Workers' Compensation Lawyers

What a workers' compensation lawyer actually does

Workers' compensation is a no-fault system. You do not prove your employer was careless; you prove the injury arose out of and in the course of employment. In exchange you receive medical treatment and partial wage replacement, and you give up the right to sue your employer.

Because fault is not in issue, the disputes that arise are narrower and more technical than in ordinary injury litigation. They are usually about whether the injury is work-related at all, how severe and how permanent it is, what your pre-injury earnings actually were, whether you can return to work and on what restrictions, and what a permanent impairment is worth. What decides a contested claim goes through each of those.

What it costs, and why the answer is unusual

Workers' compensation fees do not work like the contingency arrangements people are used to hearing about. In ordinary personal injury work the percentage is a matter of contract, and a third or more is common. In workers' compensation, most states cap the fee by statute and require a judge or board to approve it before it can be paid.

The practical effects are worth knowing. The permitted percentages are generally well below standard contingency rates. In several states the fee can only be charged on benefits the attorney actually secured, not on benefits the insurer was already paying. And because approval is judicial, the fee is reviewable rather than simply agreed.

What this means for you is that the cost of asking is usually low, and that any attorney quoting an ordinary contingency percentage for a pure benefits claim is worth questioning. What a workers' comp lawyer can charge covers the caps, how they are calculated, and the expenses question that changes your net figure.

When representation is worth it, and when it is not

For an accepted claim with a short recovery and no argument about anything, handling it yourself is often sensible. These are the situations where that changes:

• The claim has been denied, or benefits were started and then stopped.
• The injury is permanent, or an impairment rating has been assessed that you think understates it.
• You are being returned to work on restrictions you do not think are safe, or being offered light duty that exceeds them.
• An independent medical examination has been arranged by the insurer — the examining doctor is chosen and paid by them.
• A settlement is being offered before you have reached maximum medical improvement, so the long-term picture is not yet known.
• Anyone other than your employer may have contributed to the accident.

The claim a benefits-only case may never look at

Workers' compensation is the exclusive remedy against your employer. It is not a remedy against anyone else — and industrial sites are full of anyone else. Equipment manufacturers, general contractors, maintenance firms, site operators, chemical suppliers, drivers.

A third-party claim against one of them is ordinary civil litigation. It is not capped by the workers' compensation benefit schedule, it can cover pain and suffering and full lost earnings, and it runs on a different deadline set by a different part of state law. Filing for benefits does not preserve it.

This is the single most common gap in a work injury case, and it is a question worth asking whoever is handling your benefits claim. See third-party work injury claims and how the two systems compare.

What the insurer is doing while you recover

The adjuster handling your claim is not a neutral party, though the relationship is usually cordial. Their file is being built from the moment the injury is reported: the first report of injury, any recorded statement, the gap between the accident and your first medical visit, surveillance in some cases, and the report of any examination they arrange.

None of that is improper, and most claims proceed without incident. But it does mean that what you say early carries weight later, and that an early settlement offer reflects what is known at the time it is made rather than what the injury turns out to cost. See what not to say to an adjuster and dealing with the insurer.

How do I work out which route applies to me?

Two questions settle most of it: has anything about the benefits claim gone wrong, and was anyone other than your employer involved. Which route applies to you walks through the three patterns nearly every work injury falls into. If a claim has already been refused, workers' comp denied covers what happens next.