Legal Process for Workers Comp

Understanding the legal process for workers’ compensation claims can help you maximize your benefits and get you the justice you deserve. The whole process of a workers’ comp claim begins when you get hurt at work. Whether it’s a scaffolding/ladder accident or an animal attack at work, you’ve been injured at the workplace and you’re beginning to realize the effects your injury will have on your life. You know that you’re going to miss time at work, need expensive medical treatment, and you might even have long-term effects such as scarring, loss of function, and disfigurement.

Our lawyers at Powers & Caccavale will remain in constant communication with you throughout the entire workers’ compensation claim process, keeping you up to date on any developments and making recommendations to help reach the best possible outcome in your case. This step-by-step look at the legal process will help clarify any confusion you may have.

1) Get in Contact with Workers’ Compensation Attorneys

The first step in the process is to get a free consultation from an experienced and trusted workers’ comp attorney. You will never have to pay anything out of pocket to our lawyers and we only get a percentage of your benefits if we reach a settlement with the workers’ compensation insurance company. If this happens, the fee will be 20% if the insurer accepts liability or 15% if the claim does not cover medical expenses.


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2) Hire Lawyers

The next step involves actually hiring a lawyer. Once we’ve been hired, our lawyers will send a letter of representation to the insurance company to let them know we are representing you. You will never have to speak to the insurance company.

3) Focus on Your Health

While our lawyers are dealing with the insurance company, you can use this time to recover from your injuries and focus on getting better. Worrying about getting compensation should not be your priority at this time. We will make it our priority. Since we have experience in representing clients with a variety of injuries, we know how important it is to get the best medical care possible. That’s why we’ll be in constant communication with you and offer recommendations on the best medical providers and facilities in the area.

4) We Request Workers’ Compensation

After sending the notice letter, we speak directly with the insurance company and request workers’ compensation benefits for you. If they agree to start sending benefits, we make sure that they are in the proper amounts and that they are paid on time. We will continue to support you through your medical treatment. However, if they deny or stop benefits, we continue on to the next step of filing a claim.

5) We File a Claim on Your Behalf

If your workers’ compensation is denied or terminated, we will then file a claim with the Department of Industrial Accidents. We handle the complicated forms and send them to the correct parties for you. We will also collect your medical records and submit them to the court.

6) Conciliation

After all the forms have been completed and the claim has been filed, the court will then schedule a conciliation. This is a meeting that includes our lawyers, the insurance company, and a conciliator from the Department of Industrial Accidents. If an agreement can be reached at the conciliation, the insurance company pays an attorney fee to us and starts/begins paying you the agreed-upon workers’ comp benefits. You will pay absolutely nothing to us. If, however, an agreement cannot be reached, the claim will move forward to dispute resolution and will be assigned to an administrative judge.

7) Conference with Administrative Judge

If your claim gets to this point, you will have to go along with us to the scheduled conference with the judge. You don’t have to worry, though, as we will do all the talking. We give oral arguments to the judge as to why you are entitled to benefits and submit your medical records to the judge. After the conference, the judge decides whether or not you are entitled to compensation. If you are not satisfied with the judgment, we can file an appeal of the conference order.

8) Physician Exam

After filing the appeal, you must go to a doctor’s appointment, which takes place with a physician of the Department’s choosing. We make sure all of your medical records are submitted in a timely manner and in the correct form.

9) Hearing

The hearing, or trial, happens next. We handle all the paperwork and prepare you for the cross-exam by the insurance company’s attorney. After this hearing, we will depose the court’s doctor and submit any other records or closing arguments. The hearing will result in a final decision by the judge.

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