits were delayed or temporarily stopped for some reason. In these situations, you may have questions about how to get your benefits turned back on or whether or not it may be better to take a settlement.
Settlements are tricky in injury cases because they are one-time payments that often will not be large enough to cover future medical expenses if you require further treatment down the road. Because of this, it is generally a good idea to be cautious about a settlement. A workers’ compensation attorney can help determine if a settlement is right for you.
An attorney is not necessary for every workers’ compensation claim, but it is always recommended. Workers’ compensation law is complex and not something injured workers usually can and want to deal with. Additionally, if your injury or disability is disputed or serious or complex in nature, an attorney can help ensure you get the compensation you deserve. Finally, benefits and settlement offers may not be enough to cover all of your expenses. When this is the case, it helps to have someone in your corner fighting for you.
My name is Geoffrey Hillsberg, and I have solely practiced Workers’ Compensation Law in the state of Pennsylvania since 1995. Contact my law office today if you have been injured on the job. I will put my decades of experience to work for you and your right to compensation.
The advice offered above is general in nature and may not be applicable to every case. Consultation with an attorney is highly recommended. Reliance on this advice does not represent the formation of an attorney-client relationship in the absence of a fee agreement with Mr. Hillsberg.