Factor: Four Frequent Workers Compensation Lawyers Tips

Generally speaking, most people do not think about worker’s compensation until they get injured at work.  After it happens though, they have many questions such as how they “get on” workers’ compensation, which doctors they can treat with, how long will they get paid, and how much, will their job be protected, just to name a few concerns.  This is why it is important to contact a workers’ compensation lawyer early in the process, so that questions like this can be answered, and the injured person can instead focus on recovering from the work injury.

With over three decades of experience practicing workers’ compensation law, I have successfully helped many people through the often frustrating process of the workers’ compensation system.  I like to think that I take the stress off my clients when it comes to things like dealing with insurance companies, getting the appropriate medical treatment, and going to court.

With that in mind, here’s my advice for employees who get hurt on the job and need to know what to do:

1. Understand the basics

Workers’ compensation lawyers will tell you that our field of law is different from unemployment or temporary disability (as it’s known in Rhode Island) in that it’s not a government program. All companies, regardless of their number of employees, are required by law to carry workers’ compensation insurance. 

Another difference is that employees do not need to file anything. It’s the company’s responsibility to submit a claim to its insurance carrier, which in turn will report the injury to the state Department of Labor and Training.

Once the claim is filed, the law does not allow the employee’s attorney to take any legal action against the workers’ compensation insurance company until 21 days after the injury occurs.  This gives the insurance company the opportunity to investigate the incident, gathering information and in some cases, to begin paying weekly benefits.

During that time, the insurance company is supposed to determine what — or whether — it will pay on the claim. 

If the employee is not receiving benefits, or if the employee is being paid under a Non Prejudicial Agreement, meaning the workers’ compensation insurance company has not actually accepted the liability for the injury, at that point it may be necessary to go to Court.  This is of course true especially if the insurance company denies the claim altogether.  If that happens the only way an attorney can obtain benefits for the injured party is to file a petition in the Workers’ Compensation Court.

2. Contact an attorney

I typically recommend reaching out to a workers’ compensation lawyer within the first few days of an injury.  During the initial meeting, the injured worker should provide that attorney with any and all documents related to the claim, such as a copy of the incident report, relevant correspondence or medical records and treatment plans. 

If the case does end up in court, it is natural for non-lawyers to be nervous.  What I tell my clients is: I will do the talking. 

There are typically only a few reasons for the client to speak during the hearing; for example, the Judge may want to hear directly from the person as to how they were injured, who did they report the injury to, or other questions that can only be answered by the client.  However, this is not the norm since, as your legal representative, I am the one to present the case to the Court. 

3. Report everything accurately — and immediately

Let’s face it: The employer’s insurance company will do everything they can to avoid paying weekly workers’ compensation and for medical treatment — and that means they’ll look for any inconsistency or irregularity to reject your claim. 

In most cases, that means any gaps in the reporting of the incident, which makes it imperative to document everything immediately (ideally, within the first 24 hours), especially the incident that led to their injury and the initial medical appointment to evaluate it. 

The earlier and more specific that the incident is documented, the better chance the client will have in winning their case.

4. Stick to the treatment plan

After issues with documentation, this is probably the next-biggest opportunity for insurance companies to dispute a workers’ compensation case.

We’ve all heard the stories of insurance companies finding an injured worker engaging in heavy physical activity when they’re supposed to be recovering.

Situations like that usually lead to a case being denied at minimum, and could result in criminal charges for workers’ compensation fraud. 

Here’s how workers compensation lawyers typically instruct clients: Follow your treatment plan and limit your physical activity to what the doctor approves as part of your recovery.

Also, keep in mind that you can collect workers’ compensation for up to six years, and your medical bills related to a work injury can be covered for life as long as there are no gaps in care longer than 10 years. 

This comes into play when a client is found to be partially disabled and needs to complete a multiyear rehabilitation program, or when an old injury flares up and a doctor determines that it’s still related to the original incident. 

Recently, I had a client who was nine years removed from his workplace injury, and he was still able to get the insurance company to cover his treatments because he could prove that the need for further medical care went all the way back to when he initially got hurt on the job.

I hope you never have to deal with a workplace injury, but if it happens, these tips should put you in a better place to recover and get the compensation you deserve.

This page is sponsored content piece for Kirshenbaum & Kirshenbaum.