I filed a workers’ compensation claim, do I need an attorney?

By Jason Weinstock on October 4, 2019

Not necessarily! If your claim is running smoothly, you are getting the treatment you need, and you are receiving all your benefits, then proceed on your own. However, there are benefits to having an attorney that is knowledgeable regarding workers’ compensation law.

What benefits are there in having an attorney’s assistance?

A knowledgeable workers’ compensation attorney can provide an injured worker with numerous benefits and assist in making sure their claim runs as smooth as possible. Injured workers can use an attorney as sort of a case manager. Attorneys can often expedite communications with adjusters, request necessary medical records, and ensure the law is being applied correctly. Workers’ compensation attorneys are often experienced in physician selection, and can assist you in getting the best possible care. During the closing of a claim an attorney can advise a client on when to obtain a PPD (permanent partial disability), if one is not being offered, and review the settlement calculations to ensure the injured worker receives the proper amount.

Some attorneys attend rating appointments with their clients to make certain that proper procedures are used (my office always attends the rating with the client). An attorney’s knowledge of the law is useful in requesting a change in doctors, appeals, making sure benefits are being paid to injured workers that have been taking off work, and in meeting deadlines.

Is an attorney ever necessary in a workers’ compensation claim?

Only in second level hearings or in District Court. Many decisions made by an insurance adjuster can be appealed, through a process called a hearing. If an injured worker receives a determination by an insurance adjuster which they do not agree with (claim denial, refusal to transfer care, etc.), they must file a request for a hearing. The first level hearing can be done without an attorney with the injured worker representing themselves in front of a hearing officer. If the decision of the hearing officer is unfavorable, the injured worker can file an appeal. Insurers are almost always represented at the first and second level hearings, having an advocate on your side can be very helpful at these hearings.

A second level hearing is an appeal of a hearing officer’s decision. These are more formal proceedings in which an advocate is typically required. An injured worker may represent themselves (pro se), but will find that the appeals officer will request that they retain an attorney (often the appeals officer will give an application for the Nevada Attorney for Injured Workers). This is because the insurance company always has an attorney present at these hearings and it is the injured workers’ last shot at a favorable decision from an administrative judge.

There are timelines for filing a request for a hearing at both the hearing and appeal level, so it is important to stay aware of dates on letters and hearing officer decisions.

I pride myself on being upfront and honest with my clients. Give me a call or send an email for a free consultation and I will let you know if I think you need an attorney or should continue on your own.

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