Mitchell | April 24, 2023 | Workers' Compensation

What You Should Know If Your Initial Claim is Denied

Worker’s compensation claims allow victims injured on their jobs to recover compensation. Most people injured on the job in Alabama are covered by the Alabama Worker’s Compensation Act, which makes it mandatory for businesses to carry worker’s compensation insurance if they have five or more employees. This law ensures that all employees receive medical treatment and compensation for time off work, even if the injury was ultimately the fault of the injured employee.

However, worker’s comp insurance companies sometimes deny claims, even if your employer was not negligent in the incident. Under Alabama law, this action is illegal. If you cannot settle with the insurance company, you can file a lawsuit to proceed to a hearing before a workers’ compensation law judge. Lattof & Lattof, PC, will work tirelessly to prove your claim and get the compensation you deserve. Contact us at (251) 432-6691 to get started on your lawsuit.

Who is Eligible to File a Worker’s Comp Lawsuit?

Injured workers who have claims denied by the insurance company have the right to an appeal. You can request an appeal hearing before a judge to consider your worker’s compensation case.

Am I Suing My Employer?

This question is one of the most common ones we receive when workers receive a denial of their worker’s comp claims. You’re not filing suit against your company but against the insurance company that has denied your claim. In catastrophic cases with extensive injuries, you may also want to file an additional injury lawsuit against other businesses that may have been negligent and contributed to your injury. You may only press a claim against your employer if you believe they intentionally caused you harm.

When Should I Consider a Worker’s Comp Lawsuit?

Legal intervention generally isn’t necessary for simple worker’s comp issues.  Nevertheless, several injury situations necessitate considering a workers’ comp lawsuit. These are:

  • Disputes or denials from the insurance company
  • Serious, life-altering injuries that the settlement may not cover
  • You’re unsure if the payment is fair
  • You cannot agree on a settlement with the insurer

How Worker’s Comp Attorneys Get Paid

A worker’s comp attorney looks out for your rights and ensures that the worker’s comp system operates effectively for you to maximize the money received for your injuries. Not all claims require an appearance in court. Ideally, you should be able to work out a settlement, but if that doesn’t happen, you can request a hearing before a worker’s compensation law judge. If necessary, your attorney will assist you with the negotiation process and a hearing.

Attorneys take worker’s comp cases on a contingency fee basis, meaning your legal professional will only receive payment if you successfully recover compensation. The fee is usually charged as a percentage of the compensation amount. Alabama caps attorney’s fees at 15% of the compensation settlement.

Regardless of your case’s outcome, you may still have to pay any expenses associated with the case. Check with your attorney before signing a representation agreement on how they will handle the following:

  • Filing, postage, and copying fees
  • Deposition expenses
  • Fees to access medical records
  • Fees to pay physicians for independent examinations

How is a Worker’s Comp Claim Determined?

Before negotiating with the insurance company, you and your attorney will calculate what you think the payout should be. The factors determining the amount include past and future medical bills, lost wages, temporary or permanent disability, and attorney’s fees. Once you finalize the calculation, your attorney can begin negotiating with the insurance company. The final amount paid is typically a compromise between you and the insurer.

If you can’t reach a settlement, your case will go before a worker’s compensation judge, who will evaluate the case and determine an appropriate settlement.  Either side can appeal and must do so within 30 days. Once the appeal is complete, the insurance company must follow the judge’s orders.

How Long Does It Take to Reach a Settlement?

Most worker’s comp cases settle weeks to months after negotiations begin. You will receive your claim as a lump sum or structured settlement. With a lump sum, you sign an agreement concluding the case and receive a single payment. In a structured settlement, you will receive payments over an agreed period.

Hire an Experienced Worker’s Comp Attorney

Legal counsel is invaluable when trying to receive all possible compensation from a worker’s comp claim. Our experienced staff understands the difficulties you may face when injured and unable to work. Contact our office at (251) 432-6691 to schedule a free consultation regarding your worker’s comp claim.