Workers' compensation claims are usually routine, especially for minor injuries, but there are situations when you can be denied a claim for obvious injuries. You may have already been awarded benefits, only to have them taken away. The following are four different examples of when you should consult an attorney.
Your claim has been denied because it wasn't well-documented
This can happen even with a serious injury. There were no witnesses, so your employer or an insurance representative says you were careless, or not following procedure; although the accident was tragic, you only have yourself to blame. An attorney may be able to argue that even without witnesses, you are not at fault. Your claim can be denied simply because the accident occurred on a Monday. Your employer may be able to say that you were injured over the weekend when you came to work, allowing you to file a workers' compensation claim.
Your employer or the insurance company thinks you're ready to work
You know that you're not ready to work, but you're also being told that your benefits will not continue. An attorney can help document your efforts at rehabilitation and give an accurate assessment of your current condition.
Your employer or insurance company thinks you're faking your injuries
Perhaps you were under surveillance, and there is a video of you doing physical movement that is incompatible with your medical condition. Or maybe there was an anonymous tip that claimed you were not really injured. Even if the tip is false, or a video is out of context, you can lose your benefits. An attorney may be able to help.
You are offered a lump-sum settlement
If your condition has reached a medical end point, it may be time for a lump-sum settlement. In most states, this will be for future wages that will be unrealized because of your injuries. It may also include compensation for these injuries related to the quality of your life. This type of settlement should never be done without an attorney. An insurance company may realize where you're headed in your rehabilitation and offer you a settlement before you start thinking about legal representation. If you find yourself in this situation, do not sign any paperwork. Take the offer to a workers' compensation lawyer.
Anytime there is a problem with workers' compensation benefits, you should remember that the insurance company is not on your side. If you're denied a legitimate claim, consult an attorney. If you are being threatened with a loss of benefits because you are faking an injury, or you are told you have to go back to work when you're not ready, consult an attorney. And if the insurance company offers you a settlement, hire an attorney to negotiate for you.Share