Do I Need an Attorney for a Workers’ Comp Claim?

September 14, 2021

Know When to Get Help: Our Workers’ Compensation Lawyer in Philadelphia, PA Explains When to Call a Lawyer

Workers’ compensation is a no-fault system of benefits for injured workers. This means fault or liability does not need to be established. As a result, many people wonder if they can handle a workers’ comp claim themselves. After all, most people have handled an insurance claim at one point or another through homeowners, auto, or maybe even just a medical billing issue. While there are certainly instances where a workers’ comp claim could be similar in difficulty, some factors make WC claims much more complex and have higher stakes. As a result, it is crucial for injured workers to know when they need an attorney for a workers’ comp claim. Our workers’ compensation attorneys in Philadelphia, PA, explain.

What to Realize About Workers’ Compensation

Although workers’ comp is a no-fault system, it still is administered through a state-licensed insurance company. Insurance carriers have one goal in mind—protecting their bottom line. While WC carriers generally are better about fairly paying claims, that is not always true. They employ “independent” medical examiners to evaluate your injuries, disability, and future treatment.

The WC carrier pays for these “independent” medical examiners, who get further business through the carrier and usually develop relationships with insurance adjusters or WC defense attorneys to handle hundreds if not thousands of cases together each year. Rogue examiners do not last long. Thus, while medical professionals are legally and ethically bound by certain duties, you can imagine that most “independent” medical examiners will be biased in their opinions about your injuries or disability.

In addition, there are short and sometimes unforgiving time limits on giving notice of a claim, submitting a claim, responding to inquiries, and appealing an adverse decision. Failing to comply with these timeframes often may result in denial of your claim or precluding your right to challenge an adverse decision. If you are suffering from serious or significant disability or illness, these factors can make handling a WC claim yourself very difficult. Therefore, it is recommended to call a Philadelphia work injury attorney for help in these circumstances.

When You May Be Able to Handle a Workers’ Comp Claim Yourself

Whether you can handle a workers’ comp claim yourself depends on the severity of your injury, the complexity of your claim, your overall health pre-accident, actions of your employer, whether a third party was involved, and other related facts. Generally, you may be able to handle a WC claim in Pennsylvania without hiring an attorney if:

● You suffered a mild injury such as a laceration, muscle strain/back strain, rolled ankle, or other minor, temporary injury
● You do not have any pre-existing injuries or conditions which could have caused or contributed to the work-related injury or illness
● It is indisputable that your injury occurred at work (witnesses, on camera, or your employer admits it)
● You missed little or no time from work
● Your medical bills were minor
● You are comfortable filling out lengthy forms (you can understand, read, and write English)
● Your employment status with your employer is obvious (i.e., you are not an independent contractor)
● Your employer carries workers’ comp insurance
● The case appears to be straight-forward, and
● Other factors you may feel you can handle yourself.

If any of these factors above give you reason to hesitate about handling the claim yourself, contact an experienced workers’ compensation attorney in Philadelphia, PA, for help.

Factors That Indicate a Lawyer’s Help is Necessary

In addition to any of the factors above resulting in you not feeling comfortable handling your WC claim, some of the other issues that might lead you to immediately consider hiring a lawyer for help include the following:

● Your employer was supposed to have WC insurance but does not
● Your employer rejected your claim, failed to timely submit your claim, or refutes the accident occurred at work
● You have a workplace illness that could have been caused outside of work or has no obvious connection to work, but your primary care physician or another healthcare provider indicated it is a possibility
● You suffered serious or catastrophic injuries such as a brain injury, spinal cord injury, broken bone, amputation, organ injury, blindness, or other debilitating condition
● You have been out of work for a long period of time, or you are being held out of work for a long period of time
● You may be entitled to Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), or you were already approved for SSDI/SSI
● You need or already had surgery
● You have significant lost wages
● A third party may have caused or contributed to your injuries
● Your employer, supervisor, manager, or coworkers refute your claim
● You will have a permanent disability
● An independent medical examiner has unfairly limited your disability or claims there are minor injuries when your injuries are clearly much worse
● You have a back or neck injury and the independent medical examiner or adjuster is claiming it was “preexisting,” “degenerative,” or otherwise through normal aging processes
● English is not your first language
● Your injuries or illness prevents you from completing the paperwork or makes it more difficult to complete
● You handled your claim yourself, but it was denied and you want to know how to appeal, and
● Any other factors that make you hesitate whether you need to get help.

Never Hesitate to Ask Us for Help: Our Workers’ Comp Attorneys Offer FREE Consultations

Here at Larry Pitt & Associates, our experienced workers’ compensation attorneys in Philadelphia, PA, know how important it is for you and your family to be properly covered for lost wages and medical bills after a workplace accident or illness prevent you from working. We know it is tempting to try to handle a claim without a lawyer, but that is often a huge mistake. Even minor injuries could result in an adjuster taking advantage of you. Learn how we can help you and your family during a FREE consultation by calling (888)-PITT-LAW or (877) 748-8529 or by sending us a private and confidential message through our easy-to-use contact us box available here.