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Top Tips on How to Win Workers’ Comp Case

Anyone who has recently fallen victim to a workplace injury can make a workers’ compensation claim. This compensation is to cover medical bills, wages lost from time off work, and the impact on your mental health and long-term career prospects. Yet winning a workers’ comp case is much easier said than done. Most employers will argue that the accident that led to the injury was your fault and deny any responsibility for the incident. In fact, the hardest part of winning a workers’ comp case is proving the injury was the fault of the employer when they deny any responsibility.

If you want to avoid unnecessary complications and improve your chances of winning a workers’ comp case, you’re in the right place. In this article, we reveal everything there is to know about how to win a workers’ compensation case. Plus, you’ll find advice on choosing a reputable defense law firm to help fight the case for you.

How to Win Workers’ Comp Case

Many people are concerned over the value of their workers’ compensation settlement amount and want to whizz through the initial part of the process. However, to win a workers’ comp case several important points need to be addressed. Here is how you should handle the proceedings for your best chances of winning.  

1. Check your employee rights

The main reason that employees lose their workers’ compensation claims is that the injury in question isn’t covered under their employee rights. Workman’s rights are governed by state law, so the eligibility rules may vary slightly depending on the jurisdiction in which you reside. Nevertheless, most legitimate claims need to fall into one of the three below categories boxes to be successful:

Accidents in the Workplace: To be eligible for a workers’ comp claim, you must have been injured within the workplace. Moreover, covered workers must have been injured while working on the job and carrying out a task associated with their job role.

Repetitive Strain Injury: Some injuries can build over time rather than resulting from a one-off event, such as repetitive strain injuries. These can still qualify for a workers’ comp claim, so long as the repetitive strain injury can be linked back to work.

Occupational Illness: Exposure to toxins and chemicals can cause negative health consequences, including cancers and other serious illnesses. Workers’ compensation can help cover the devastating losses to injured employees and help protect others from falling victim to exposure to these harmful substances in the future.

2. Investigation into the claim

For the best odds of winning a workers’ comp case, the incident must be reported correctly as per the state’s protocols. The first step is to report the accident to the employer, which usually must be done within 30 days. When you inform your employer or managers of your injury, you need to clearly describe the events that led to the injury as well. The employer typically requests the information from the injured worker, but providing as much information as possible will support your claim.

It is also worthwhile creating documents that detail the incident for your own personal record. Again, be as specific as possible and write down as much as you can remember about the events of the day that the injury occurred. We’d also recommend seeking the advice of a defense attorney at this stage. Although it is possible to settle your case without the help of legal professionals, an experienced workers’ compensation attorney will be able to investigate the claim from a legal perspective and tell you whether you have a good claim.

3. Denial and disputing the claim

Some workers’ comp cases will reach an amicable settlement quickly after reporting the accident with your employer. However, workers’ compensation claims are often denied by your employer and their insurance adjuster. Not all is lost, though, and if there is one take-home tip on how to win a workers’ compensation case, it’s this: don’t give up! Many workers’ comp cases are denied initially, but you can bounce back by filing an appeal.

An appeal is where you dispute the resolution and ask the courts to reconsider the original workers’ compensation claim in the hope of a different outcome. It is an uphill battle, and there is no guarantee that the appeal will be successful. Time is of the essence here, so speak to your workers’ compensation attorney and file an appeal as soon as possible for the best chances of a favorable resolution.

4. Recognizing fraud

There is such a thing as workers’ compensation fraud. In regards to the employer, any fraudulent activity is usually to minimize the amount they are required to pay out to injured employees. Examples of workers’ compensation fraud could include underreporting payroll or misclassifying employees for lower insurance premiums. It is important that anyone filing a claim recognizes these accounts of fraud and highlights them to the court to ensure a fair resolution of the case. If the employer is found to be committing fraud, winning a workers’ comp case is much easier.

However, note that employees can also easily commit fraud when filing workers’ compensation claims. This is illegal and detrimental to winning the claim. Examples of fraudulent activity from the employee include claiming a workplace injury that never occurred or exaggerating the incident, claiming a non-work-related injury as a workplace injury, or working while disabled and not reporting any income. Avoid making any of these mistakes for improved chances of success.

Do you need legal assistance?Find the right lawyer in your area.

Tips to Win Your Workers’ Compensation Claim

The above steps are essential if you want to know how to win workers’ comp cases. But there are additional tips you can implement to further increase the odds of winning and reach a more favorable settlement. Here are all our top tips and tricks to help guarantee success.

