Do You Need a Lawyer with a Workers' Compensation Claim?

Workers’ compensation is a system that provides benefits to employees who suffer work-related injuries or illnesses. It is designed to cover medical expenses, lost wages, disability benefits, and vocational rehabilitation. Workers’ compensation also protects employers from being sued by injured workers in most cases. What are wage loss benefits?

However, workers’ compensation is not always straightforward or easy to navigate. There are many issues that can arise when filing a claim, receiving benefits, or disputing a decision. Some of the most common issues that workers in Montana face are:

Eligibility

Not all workers are eligible for workers’ compensation in Montana. For example, independent contractors, domestic workers, agricultural workers, and some volunteers are generally excluded from coverage. However, some of these workers can opt-in to coverage by paying a premium. Additionally, some employers may try to misclassify their employees as independent contractors to avoid paying for workers’ compensation insurance. Workers who are unsure about their eligibility should consult with an attorney or the Montana Department of Labor and Industry.

Reporting

Workers who are injured on the job must report their injury as soon as possible, but no later than 30 days after the incident. Failure to report within this time frame may result in denial of benefits. Proof that the accident was reported can protect the worker’s right to make a claim at a later date, so the best practice is to report all accidents in writing. Workers should also seek medical attention as soon as possible and inform their doctor that their condition is work-related. What is FROI?.

Claim Denial

Sometimes, workers’ compensation claims are denied by the employer or the insurance company for various reasons. For example, the claim may be denied if the injury or illness is not work-related, if the worker was intoxicated, if the worker failed to report or seek medical treatment in a timely manner, or if the worker provided false or incomplete information. What is an IME? If a claim is denied, the worker has the right to appeal the decision with the Workers’ Compensation Court, but must first attempt mediation with the Montana Department of Labor & Industry. There is a time-limit to appeal denied benefits; this “statute of limitations” is generally 2 years from the date of the denial.

Benefit Disputes

Even if a claim is accepted, there may be disputes over the amount or duration of benefits. For example, the employer or the insurance company may dispute the extent of the worker’s disability, the necessity of certain medical treatments, or the worker’s ability to return to work. If there is a dispute over benefits, the worker can request mediation. If mediation is not successful, a worker may file a petition with the Workers’ Compensation Court.

Retaliation by Employer

Workers who file workers’ compensation claims are protected from retaliation by their employers. Retaliation can include termination, demotion, harassment, discrimination, or any other adverse action that affects the worker’s employment. If a worker believes they have been retaliated against for filing a claim, they may have grounds to pursue a civil lawsuit.

Hiring an Attorney

While some workers may be able to handle their own claims without legal assistance, others may benefit greatly from hiring an experienced workers’ compensation attorney. An attorney can help them understand their rights and options, gather evidence and documentation, negotiate with the employer and the insurance company, and represent them in mediation or court proceedings.

Some situations where hiring an attorney is advisable include:

• The employer disputes or rejects the claim
• The claim is not supported by strong medical evidence
• The claim involves permanent or life-altering injuries
• The worker has been offered a settlement that does not cover all of their expenses and losses
• The worker has a pre-existing condition that may affect their claim
• The worker misses several days of work due to their injury or illness
• The employer fails to report the injury to the insurer or does not have insurance at all
• The employer fires or retaliates against the worker for filing a claim
• The employer or insurer requests a medical examination from a specific doctor

Workers’ compensation can be a complex and challenging process for injured workers in Montana. However, with proper guidance and representation, they can overcome these issues and receive the benefits they deserve.

We are here to help you

If you have been injured at work and have questions about your workers' compensation rights, our workers' compensation lawyers have extensive experience in this space. At Odegaard Injury Lawyers, we can advise you about your coverage and guide you through your options and opportunities. Contact us for a free consultation.

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