What Does A Workers Compensation Attorney Do?

A workers’ compensation attorney specializes in helping injured workers navigate the complex legal system to secure benefits they’re entitled to under state law. These legal professionals handle everything from filing initial claims to representing clients in court, ensuring injured workers receive proper medical care, disability payments, and vocational rehabilitation services while protecting them from employer retaliation.

Responsibilities of a Workers’ Comp Attorney

At its core, a workers’ comp attorney serves four primary functions. First, they evaluate and document your case. Then, they manage all interactions with insurance companies. They also calculate and pursue maximum benefits. Furthermore, they represent you in disputes or hearings.

Initial Case Evaluation and Documentation

During your evaluation, your attorney examines all medical records, from emergency room visits to specialist consultations, ensuring every injury and treatment is properly documented. They analyze accident reports, witness statements, and workplace safety records to establish clear liability and identify any safety violations that can strengthen your case.

During this evaluation phase, your attorney determines the true value of your claim, something insurance companies hope you won’t discover on your own. They identify all available benefits under state law, including medical coverage, temporary disability payments, permanent disability compensation, and vocational rehabilitation services.

Your attorney also assesses whether third-party claims exist beyond standard workers’ compensation. If defective equipment caused your injury, they may pursue a product liability claim against the manufacturer on your behalf.

Filing and Managing Your Claim

Workers’ compensation claims involve strict deadlines and specific procedural requirements that vary by state. Your attorney ensures all paperwork is completed accurately and submitted within required timeframes.

A single missed deadline or improperly filed form can jeopardize your entire claim. In Utah, for example, you must report your injury to your employer within 180 days and file a formal claim within one year, but earlier notification often leads to better outcomes.

Your attorney handles all required notifications to employers and insurance companies using language that protects your interests. They know which phrases trigger coverage and which statements insurance companies might use against you.

They coordinate directly with your medical providers to obtain detailed reports that support your claim, ensuring doctors properly document the connection between your work activities and your injuries.

Negotiating With Insurance Companies

Insurance companies employ teams of adjusters and attorneys whose primary goal is to minimize claim payouts. Your workers’ compensation attorney levels the playing field by handling all communications with these insurance representatives, preventing you from making statements that could harm your case.

They understand the tactics insurers use to deny or devalue claims and know how to counter them. When insurance companies make lowball settlement offers, which they almost always do initially, your attorney knows the true value of your claim and won’t let you settle for less than you deserve.

They challenge claim denials with compelling evidence and legal arguments, often reversing initial rejections that unrepresented workers might simply accept. If insurers delay payment or authorization for medical treatment, your attorney can file formal complaints and seek penalties against the insurance company for bad faith practices.

What Is Workers’ Compensation?

Workers’ compensation is a state-mandated insurance program that provides medical benefits and wage replacement for employees who suffer job-related injuries or illnesses. It’s designed to ensure that injured workers receive necessary care and financial support without having to prove fault, while also protecting employers from lawsuits.

What Does Workers’ Compensation Cover?

• Medical Benefits and Treatment: This typically includes emergency room visits, surgeries, doctor appointments, physical therapy, prescription medications, and medical equipment like crutches, braces, or wheelchairs. Unlike health insurance, workers’ comp medical benefits have no deductibles, co-pays, or out-of-pocket maximums.
• Wage Replacement Benefits: When work injuries prevent you from earning your regular income, workers’ compensation provides several types of wage replacement benefits.
  • Temporary Total Disability (TTD) benefits pay approximately two-thirds of your average weekly wage while you’re completely unable to work during recovery.
  • Temporary Partial Disability (TPD) benefits apply when you can perform some work but earn less than before your injury.
• Vocational Rehabilitation Services: Workers’ compensation covers extensive vocational rehabilitation services when injuries prevent you from returning to your previous job. This includes vocational assessments to identify suitable alternative occupations based on your physical restrictions, education, and experience.
• Specific Injury Benefits: Certain injuries trigger additional compensation under workers’ compensation “scheduled loss” provisions. For example, losing a thumb might provide 60 weeks of compensation, while losing an arm at the shoulder could provide 500 weeks.
• Death Benefits and Survivor Support: When workplace injuries or occupational diseases result in death, workers’ compensation provides critical benefits to surviving family members.
  • Dependent spouses typically receive weekly benefits equal to two-thirds of the deceased worker’s average weekly wage, continuing for life or until remarriage in many states.
  • Children receive benefits until age 18, or longer if they’re full-time students or have disabilities preventing self-support.
  • Funeral and burial expenses are covered up to state-specified limits, typically ranging from $7,500 to $15,000.

