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Workers’ compensation claims can be complex, and even legitimate claims face obstacles. Many cases are settled before going to trial, but securing fair compensation requires careful steps.
Understanding how to navigate the process can significantly increase the chances of a favorable outcome.
This guide outlines four essential tips that can improve the odds of winning a workers’ compensation case, from documenting evidence to working with an attorney.
Summary of the Key Findings
- Most workers' comp cases are settled outside of a trial.
- You can do several things to increase the chances of winning a workers’ comp case.
- An attorney can help you get workers’ comp benefits and an average weekly wage while you’re unable to work.
What to Do After an Injury at Work
Taking the right steps immediately after a workplace injury is crucial for a successful claim. Follow these actions:
- Report the injury to your employer – This should be done in writing (email or official report) to establish a record.
- Seek medical attention – Visit a doctor immediately and ensure your injury is documented as work-related.
- Follow the doctor’s orders – Failing to comply with medical advice can give the insurance company an excuse to deny benefits.
- Document everything – Keep detailed records of medical visits, prescriptions, and work absences.
- Consult a workers’ compensation attorney – Legal guidance ensures that rights are protected from the start.
Stat: Only 7% of workers’ comp cases are denied, and just 5% go to trial [1]. Most cases settle out of court, making proper documentation and strategy essential.
4 Tips That Increase the Odds of Winning
1. Document Everything
Proper documentation is one of the most effective ways to strengthen a claim. This includes:
- Incident reports – Submit a written report to your employer detailing how the injury occurred.
- Medical records – Keep copies of doctor’s notes, test results, prescriptions, and any treatments.
- Witness statements – If coworkers saw the accident, obtain written statements.
- Communication logs – Record every conversation with your employer, doctor, and insurance adjuster, noting names and dates.
Pro Tip: Some states require injuries to be reported within 30 days. Missing this deadline can jeopardize the claim.
2. Be Careful When Speaking with an Insurance Adjuster
Insurance adjusters may look for ways to minimize or deny claims. Protect yourself by:
- Avoiding recorded statements – You are not legally required to provide one.
- Being cautious with wording – Adjusters may use inconsistencies to dispute claims.
- Consulting an attorney before responding – A legal expert can guide conversations to avoid pitfalls.
Related Articles:
- Ways to Avoid Being Tricked by Insurance Adjusters
- Workers Comp Adjuster Tricks You Should Know
- Workers’ Compensation for Carpal Tunnel Syndrome
3. Understand Your Disability Rating
Disability ratings impact workers’ compensation benefits. The four main categories include:
- Temporary Total Disability (TTD) – Unable to work for a limited time.
- Temporary Partial Disability (TPD) – Can perform some work tasks but not all.
- Permanent Partial Disability (PPD) – Permanently unable to perform certain job duties.
- Permanent Total Disability (PTD) – Unable to work again, qualifying for lifetime benefits.
Fact: A doctor assigns a disability rating (5%-100%) that determines the compensation amount. Higher ratings result in more benefits.
Related Article: FCE Permanent Restrictions (Everything to Know)
4. Hire an Experienced Workers’ Comp Attorney
The legal process is full of loopholes that can be exploited by insurance companies. An attorney helps by:
- Ensuring deadlines are met – Late paperwork can lead to denial.
- Gathering strong evidence – Medical records, expert testimonies, and case precedents.
- Negotiating settlements – Lawyers can secure better compensation than self-representation.
- Appealing denials – If a claim is rejected, an attorney can fight for reconsideration.
Stat: Claimants with legal representation receive 30% higher settlements than those without.
FAQs
How long do workers’ comp settlements take?
Timelines vary by state. In some cases, insurance companies must respond within 14 to 30 days. However, complex claims can take months.
Can I still win if my claim is initially denied?
Yes, appeals often succeed if additional evidence is presented. An attorney can review the denial and prepare a strong appeal.
What if my employer disputes my claim?
If an employer challenges a claim, it may proceed to a hearing where evidence is reviewed by a judge. Legal representation significantly improves success rates.
How does an attorney help in a workers’ comp case?
A lawyer provides legal guidance, compiles evidence, negotiates with insurance companies, and represents claimants in hearings, increasing the likelihood of fair compensation.
Get an Experienced Attorney to Help with Your Workers’ Comp Case
There are several steps you should follow after getting injured at work. Inform the employer of the injury, get medical care, and save all the medical records.
Be careful when speaking with insurance adjusters and doctors, and hire experienced attorneys.
Law firm Schmidt & Clark has won numerous workers’ comp cases. Our team of attorneys can help you win your claim.
Contact us for a free consultation as soon as today, and we will discuss your legal options.