What to Expect in a Workers’ Compensation Matter
Most job injury victims can expect considerable opposition, at least initially, and, ultimately, a settlement. Over 80 percent of Florida workers’ compensation claims settle out of court. An out-of-court settlement is usually the best possible resolution because, in most cases, a bird in the hand is worth two in the bush. A firm hold of something good (a favorable settlement) is better than the possibility of something better (a larger ALJ verdict).
However, some variables come into play. Not all birds are the same size, and not all bushes are the same size. So, a Tampa workers’ compensation lawyer must properly assess the size of the bird in the hand as well as the approximate size of the bush. Then, and only then, can a victim determine if it’s best to take the settlement offer or continue pressing forward.
Workers’ Compensation Defenses
Usually, workers’ compensation is no-fault insurance that replaces lost wages and pays medical expenses. Two defenses could affect these benefits.
Lost wage replacement benefits are unavailable if the victim sustained a work-related trauma injury, like a fall, and the victim was under the influence of alcohol at the time. The insurance company could use a drug test or circumstantial evidence to establish intoxication.
Most insurance companies require claimants to immediately take drug/alcohol tests. There’s a strong presumption that if the victim refuses to take the test, the victim has something to hide.
Not all birds and bushes are the same size, and not all drug and alcohol tests are equally reliable. Additionally, insurance companies frequently cut corners during this process. They use cheap tests and cheap analytical methods. Other insurance companies don’t administer tests and rely on circumstantial evidence, like physical symptoms, to establish intoxication. This evidence is much weaker than scientific test evidence.
As for medical benefits, insurance company lawyers often argue that a pre-existing or non-work condition affected the amount of medical bills in the case.
Hearing loss, one of the most common job injury occupational disease claims, is a good example. Most people hear loud noises all day, every day, and not just at work. Maximum medical benefits are available if a Tampa workers’ compensation lawyer proves that a job-related condition was the substantial cause, as opposed to a contributing cause, of the hearing loss. Attorneys usually partner with independent doctors in this area. These doctors then provide the necessary evidence to prove this point.
Settlement Assessment
These defenses could affect the settlement assessment. That’s especially true since, in most cases, the insurance company’s first offer is artificially low.
Most insurance companies use boilerplate actuarial tables to determine benefits in job injury cases. For example, if Vicki breaks her arm, the insurance company may offer to pay for a simple procedure to set the bone, a little follow-up medical care, and a few physical therapy sessions.
However, there are broken bones and there are broken bones, if you get what we mean. More severe broken bones, which are commonly associated with severe work-related falls, often are much more ex[pensive to treat. Usually, doctors must use metal parts to surgically reconstruct the bone. The more intense medical therapy means more intense, and more expensive, follow-up care and physical therapy sessions.
Once again, a partnership with an independent doctor may be critical. An independent doctor assesses the actual cost of injury treatment and recovery, not the ideal cost.
Reach Out to a Dedicated Hillsborough County Lawyer
Injury victims are entitled to important financial benefits. For a confidential consultation with an experienced workers’ compensation lawyer in Tampa, contact Kobal Law. Virtual, home, and hospital visits are available.
Source:
pejif.com/blog/july-2022/nj-wc-reduce-costs