Common Roadblocks to Workers’ Compensation Claims

Navigating workers’ compensation claims can be fraught with challenges, even for seemingly straightforward cases. Understanding the common roadblocks and pitfalls is crucial for injured workers to protect their rights and secure the benefits they deserve.

Denied or Delayed Claims

One of the most devastating roadblocks to workers’ compensation claims involves missed deadlines that can completely bar your right to benefits. Each state has strict notification and filing requirements—in Utah, you must report your injury within 180 days and file a claim within one year, but even shorter deadlines may apply for certain benefits or appeals.

Your workers’ compensation attorney ensures every deadline is met, from initial injury reporting to appeals of denied benefits. They also manage the numerous ongoing deadlines throughout your claim: responses to insurance company requests, filing for hearings, submitting medical documentation, and appealing adverse decisions.

Pre-Existing Conditions and Aggravations

Insurance companies aggressively search for any pre-existing conditions they can blame for your current symptoms, even when your work clearly caused or aggravated your injury. Your representative overcomes these denials by proving the crucial legal distinction: your work either caused a new injury or substantially worsened a pre-existing condition to the point of requiring treatment.

Your workplace accident attorney documents your condition before and after the work incident, showing clear changes in symptoms, functionality, and need for treatment. They obtain statements from coworkers confirming you had no problems performing your job before the injury.

Third-Party Liability Cases

Some workplace injuries involve negligence by parties other than your employer, opening doors to additional compensation beyond workers’ comp benefits. Your workplace accident lawyer identifies all potentially liable parties: equipment manufacturers whose defective products caused injuries, contractors who created unsafe conditions, property owners who failed to maintain safe premises, or drivers who caused accidents while you were working.

These third-party claims operate under different legal standards than workers’ compensation and can provide compensation for pain and suffering, full wage losses, and punitive damages—benefits not available through workers’ comp alone. Your lawyer coordinates both claims to maximize total recovery while avoiding potential conflicts or benefit offsets.

Employer Retaliation

It’s illegal for employers to retaliate against workers who file compensation claims, but it happens frequently. Your workers’ compensation attorney documents any adverse employment actions following your claim: termination, demotion, reduction in hours, denial of promotions, harassment, or forced transfers.

They establish timelines showing the connection between your claim and the retaliation, building evidence for additional legal action. They also protect you from subtle forms of retaliation, like being assigned impossible tasks, excluded from meetings, or subjected to increased scrutiny designed to create grounds for termination.

Step-by-Step Claims Process

Understanding the timeline and process helps you know what to expect when working with a workers’ compensation lawyer:

• Initial Consultation and Case Review: Your lawyer conducts a comprehensive intake interview, gathering details about your injury, medical treatment, and employment history. They review any documents you’ve already received and immediately identify urgent issues requiring immediate attention, such as denied medical treatment or unpaid benefits.
• Evidence Gathering and Claim Filing: Your attorney files formal claims with appropriate agencies and insurance companies, ensuring all deadlines are met. They coordinate with your medical providers to obtain detailed reports supporting your claim and begin building a comprehensive case file documenting every aspect of your injury and its impact.
• Negotiation With Insurance Companies: Your attorney responds to insurance company requests for information while protecting you from overreaching demands. They challenge any denials or disputes, filing necessary appeals and scheduling hearings when informal negotiation fails.
• Hearing Preparation if Needed: If your case requires a hearing, your lawyer conducts thorough preparation, including depositions of witnesses, obtaining expert opinions, and preparing you for testimony. They file pre-hearing briefs outlining legal arguments and organize all evidence for presentation.
• Settlement Negotiations or Trial: Your attorney continues pursuing maximum compensation through either settlement negotiations or trial proceedings. They evaluate settlement offers against the potential value of going to trial and advise you on the best course of action.

Choose the Workers’ Compensation Lawyers at Valley Law

Don’t navigate the workers’ compensation system alone when professional help is available. Our attorneys at Valley Law Accident & Injury Lawyers offer free consultations to evaluate your case and explain your options.

With contingency fee arrangements, you have nothing to lose and potentially thousands of dollars in additional benefits to gain. Contact a qualified workers’ compensation attorney from Valley Law at (801) 810-9999 to protect your rights and maximize your recovery.