How the System Works
Find out who are the players and what their role is.
A state agency, they in turn have arbitrators that travel throughout the state. Their job is to either approve a settlement or conduct an arbitration hearing and decide the issues if the case is not settled. These arbitrators are hard-working, good people that do not represent either side, they are neutral.
- The employer typically has a person(s) to manage claims within the workplace. These people, often in human resources, are usually the first to tell the injured worker what the employer and their insurance company, want the worker to do such as see the company doctor for medical care.
- The Insurance Company has received a payment from the employer and issued a policy of workers compensation insurance. The Claim Adjuster is a full-time professional who has been trained and educated extensively in workers compensation law. The Adjuster in turn typically has a Supervisor, a Claims Committee and others to provide guidance and assistance to the Adjuster.
- The Insurance Company Attorney. This attorney typically does nothing but litigate workers compensation cases. Many insurance companies employ both “in-house counsel” who are always available to assist as well as “outside” counsel for representation.
NO ONE ON THE EMPLOYER’S TEAM IS REQUIRED TO PROTECT THE INTERESTS OF THE INJURED WORKER. IT IS AN ADVERSARY SYSTEM, WHICH MEANS THAT EVERYONE ON THE EMPLOYER’S TEAM IS PROTECTING THE INTERESTS OF THE EMPLOYER, NOT THE EMPLOYEE.
A typical working man or woman facing a work injury is usually involved in the workers compensation system for the first time. Although it may seem like an uphill battle facing the adversaries listed above, it can be done. Some of the best attorneys in the state are available to help you and protect your interests. Attorneys are paid on a contingent basis, meaning they are paid a fee as a percentage (usually 20%) of the recovery. Therefore, if you do not win your case, there is no fee. Additionally, expenses such as copying of medical records are usually advanced by your attorney so that no money has to be paid out of your pocket.
This content is intended to provide general information and guidance only. You should see an attorney and obtain advice if you have questions or concerns regarding workers compensation. Most lawyers will not charge any fee for an initial consultation to review your case. Only by asking questions and obtaining answers will you obtain the rights and benefits to which you are entitled.