When workers are injured on the job, the number-one priority is to get them immediate medical attention and ultimately back to work as soon as they are able. Workers’ Compensation insurance responds to on-the-job injuries and illnesses and pays for medical treatment, temporary disability, loss of wages up to a certain amount, and payment for permanent disability.
The optimum scenario in the event of a workplace accident is for the employer, medical professional, and insurance company to work in concert – all in the best interest of the injured worker. This, however, is not always the case and attorneys become involved in the mix. Attorney involvement occurs for several reasons.
Lack of Communication
In general, most employees aren’t familiar with the Workers’ Compensation system. When they become injured, they typically don’t understand how the process works and what to expect. The more time that goes by without communication from the employer and/or the insurer’s claims adjuster, the more likely the injured worker will turn to an attorney for help.
Prescient National recommends a three-point contact that begins within 24 hours of receipt of injury:
- Employer contacts the insurer to report an accident and provide the necessary information.
- A claims adjuster contacts the medical professional on the case to go over the recommended medical treatment required.
- Employer communicates with the injured employee immediately post-injury to reinforce that their health and welfare come first. If an employee feels as if they are not being heard, they may distrust the process or feel that the employer doesn’t care about their wellbeing. An employer’s positive involvement in the post-injury experience can reduce the need for the injured worker to consult an attorney. The claims adjuster should also immediately contact the injured worker to explain how Workers’ Compensation benefits work and the injured worker’s obligations.
Both the employer and claims adjuster should maintain ongoing communication with the injured worker.
Advice from Family and Friends
Again, because most employees are not familiar with the Workers’ Compensation system until they are injured on the job, they may begin to ask family and friends questions about the process and how compensation works. Some may have had an injury and shared their experience, including the fact that they retained an attorney to help with their claim. Often, after a holiday weekend where big gatherings take place, there is a spike in attorney involvement with Workers’ Compensation cases.
Employee Dissatisfaction
The less satisfied an employee is with his or her job prior to an accident, the more likely it is that a work injury will result in the hiring of an attorney. Extensive absences due to a job-related injury are frequently associated with job dissatisfaction. A mutually beneficial employer/employee relationship should foster an environment in which the injured worker wishes to return to work as soon as possible, thereby reducing the possibility of legal involvement.
Attorney Advertising
Attorneys advertise their Workers’ Compensation expertise and ability to get large compensation settlements from insurers on television, on their websites, and on social media platforms. Just search “Workers’ Compensation accident lawyer” or a variation of this term and you will see page after page of law firms advertising their services and why injured workers need an attorney to “fight to get the benefits they deserve.” Legal consultation is free and the attorney doesn’t get paid unless a settlement is reached so the injured worker may feel he or she has everything to gain. However, while an injured employee may feel he or she will get more compensation from the insurance company with an attorney in his or her corner, it doesn’t necessarily work out this way after taking into account the attorney’s percentage of the settlement.
Claim Denial
The insurance company receives a report of injury, investigates the facts, and determines that the injury did not arise out of and in the course of employment and/or there is no compensable incapacity related to an injury. This could trigger the injured worker to call an attorney to get involved.
Prescient National’s claims adjusters are committed to collaborating with employers on each claim for excellent results. This means communicating with injured employees immediately so they understand the process and get the treatment they require. We also work with employers and medical professionals to see if an employer can accommodate light-duty work. A return-to-work program offers alternative job duties to injured workers for a better claims experience and a happier workforce.