1. Obtain witness statements

When filing workers’ compensation claims, it is usually a case of “he said, she said”; you are saying you are injured due to workplace negligence, your workplace is saying it isn’t their fault. These types of scenarios are notoriously difficult for judges to decide fairly. Therefore, witness statements can go a long way in strengthening your argument. If a member of your team or a customer witnesses the incident, ask them to make a written statement. Written statements are far superior to verbal ones as memory fades over time and can be used as evidence in court.

2. Document the injury correctly

You want to ensure that you file the claim promptly and correctly. Each U.S. state has different time constraints on how long you have to do this. For example, workers’ compensation claims must be filed within the two years following the incident in Colorado. However, the sooner the incident is documented, the better. The memory of events can change over time, which employers will use against you. File the claim as soon as possible and write down a detailed account of the incident right away.

3. Seek prompt treatment from a doctor

Having medical records and medical bills is great supporting evidence for any workers’ comp case. Go to a doctor for treatment as soon as possible. If you delay getting treatment, your workplace or insurance adjuster could claim that the injuries are not as severe and debilitating as you’re alleging. Moreover, talk to your doctor about the accident and be sure they understand that it happened at work. Having information such as this on file will reduce the risk of your claim being denied.

4. Obtain other supporting evidence

There are no set requirements for the evidence needed to win a workers’ comp case. However, the more supporting evidence you can gather, the stronger your argument. We have already discussed medical records, witness statements, and documentation, but see if there is any security footage or surveillance that shows the incident unfolding. Employment records are also useful as they prove that you had a professional relationship with your employer at the time of injury.

How Long Does it Take to Win a Workers’ Comp Case?

We now know how to win a workers’ comp case, but how long does the process take? Unfortunately, there is no simple answer to this. If a settlement can be agreed upon with your employer’s insurance and compensation provider, the process could take as little as a couple of months. However, where the case is denied and you have to file an appeal with the courts, things take longer. The type and severity of the injury and whether or not you have legal representation also alter the timeline.

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As a rough guide, you can expect a non-permanent injury claim that does not undergo negotiation for a settlement to take around 12 months. Where your lawyer helps you negotiate for a more favorable settlement, the time taken typically extends by 20%, but you will likely receive more at the end of it.

How Do You Find a Great Workers’ Comp Attorney?

What are the chances of winning a workers’ comp case? Well, this all depends on the nature of the injury and what evidence you have to support the claim. However, a great workers’ compensation attorney can make winning a workers’ comp case much more likely. Here are all the things you should consider when retaining a law firm to act on your behalf.

1. Success rate and prior case results

A great starting point is to look at the previous success rates of the law firm. If they have a great track record of winning workers’ comp cases, there is no reason they can’t achieve the same success with your case. Pay attention to the final settlement amount as well and how good their negotiation skills are. This can ensure you end up reaching a favorable outcome with your employer.

2. Client recommendations

Another option is to go for a law firm that has been recommended to you. If any friends, family members, or colleagues have filed workers’ compensation claims in the past, ask which law firm they used and about their experience using them. If you already use an attorney that specializes in another practice area, it is also worthwhile speaking to them. Attorneys know other attorneys, so they’ll likely have someone they can recommend.

3. Professional experience

Always check that the law firm has a department specializing in workers’ compensation law with plenty of professional experience in this area. The more time they have spent practicing this area of law, the better. You will get a gauge of the firm’s professionalism at your initial consultation too. If anything feels at all off, go with your gut. There are plenty of firms specializing in workers’ comp law, so shop around until you find one you’re happy with.

Conclusion

Anyone who has been injured at work has the right to seek compensation for their losses. Employers need to value the health and safety of their employees, and failure to do so can make them liable. However, winning a workers’ comp case is easier said than done. Employers and their insurance companies tend to try and not pay or to pay as little as possible. Follow these top tips on how to win a workers’ comp case and hire great legal representation you can trust for the best chance of a generous settlement.

Article by Sofi Ostymchuk

Sofi Ostymchuk is a Content Lead and Legal Writer at Lawrina. Sofi manages the content on the blog, communicates with contributors, looks for interesting topics, and creates articles in cooperation with lawyers and law experts. If you would like to be a blogger for Lawrina, you can contact Sofi for all the details via email at s.ostymchuk@lawrina.com.


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