The Small-Business Owner's Guide to Workers' Compensation Insurance

Chapter 3: Everything You Need to Know about Workers' Comp Claims
Part 3: Do I Need a Workers' Compensation Lawyer?

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 a single claim involves several entities.

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.

Although it's rare for an employer to need a Workers' Compensation lawyer, it's not uncommon for an employee to hire one to help them through a claim.

What Does a Workers' Compensation Lawyer Do?

Though employees don't necessarily need a lawyer when filing a claim for Workers' Comp benefits, they 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, every rule must be followed for a claimant to be eligible for benefits. Employees may feel more comfortable working with a local lawyer who thoroughly understands the state's 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 assess 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 the employee's medical costs, rehabilitation costs, and type of disability.

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 might 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 claim decision, they can appeal. In this case, your insurance provider may 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 over their occupational injuries. However, they can reject these benefits from the outset and sue your business instead. (This is where your Employer's Liability Insurance kicks in.)
  • You don't carry Workers' Compensation Insurance. If you decide to break the law and forgo Workers' Compensation Insurance, 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.

Now that you understand some of the finer points of Workers' Comp claims, let's explore how to prevent workplace accidents from happening.

Next: Part 4: How to Prevent Workers' Comp Claims

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