Workers’ Compensation Vol 3: Questions & Answers

A Medford physician asks, when does my patient need an attorney for Workers’ Compensation and motor vehicle accident injuries?

Not every injured worker needs legal counsel. However, after Senate Bill 369 (1995), the cards are highly stacked against injured workers. An unsophisticated injured worker may delay filing a claim – out of fear of losing the job or for other reasons – to his/her detriment.

For example, a worker with an occupational disease (which may develop over a long period of time), has to file within one year after his doctor first tells him/her that the condition or ailment is work-related. All rights can be lost for failure to file on time. Another potential trap: a delay in reporting a work injury may result in a denial stating that the injury did not really happen at work. Workers need to be aware of rules like this which may affect their claims.

Once a workers’ compensation claim is filed, the employer’s insurance carrier begins an investigation which may include taking statements from the worker and witnesses, contacting the employer and doctors, and other actions. This investigation may position the claim for denial. Therefore, patients may need legal counsel to help prevent loss of rights which may occur early on in the process.

Like the workers’ compensation carrier, the auto liability insurance company of the driver who caused the accident begins investigating immediately. The reason: to minimize or eliminate responsibility on the part of their driver.

However, the insurance company of the injured victim of the wreck is not protecting the rights of its insured, but is protecting its own interest to the extent of its involvement.

One of the first priorities of the “at-fault” driver’s insurance company is to get a recorded statement from the injured victim. The insurance company has a legitimate need for information, but the only purpose for recording the statement is to play it back for a jury. If the injured person misstates a fact (due to stress or failure to recognize the need for precision when speaking for the record), it could be used against him/her later. In two recent cases (one involving a 17 year-old girl), taped statements were used against injured people in the courtroom.

If the “at-fault” driver’s insurance company is denying liability, an attorney can help the injured person decide whether to challenge the denial in court.

If the injury is so serious that it will have significant impact on the injured person’s economic future, the person should probably hire a lawyer to deal with the professionals on the other side

In cases of less serious injury, it is like the decision to hire help doing your taxes: some people will tear their hair out for a weekend or two doing their own taxes; others prefer to turn it over to a professional.

Finally, if the stress of dealing with an injury claim is interfering with the healing process, it may be a good idea for the accident victim to get professional legal help.

This article was prepared by Robert L. Chapman & Dennis H. Black