For the past few weeks, we’ve been discussing Workers’ Compensation Insurance, the policy that compensates employees for their occupational injuries and diseases. Our post “How Do I File a Workers’ Comp Claim?” navigated you through the meticulous process of responding to a workplace accident.
Now you may be wondering whether or not you need a Workers’ Compensation lawyer to protect your business’s interests throughout the claims process. After all, there is a lot of money at stake and several entities – including insurance providers, medical practitioners, your employee, and the state’s Workers’ Comp board – are involved in a single claim.
The good news is that small-business owners rarely need to hire a lawyer for Workers’ Compensation claims because claims rarely turn into lawsuits. Usually, your injured employee is simply exercising their right to compensation, and your insurance provider will decide whether they are eligible for benefits.
However, it’s not uncommon for employees to hire Workers’ Compensation lawyers to help them through the claims process. And, of course, claims don’t always unfold so smoothly.
What Does a Workers’ Compensation Lawyer Do?
Employees may hire a lawyer when filing a claim for Workers’ Compensation Insurance benefits. As we discussed in our post “How Do I Handle a Workers’ Comp Claim?” this action is not usually necessary, but an employee may feel more comfortable doing so if…
- They don’t understand how the claims process works.
- They want to make absolutely sure they are filing correctly.
- They feel a lawyer can help them prepare their case better than they could alone.
Speaking openly to employees about their Workers’ Compensation benefits may reduce the likelihood that they will involve lawyers in a claim. But even if they do, filing for Workers’ Comp benefits is much different than negotiating a settlement, defending a person in court, and other areas of a lawyer’s expertise. Workers’ Compensation lawyers help employees…
- Navigate Workers’ Compensation laws. As you know, each state’s laws are different and every rule must be followed in order to be eligible for benefits. (For more information, consult our state-by-state guide to Workers’ Compensation laws.) Employees may feel more comfortable working with a local lawyer who thoroughly understands the law.
- Build their case. A lawyer will be able to analyze the details of a particular case to make sure an employee receives proper benefits. They might look over medical records to determine the extent of the injury in question. They might also look at your business’s records to see if you’ve had any previous safety violations.
- Determine a rightful benefit. Lawyers help employees asses the cost of their injury or illness to determine how much money they should receive (based on your state’s law). In order to do so, they will consider medical costs, rehabilitation costs, and the type of disability the employee incurs.
Lawyers can also advise employees after your insurance provider decides whether or not to grant the employee benefits. If the claim is denied or the payout is unsatisfactory, the employee’s lawyer may encourage them to appeal the decision. In this case, you might need a lawyer of your own.
When Do Small-Business Owners Need a Workers’ Comp Lawyer?
Despite the fact that the majority of Workers’ Compensation Insurance claims can be resolved without the help of an attorney, there are a couple instances when small-business owners benefit from legal counsel:
- Your employee appeals your insurer’s claim decision. Usually this happens when a benefits claim is denied. If employees are dissatisfied with the claims decision, they can appeal. In this case, your insurance provider will likely appoint you an attorney.
- Your employee rejects their right to benefits. When employees file a Workers’ Comp claim, they are no longer able to sue your business for their occupational injuries. However, they can reject these benefits from the get-go and sue your business instead. This is called an Employer’s Liability lawsuit, and most Workers’ Compensation policies come with protection to help you pay for the legal costs associated with such a claim – including hiring a lawyer. To learn more, read “What Is Employer’s Liability Insurance?” on our blog.
- You don’t carry Workers’ Compensation Insurance. If you decide to forego Workers’ Compensation Insurance and break the law, you’ll definitely need a lawyer to represent you when OSHA comes knocking at your door. If an employee is injured and you don’t carry proper insurance, you can be found liable for penalties and the cost of the lawsuit. Additionally, you probably won’t be able to use certain defenses in your case. To learn just how much this can cost you, read our post “What Happens If I Don’t Have Workers’ Compensation Insurance?”
This post is part of an ongoing series on Workers’ Compensation Insurance and the high cost of occupational injuries. Stay tuned for more on how to handle work injury claims, adhere to state Workers’ Comp laws, and find affordable coverage!