Do I Really Need an Attorney in a Workers’ Compensation Claim?

Workers’ compensation claims can be clear cut and easy to navigate using the system your employer has in place. But there are also claims where your employer disputes your claim and undercuts the compensation you should receive. These are the cases where you absolutely need a workers’ compensation attorney.

If you’ve been working through the process of your workers’ compensation claim but are facing resistance, it’s time to lawyer up. Your employer has made commitments to ensure your livelihood in case of an accident and you’re entitled to that compensation.

The longer your claim goes unpaid, the longer you must shoulder the burden of medical bills. Depending on the severity of your claim, you also might be off work. Short-term disability plans often only pay a percentage of your salary so don’t let your employer tell you that your work-related injury should be paid under short-term disability. You’re entitled to full compensation if your injury truly took place during the course of your job.

As you work through these details and evaluate if an attorney is right for you, here are some things to consider.

Simple workers’ compensation claims

Your workers’ compensation claim is likely to be pretty simple and undisputed if it clearly involves:

  • Work-related injuries as your employer will have trouble refuting these
  • Simple medical treatment that isn’t long or ongoing
  • A short time period where you’re off work
  • Temporary injuries that heal quickly and have no lasting effects

If you read this list and realize your claim does not fall into these simpler categories, you should keep reading. This means that you likely have a more complicated claim that requires expert advice and guidance throughout the process. Hiring a workers’ compensation attorney makes a lot of sense in those cases, which we cover below.

Knowing when a workers’ compensation attorney is necessary

The simple way to understand when to hire a workers’ compensation attorney is whether or not the insurance company or your employer is disputing your claim. If this is happening, be sure to retain legal counsel.

But what makes an insurance company or employer refute your claim? Here are some instances to be aware of as you go through the workers’ compensation claim process.

Claiming your injury is not work related

Insurance companies may try to prove that your injury originated elsewhere and therefore shouldn’t be paid. You can appeal these decisions but going through that process on your own is very difficult and confusing. There are loads of paperwork and if you don’t present the right information, your claim may still be denied.

The insurance company disputes your permanent disability rating 

Permanent disability benefits are calculated using this rating. When the insurance company and your doctor don’t see eye to eye when it comes to the severity of your permanent disability, your claim may be denied or challenged. The medical professional from your insurance company will likely assign you a lower rating than your personal doctor in an effort to lower the amount they must pay out. To receive your full settlement, you’ll need to prove to a judge that you truly fall under the higher rating. Presenting your case to a judge calls for an attorney to represent you.

The insurance company is delaying treatment 

Your goal is to feel 100 percent again. The insurance company’s goal is to close your claim while paying out as little as possible. As such, they might delay treatment as they further investigate your claim. They might also pressure you into accepting less than what your doctor is recommending. This is when you need an attorney to fight for you to receive the right medical treatment for full rehabilitation.

You’re unable to continue working

This is a big one. The long-term effects of a work-related injury can mean that you’ve lost your ability to earn a living. In this case, you need a settlement that recognizes this and pays out so that you can sustain your way of life. This is a situation where you’ll seriously need to plead your case to ensure lifelong wellness and prosperity. You should certainly hire a workers’ compensation attorney in this case.

When the cost is justifiable

Hiring an attorney might seem like it will simply cost you money instead of bringing it in. This time of recovery is vulnerable and difficult to navigate alone. If you’re concerned about what an attorney will cost you, contact one to learn more because some attorneys will work with your financial situation.

Gore and Kuperman know that at times, a workers’ compensation settlement is your lifelong livelihood. We recognize the importance of that payout and respect your need to care for yourself and pay your medical bills. That’s why we discuss a fee structure that works for you during your free consultation.

Find your workers’ compensation attorney by calling Gore and Kuperman at 703-385-7300. We’re your northern Virginia workers’ compensation partners.


This blog post is not legal advice, nor is it intended to be used as such. Specific case facts should be discussed with an attorney.