Worker's Compensation works for who?

I just had a call from a long time client about her worker's compensation case.  She was trying to deal with the insurance company on her own, but felt she was getting the run around.  A 20 year run around!. 

Whoa why did she wait 20 years?  Simple, there was ongoing treatment and continued care, however as she looked back she realized that the employer wasn't paying what they should.  they were letting the costs default to her health insurance, her time off was coming out of her vacation  and sick time and she didn't even know she was entitled to any mileage or lost time at work for doctor's visits. 

Now my client has had various things done by us in this office and never once mentioned her worker's compensation case.  Further she thought that she would have to pay a large percentage of everything she got over to us for the case.

This is how worker's compensation works.  There is a social contract set out by law between employers and their employees.  In exchange for not having to prove the employer caused the injury, the employee gets paid based upon their wage scale automatically for everything they incur as an expense related to an injury on the job.  There is no large potential recovery, as there might be with an auto accident, but there is also a guarantee of support while getting taken care of.  While there are often claims of abuse by people who have a second job, or are faking a claim, for the most part, people are honest, few want to have a permanent injury and fewer still actually fake anything.  The vast majority of people are honest and can't wait to get back to a healthy life. 

The insurance company, however, has as their job the protection of the employer, and if there is ANY doubt about the matter they immediately deny the claim.  even if they accept the claim, they do everything they can to delay payment. Why?  The insurance company makes money on the money in there hands.  If they can delay payment for a month they make a little more on their investments before they have to cash it in and turn over the payment to the injured employee. 

This phenomenon actually got bad enough at one point that there are now rules in place adding significant penalties for delays in payments once ordered by the Worker's Compensation Commissioner. 

So why not have an attorney do it?  People wonder how the attorney gets paid, they worry they won't get enough from the employer to pay for their needs and he attorney.

First the attorney's fee in a Worker's Comp case is limited to 20% of the actual recovery.  Unlike an automobile suit, the fee does not apply to any medical fees paid, nor for any medical records or other such recoveries.  Thus where an automobile law suit might reimburse for all the medicals and paid an suffering and other damages, the damages and the attorney fees are both restricted by law. 

The other thing you get by having an attorney help with the case should be a better understanding of the outcome and someone who knows how to ensure that you are getting everything you should from the insurer.  The insurer may have their own doctor look at your file and reduce the claims that your doctor makes on your behalf.  An attorney can help deal with that, right or wrong, and likely improve your overall outcome by questioning the doctor's reports and even helping work with your doctor to counter the insurance company doctor's claims. 

More about that in another blog.  The message here is call to find out if your case is one that can benefit from our help.  There is no charge to discuss it.

Bruce Gordon