As state senators review a comprehensive workers’ compensation reform law, the traditional pro-business Republican and pro-labor Democrats are lining up on either side.
Alarmed after a 14.5% insurance premium increase, Republicans in the House passed a bill that’s designed to “reduce attorney involvement in the system,” according to Rep. Danny Burgess (R-Zephyrhills). The House measure caps attorneys’ fees at $150 per hour regardless of the nature of the case; the House proposal would also cut provider payments, a move that would probably reduce worker options in terms of injury treatment and physical rehabilitation. State senators have so far opposed both these cost-cutting measures, instead endorsing a plan with a $250 per hour cap that does not reduce medical reimbursement. Democrats say that a higher cap would ensure that injured workers are not forced to settle complex claims at less than full value. “The playing field has already been severely tilted against the injured workers,” complained Rep. Evan Jenne (D-Fort Lauderdale).
So far, there has been no increase in workers’ compensation claims, despite dire predictions from the National Council on Compensation Insurance. In fact, the number of claims has dropped by 50% since the Legislature last overhauled the system in 2004.
Attorney Involvement in WC Claims
Although fewer than one in 10 workers’ compensation claims are resolved at trial (most of the others settle out of court), attorneys are essentially the great levelers in this forum. It is fairly easy for insurance company lawyers to bully unrepresented victims. One common tactic is to make multiple requests for obscure documents. The insurance company lawyers know that the victim is both a layperson and struggling to deal with a serious injury, so they also know that these requests will cause considerable consternation.
The lawyers also know that the victim is not working and is probably experiencing substantial financial strain, so they often make settlement offers for a few pennies on the dollar and hope that the victim will be desperate enough to accept. Sadly, in many cases, that is exactly what happens, and victims sell their claims for a fraction of their value.
Part of the reason victims undervalue their claims is that many of them do not receive the proper kind of medical treatment. Many job injuries require a specialized approach, and it is not always easy to locate doctors who have the right skill set to diagnose and treat such injuries. As a result, some victims settle their claims too early, and only realize later that their injury was much worse than they had originally believed.
An attorney addresses all three of these deficiencies.
- Legal Tactics: Experienced workers’ compensation lawyers can identify both the strengths and weaknesses of a given case. By emphasizing the strong points and being prepared to defend the weak points, they maximize compensation for injured victims.
- Legal Strategy: Because of their knowledge, attorneys can accurately evaluate how much a claim is worth, based on a combination of factors like that particular insurance company’s attitude toward that particular type of claim (i.e. will they fight it tooth and nail or will they be willing to compromise), the nature of the injury, the normal treatment protocol and prognosis for that injury, and the legal arguments that support (or do not support) the claim.
- Trusted Counsellor: Finally, because of their experience, workers’ compensation attorneys can connect victims with the medical help they need, normally at no upfront cost. So, they see their maximum medical improvement.
The bottom line is that a workers’ compensation attorney takes care of the important legal and financial details while victims simply focus on getting better.
Forcing attorneys out of the system, as some Republicans want, has the opposite effect. When the injured victims return to work, unless they were fairly compensated, they are not 100% healthy and thus at risk for future injury. Moreover, if they feel they were short changed, they may be demoralized or, even worse, have an outright negative attitude towards the company.
All this opposition to attorneys’ fees may be something of an overreaction anyway. Workers’ compensation costs have plummeted since the 2004 reforms, so even with the rate increase, costs are nowhere near as high as they were a decade ago.
To start your workers’ compensation claim on the right foot, reach out to Barnett, Lerner, Karsen & Frankel.