While there are certain stages in the workers’ compensation process where you can represent yourself, the workers’ comp hearing is usually not one of them. Workers’ compensation hearings require a great deal of preparation and detailed knowledge of the workers’ compensation system. The earlier you get a lawyer involved in the process, the more likely you will receive a favorable outcome.
Your Case is Going to a Hearing for a Reason
If your case is scheduled for a workers’ compensation hearing, it means that you are involved in some sort of the dispute with the insurance company. For example, the insurance company may have denied your claim because it doesn’t believe your injury is work-related, because it doesn’t believe your injuries are as serious as you say they are, or because it doesn’t believe you followed the proper channels for reporting your injury, making a claim, or seeking medical treatment. (For more information, see Common Reasons Workers' Compensation Claims Are Denied.)
Insurance companies often base their decisions on a cost-benefit analysis. Before disputing a claim, they will look at whether it makes financial sense to do so, given the resources they will have to expend and the probability of success. In other words, the insurance company probably isn’t going to spend the time and money fighting your claim if it doesn’t think it has a good chance of winning.
The Insurance Company Will Have a Lawyer
A big reason to hire a lawyer is that it will even the playing field. You can bet that the insurance company will be represented by a lawyer at the hearing. The insurance company's lawyer will be experienced in defending against workers’ compensation claims and will know the ins and outs of the workers’ compensation system. Even the most well-organized and eloquently spoken worker will likely be unable to match the lawyer’s knowledge of the law, procedural rules, and strategy. And for good reason: workers’ compensation lawyers have been through extensive training through school and work experience.
A Lawyer Will Increase Your Odds of Success
To achieve a successful outcome, there’s a lot of preparation that goes into a workers’ comp hearing. Much of this preparation happens in the several months leading up to the hearing, during a period called “discovery.” Discovery is a time when your lawyer will use certain legal tools to gather information and evidence in support of your claim. For example, he or she may send written questions to the insurance company (called “interrogatories”) to get a better idea of its strategy and the evidence it plans to use against you at the hearing.
Your lawyer may also question witnesses under oath (called “depositions”), represent you at your own deposition taken by the insurance company’s lawyer, and secure another medical opinion if there’s a dispute about the severity of your injuries. All of these legal tools must follow a certain procedure and format, including paperwork requirements and strict deadlines.
At the hearing, your lawyer will need to present your case in a clear, and persuasive, manner to a workers’ compensation judge. Among other things, your lawyer will make an opening statement, present documents, question witnesses who support your case, cross-examine witnesses who undermine your case (such as a doctor working for the insurance company), point out errors or inconsistencies in the insurance company’s legal defense, and make a closing statement.
A lawyer can also increase your odds of getting a fair settlement without even going to a hearing. With a lawyer in the picture, the insurance company will be much more motivated to negotiate. And, your lawyer will be able to evaluate whether the settlement offers are fair, given the benefits that you could recover at a hearing and likelihood of success.
Hiring a Workers’ Compensation Lawyer is Affordable
Because of how the workers’ compensation system is set up, hiring a lawyer is often a win-win situation for injured workers. Workers’ comp lawyers work on a contingency basis, which means that they take a percentage of any settlement or award that they receive on your behalf. In other words, you don’t have to pay for attorneys’ fees up front, and you only pay if you win. And, although you will have to give up a portion of your settlement or award, your lawyer will likely get you a much larger recovery than you could have achieved on your own.Hiring a lawyer is also made feasible by state law caps on attorneys’ fees. While the maximum amount a lawyer can charge varies from state to state, it is usually in the range of 10% to 25%. For example, in California, attorneys’ fees are usually between 10% and 15%. In Texas, the maximum fee is 25%. Some states, including California, also require attorneys to provide an initial consultation, free of charge. (For more on fees and costs, see What Does It Cost to Hire a Workers’ Compensation Lawyer?).