What Does My Workers’ Compensation Lawyer Need to Know?
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What Questions Should I Expect at a Meeting with a Workers’ Compensation Lawyer?
It’s important to prepare for your first appointment with a workers’ compensation lawyer. Workers’ compensation pays valuable benefits to employees with work-related injuries or illnesses. However, eligibility and the claim and appeal processes vary from state to state. In order to evaluate your claim and provide accurate legal advice, the lawyer must have a lot of information. You can help streamline the interview process by compiling this data in advance. While every lawyer has his or her own interview process, this is a list of common questions.
How Did You Injure Yourself at Work?
Workers’ compensation is a no-fault system and you do not have to prove that your employer intentionally or negligently caused your injury. Most work-related injuries and illnesses are covered by workers’ compensation (as long as they arose out of your employment). This includes:
- Accidental injuries (such as a slip and fall),
- Repetitive use injuries (such as arthritis or carpal tunnel syndrome),
- Conditions caused by workplace exposures (such as hearing loss), and
- Occupational diseases (including mesothelioma and cancer).
If you have evidence showing your injury or illness is work-related, you are typically entitled to benefits. However, not all injuries and conditions are work-related. You may have difficulty winning your workers’ comp claim if your injury was caused by horseplay, illegal misconduct, intoxication, or fighting.
The workers’ compensation lawyer will want to know exactly how you injured yourself. It is important not to exaggerate or leave out facts when you describe your accident or injuries. Inaccurate information can impact the lawyer’s assessment of your claim (and can damage the attorney-client relationship).
Were You an Employee of the Company?
To be eligible for workers’ compensation, you must be a covered employee. Certain types of workers (such as agricultural workers and domestic workers) may not be protected by workers’ comp. And, independent contractors and volunteers are not typically considered employees under workers’ comp laws. However, some employers improperly categorize workers as independent contractors in order to avoid paying workers’ comp and other obligations. Do not assume you are ineligible for workers’ comp because you are called a contractor. (The workers’ comp lawyer can help you determine your employment status.)
What Workers’ Comp Benefits Are You Receiving?
You can only receive specific benefits in a workers’ compensation claim. These benefits typically include:
- Wage loss benefits (typically two-thirds of your average weekly wage),
- Reasonable medical treatment,
- Total and partial disability benefits (for the loss of function in a body part),
- Vocational retraining and assistance, and
- Death benefits.
You cannot receive punitive damages or compensation for your pain and suffering in a workers’ compensation case. Depending on where you live, the amount and duration of your benefits may vary.
Sometimes, disputes arise about whether specific medical treatment is necessary. Other times, the insurance company may incorrectly calculate your wage loss or disability benefits. And, the insurance company may completely deny your workers’ compensation claim. The lawyer must understand the exact dispute if your case.
If you have any unpaid medical bills, bring them with you to the appointment. Similarly, if the insurance company is not paying your wage loss benefits, you should bring in recent check stubs or income tax documents.
Have You Filed a Workers’ Compensation Claim or Appeal?
In order to receive workers’ compensation benefits, you must:
- Follow the correct procedures to notify your employer and file a workers’ comp claim. (If you do not follow the correct procedure, your benefits may be denied.)
- Seek medical treatment with an authorized doctor or clinic, and
- Cooperate with the insurance company’s investigation.
Additionally, specific notice and filing deadlines may apply. If you do not meet these deadlines, you may lose your right to workers’ compensation.
If the insurance company denies your claim, you have the right to appeal. Typically, you must file a complaint or petition with your state workers’ comp agency. Again, strict filing deadlines apply in workers’ comp appeals. A late appeal may be automatically dismissed by your state agency.
The lawyer will need to know exactly where you are in the claim process. If you have any documents from the insurance company or state agency (including a denial or approval of benefits), bring them with you to the appointment.
Are You Getting Medical Treatment?
Medical evidence is essential to a workers’ compensation claim. Medical records can:
- Document the severity of your injuries,
- Prove that your injuries are work-related,
- Establish your work restrictions and limitations, and
- Recommend additional treatment.
Without this information, it is virtually impossible to win a workers’ compensation claim. Your lawyer will need to know the names and addresses of every doctor or clinic that has treated your injuries. If you have any medical records, bring them with you to the appointment.
Are You Working?
Your ability (or inability) to work may impact the value of your workers’ compensation claim. The lawyer will need to know if:
- You have returned to work,
- Whether your wages are reduced, and
- Whether you are working for a new employer.
If you are working, bring your work restrictions and most recent check stubs to the appointment.
How Much Education and Work Experience Do You Have?
Some states pay wage loss and disability benefits only if you have a reduction in your wage earning capacity. In these states, you must prove that you cannot perform work within your training and qualifications (or that your ability to earn wages is reduced). Your ability to transition to new work will vary, depending on your level of work experience and education. If you have an up-to-date resume, bring it to your appointment.
Are You Receiving Any Other Insurance, State, or Federal Benefits?
Certain benefits, including Social Security and unemployment and short-term disability, can reduce your workers’ compensation benefits. In order to correctly calculate your workers’ compensation benefits, the lawyer must know what offsets are involved.
If you are a Medicare or Medicaid beneficiary, you must also contact these agencies and protect their interests before you settle your workers’ compensation claim. You may have to repay any conditional payments made by Medicaid or Medicare. And, you may have to establish a Medicare Set-Aside Trust Account. If you do not follow Medicaid and Medicare’s rules, you may be penalized. Make sure you tell your lawyer about any other benefits you are receiving.
What Should I Bring to a Meeting with a Workers’ Comp Lawyer?
It is important to bring any evidence you have to your first appointment. This may include:
- Medical records and accident reports,
- Work restriction slips,
- Unpaid medical bills,
- Correspondence between you, your employer, and the insurance company
- Check stubs or W-2 forms,
- Your up-to-date resume, and
- Any documents that you have filed (or received) from your state’s workers’ compensation agency.
This information will help the lawyer evaluate and understand your workers’ comp claim.
Do I Need a Workers’ Compensation Lawyer?
Workers’ compensation claims require a detailed understanding of legal, medical, and vocational issues. And, many states’ laws have changed dramatically over the past decade. It may be in your best interest to speak with a workers’ compensation lawyer. An experienced lawyer can help you understand your rights and guide you through the claim and appeal processes.
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Last Modified: 03-22-2017 10:44 PM PDT
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