Some people think the law protects them and that they’ll be treated fairly no matter what. Some people think that they can handle the claim themselves. Some people think hiring an attorney means they’ll get less compensation. Does it, though?
I’ve seen enough people damage, delay, or otherwise ruin their cases and end up without the representation, medical care, and compensation they really needed. Many people (especially insurance adjusters) may give you all sorts of reasons not to hire an attorney to help you.
We’ve actually got an entire page dedicated to why you should hire a workers’ compensation attorney. But, since people still resist the idea, we’ll break down the most common excuses we’ve heard for not consulting a workers’ comp attorney.
Excuse #1: The Law Clearly States What Workers’ Compensation Benefits I Am Entitled To
Does it, though? The law provides a formula for possible wage compensation, and it does require medical treatment to be provided as needed for qualifying injuries. Notice the wording there? “Possible” wage compensation? “Qualifying” injuries? The fact is, there’s a lot of gray area in the law, primarily because it simply cannot address every single injury or circumstance. A great deal is left to interpretation.
Yes, you are entitled to certain benefits if you’ve been hurt at work, with a few exceptions. How much you may get, how you’re cared for, and how long that all continues are all handled case-by-case. What could go wrong?
- Did you know that if you’re injured at work in North Carolina, the insurance company has the right to direct your medical care? That means deciding which doctors you get to see, and having to sign off on how often you can see them and what treatments you can receive.
- Who’s doing the math? It’s important to remember that, just because you may be receiving some workers’ compensation benefits now, that doesn’t mean it is everything you may be entitled to. Wage numbers can be “miscalculated.” Things like permanent disability or future medical needs can be left out of the equation – or negotiated.
- Who’s watching out for you? Typically, it’s in an insurance company’s best interest to get you into a job and off of workers’ compensation benefits as soon as possible. What if you are cleared back to work before you feel physically ready, or into a lower-paying job, or even into a “made-up” position that is later eliminated?
The truth is, the North Carolina Workers’ Compensation Act is a long, complex compilation of legal rules and procedures that apply to work-related injuries and occupational diseases. While it’s true that the law provides a way for injured workers to potentially be compensated, clarity can be hard to come by. The nuances of handling a workers’ comp claim already fill many books, large and small, trying to explain it adequately. Experience tells us that seeking fair compensation is often easier said than done.
Excuse #2: I Can Handle My Workers’ Compensation Claim Myself
This is technically true (again, with exceptions), though it may be ill-advised. You are by no means required to hire an attorney to represent you. However, there are good reasons to consider doing so.
Sorting through North Carolina’s workers’ compensation laws can get pretty confusing. Laws require injured workers to follow meticulous steps, file specific forms, and comply with various deadlines, all while recuperating from an injury under the care of a physician they didn’t even get to choose. If you fail to meet any of these requirements, you could miss out on potential benefits or, in extreme cases, lose your right to pursue your case.
We have put together some information to help those who choose this path, but we do not recommend it. The insurance company knows the laws, and it may recognize opportunities to trip up workers who choose to represent themselves. For example, what would you do if:
- The Insurance Company Withholds Benefits Checks (or Stops Them for Reasons You Disagree With) – Workers’ compensation clients typically receive checks every week. Some adjusters may try to keep you from getting on “repetitive pay,” which is when the checks are delivered on the same day each week.
Instead, they’ll issue a check on one day one week and then another day on the next week, forcing you to go almost two weeks without a check. Your hands are tied, though because technically, you’re getting a check every week. It’s not until there’s a 14-day lapse between checks that a violation occurs. How would you prevent this situation? And what if the checks stopped coming?
- Miscalculation or Disagreement Regarding Benefit Amount and Mailing Checks Irregularly – We have seen insurance companies fail to calculate the weekly amount due to an injured worker correctly. Such miscalculations can lead to you receiving substantially less benefits for several weeks or months while you’re receiving medical care. Sometimes, insurance companies may fail to enroll you in a direct deposit or automatic payment plan, and make you go almost two weeks without payment (which should technically be weekly). An experienced attorney can investigate what they think is the correct weekly amount and fight, if necessary, with the insurance company to try to get those benefits corrected and promptly paid to you.
- You Disagree With the Care Provider the Insurance Company Has Chosen – Yes, in North Carolina, the insurer/employer gets to choose where you go for treatment. They’re not going to send you to your general practice physician in all likelihood. What if you’re not happy with their physician, the care they recommend, or their evaluation of your injury? What if they clear you to return to work when you know you’re not ready? The law provides ways to appeal, but knowing when and how to file is vital.
North Carolina workers’ comp laws are packed with rules. If you fail to meet any of these requirements, you could miss out on potential benefits or even lose your right to pursue your case.
Excuse #3: I Don’t Need an Attorney Until the End of My Case, and I Don’t Want to Pay One the Whole Time
Let’s say for the sake of argument that your particular case proceeds without incident. That’s not common in our experience, but assuming it does, you want to wait because you’re not willing to pay an attorney.
While it is never too late to discuss your case with an attorney, there does come the point when an attorney cannot help you anymore. The longer your case goes, the more likely doors will close on our opportunities to try to make a positive difference for you.
As for not wanting to pay a fee, our firm works on what’s called a contingency fee basis.2 In other words, you are not billed by the hour. The fee is a percentage of any compensation and/or settlement you receive.
This is a good thing for two reasons.
