Getting injured on the job can be painful and stressful, not to mention life-altering if your injuries are serious. While the workers’ compensation insurance program is designed to pay injured employees financial compensation, it wasn’t technically created to protect employees. It was created to protect employers from lawsuits and reduce the strain on the court system. Because of this, the system doesn’t always work in favor of legitimately injured employees.
If you feel like you’ve been short-changed by this system, either through a denied claim, denied appeal, or lack of coverage, it’s important to know when to get a lawyer involved. Without an attorney, you probably won’t get very far with an unfairly denied claim or an employer who is breaking the law. Knowing when to hire a workers’ comp lawyer can mean the difference between being shorted and receiving the full benefits you deserve.
Here are some of the top signs that it’s time to retain legal counsel.
1. Your employer doesn’t have workers’ comp insurance
With limited exceptions, most employers are required to carry a workers’ compensation insurance policy. Each state has a different set of requirements, but they’re similar in the sense that the requirement is usually triggered when a business hires just a couple of employees. This means even small businesses that only have an office staff of five or six people are usually required to carry workers’ comp.
If you were injured, tried to file a workers’ comp claim, and were told there’s no policy to file a claim with, then there’s a chance you might have a strong case against your employer. You’ll need to consult with an attorney to find out for sure because even if your employer is breaking the law by not having a policy, there are some injuries that don’t qualify for compensation. A workers’ comp attorney can help you sort everything out properly.
2. Your valid claim was denied
The reality of workers’ comp is that it’s run by insurance companies that exist to make a profit, and their end game is to pay out as little as possible. Often, insurance companies deny perfectly valid claims hoping people will just give up and not even try to appeal.
Common injuries that are typically valid include:
· Overexertion when lifting, pushing, pulling, carrying, or throwing heavy objects
· Slips, trips, and falls, whether it’s on the same level (like slipping on the floor) or falling from a ladder or roof
· Being struck by an object or piece of equipment
· Repetitive motion injuries
If you have a valid injury claim that was unfairly denied, that’s a sign you need to talk to an attorney. Insurance companies can come up with all sorts of reasons for denying a claim, whether or not it’s based in truth. A lawyer will be able to look at your injury, your claim, and the denial letter to spot any games the insurance company may be playing.
3. Your employer is interfering with your claim
It’s unfortunate, but sometimes employers intentionally do things to deny a workers’ comp claim because they don’t want their premiums to rise. They’ll do things like deny your claim on false grounds, tell the insurance company your injury happened off the clock or was not sustained at work. They might even claim you were hurt while roughhousing with another employee, knowing that type of injury isn’t eligible.
If you believe or know your employer has been interfering in your ability to file a claim to receive benefits, it’s definitely time to call a lawyer.
4. You’re not sure if your denied claim is valid
If your workers’ comp claim was denied, but you’re not actually sure if your claim was valid to start with, it’s always a wise move to talk with an attorney.
Around 7% of all workers’ comp claims are denied, and many are valid denials. The following reasons for denying a claim are valid:
· The filing deadline was missed
· The injury wasn’t work-related
· The injury or condition doesn’t meet workers’ comp guidelines
· The claim was filed after the employee quit
· The injury was the result of rough housing or a prank
Most legal consultations are free, so it won’t cost you more than your time. Talking to a lawyer is the only way to know for certain.
Exercise your rights
Insurance companies and employers don’t always play by the rules. When you’re unfairly denied, your only option to recover compensation for your injury is to get a lawyer.
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