- First, working on a contingency fee motivates us to try to maximize whatever compensation we can get for our clients and try to obtain that compensation as quickly as possible. We’ll end up being paid the same percentage whether we work for 20 hours or 2,000 hours on your case.
- Second, because your attorney is working on a contingency fee basis, you don’t have any out-of-pocket costs to hire one.2 It literally costs you nothing to start working on your case.
Generally speaking, then, hiring an attorney early in your case doesn’t cost you any more or less than it would if you hired one at the last minute (more on that below). Hiring us earlier means we can safeguard your rights, advise you on decisions, ensure all forms are correct and complete, meet deadlines, deal with issues as they arise, build your case, and fight for the most compensation possible on your behalf.
Excuse #4: I Can Negotiate My Own Settlement
Are you a professional negotiator? If that’s true, then you may be right. However, with the many different facets of workers’ compensation law in North Carolina, you may not know precisely what you could be entitled to.
Furthermore, can you reliably predict and account for future care costs if your injury causes more harm down the road? What do you ask for? How much, and how do you back up your claim? Many insurance companies know how to play hardball, and some are happy to do it. Here are a few tactics we’ve seen used:
- Delaying: They may drag their feet forever, taking far too long to respond or react to issues you’re having. They might try to extend or delay settlement multiple times, during which time you may have bills piling up. They may hope that you’ll take less to get paid more quickly.
- Rushing: Some will quickly offer a settlement to you. It may even seem generous. Beware, though. If you haven’t healed yet, how can you know what your medical treatment will cost in the long run? What if there are complications? The rapid settlement offer is often a red flag.
- Friendliness: People can be friendly. Insurance companies can seem friendly. Your adjuster may very well be a nice person. However, he or she is paid by the insurance company and part of that may be to limit their payout in cases just like yours. This isn’t about friends. This is about your health – physical and financial.
- Hardball: Some insurance companies may issue ultimatums to injured workers. They might say the settlement is their “best offer” and even invite you to “take it or leave it.” But how do you know that’s their best offer? An attorney could help you deal with this tactic.
If you do nothing else, absolutely consider hiring an attorney when the time to settle your case arrives. Having an experienced workers’ compensation attorney review settlement offers and documents can save you from a huge mistake. When this kind of case comes along, and we are hired near the end, we have often been able to spot ways clients could have received better compensation or care. Opportunities lost, in other words.
Excuse #5: It’s Too Late to Hire a Workers’ Compensation Attorney to Help Me
Unless your case is settled or closed, there may still be something a workers’ compensation attorney can do for you. There are obviously things we cannot undo, like statutes of limitations and you signing settlement documents.
The truth of the matter is, the only way to know if it’s too late for a workers’ compensation attorney to help you with your case is to ask one. We work in this system every day. We know the rules and how to try and claw back missed opportunities when that’s possible. Most of all, we work for you. Unlike an insurance company, we’re 100% working for you, and we’ll tell you what your options are so you can make the right decisions for yourself.
Even if you think it’s too late to get an attorney’s help, it costs you absolutely nothing to call us. We’ll evaluate your case for free.
Workers’ Compensation Is Complicated – Hire an Attorney
Attorneys do not create rights. Under the workers’ compensation system, your rights are established by our state legislature and enforced through the North Carolina Industrial Commission.
We discuss those rights with injured workers on a daily basis. We see firsthand how some insurance companies sometimes try to circumvent those rights. We have talked with people who are near or at the end of their case who believe they have been treated “fairly.” When we explain what the law actually may provide, these people often feel betrayed by the insurance company.
Why Would You Want a North Carolina State Bar Board Certified Workers’ Compensation Specialist?
The North Carolina Bar is very particular about using the word “specialist,” and for a good reason. The word denotes a specialized level of training and skill.
In the case of workers’ compensation, the law is open to interpretation, and everything frequently depends on how well you know the law, how much specific education you have, your experience in dealing with unique and difficult circumstances, how thoroughly you build your case, and how well you communicate within the system. If you need any more evidence that the workers’ compensation system is complicated, consider the fact that the North Carolina State Bar offers a specialization in this aspect of the law.
We have several North Carolina State Bar board-certified specialists on our team, and our dedicated team does nothing but workers’ compensation, morning, noon, and night.
What’s the Worst That Could Happen If I Don’t Hire a Workers’ Compensation Attorney?
If you want to talk about worst-case scenarios, there are several. Here are some nightmare consequences that could happen if something goes wrong in your case and you do not have an experienced workers’ compensation attorney in your corner:
- Lose any opportunity at compensation because you fail to file a claim in time or sign something you should not from the insurance company or your employer
- Drastically reduce the possible compensation you receive because you agree with an interpretation of the rules that is not in your best interests, or fail to fight for the actual compensation you may deserve because you’re unaware of the rules and how the formulas should work
- Receive incomplete or subpar care for your injuries because you don’t know how to request a second opinion or appeal the decision of the workers’ comp physician (whom you did not get to choose)
- Return to work too soon, which can mean: reducing or eliminating your compensation; taking a position that is not right for you or that may be quickly eliminated; making yourself vulnerable to reinjuring yourself
- Settle for less compensation than you may have been entitled to receive because you didn’t know what to watch for or underestimated your future medical needs
The most mind-bending fact of all is that these excuses can be easily overcome at no cost. Our firm will evaluate your workers’ compensation case at no charge whatsoever. You’ve got nothing to lose by speaking to us. And a whole lot you can lose if you don’t.