Attorney vs. Self-representation for Workers’ Comp Claims

Hiring an attorney often sounds intimidating, even at times when it’s just the practical thing to do. In cases of workers who were injured on the job, it’s not only practical, but imperative to seek out legal help. Research has shown time and time again that injured workers who hire attorneys receive greater financial benefits than those who choose to represent themselves.

In the United States, there is no minimum federal standard for workers’ compensation benefits. States govern their systems differently, and those systems can be difficult to navigate. Attorneys, especially those who focus on workers’ compensation, have the experience, resources, and familiarity with these systems to put together a claim that will have the best outcome for people who were injured or became ill due to work-related activities.

How long do these claims take?

Workers compensation claims can drag on for months or even years based on the intricacies of the case. A survey done by Martindale Nolo Research found that the average time it takes to resolve a workers’ compensation case is about 16 months. Though the survey accounts for both voluntary settlements with insurance companies and legal hearings, only 19 percent of respondents reported their claims to be resolved in under six months. Around half of the respondents fell between 13 and 24 months, with 9 percent reporting their claims taking over two years.

One thing that can make a case take longer is hiring an attorney, which makes sense. Attorneys have more resources, make more appeals, get second opinions from medical professionals, and document everything. They do things that workers representing themselves may overlook or deem less important. This attention to detail and thoroughness in legal proceedings is part of the reason they also get better results. In fact, according to the same survey that accounted for time to resolve a case, claimants with lawyers received nearly one-third more in compensation compared with workers who chose not to hire attorneys. Experienced workers’ compensation attorneys can also provide estimates for how long a case will take to be resolved, and what factors will determine the case length, which are important considerations in determining how claimants should manage their finances or medical regimen during that time.

What kind of compensation should you expect?

The same company that did research on the length of workers’ compensation proceedings has data on their outcomes. A 2015 survey by Martindale Nolo Research placed the average compensation at $21,800 for injured workers, though payouts typically range from $17,000 to $27,000. The results also showed that 73 percent of claimants received compensation, while 27 percent received no settlement or reward. Interestingly, the numbers varied quite a bit when comparing claimants who hired attorneys with those who did not. Injured workers who hired attorneys received an average of $23,500 while those who represented themselves received around $18,000. So on average, claimants with attorneys received $5,500 more than those without.

Hiring an attorney does come at a cost, but according to this research, the net gain of having legal help outweighs the funds spent on it. In this instance, respondents reported that lawyers received about 15 percent of a worker’s settlement or award as part of their contingency fee. These percentages are typically capped at a reasonable amount according to the laws of a particular state. Even if you take out 15 percent for a contingency fee, the sum for those who had legal representation averages to $20,000, still quite an increase over the $18,000 taken in by workers without representation.

When making the same comparison but with workers who had claims denied by insurance companies or had their permanent disability ratings challenged by insurers, the results are even more staggering. Responses showed that workers with disputed permanent disability ratings received an average of $18,100 if they were represented by an attorney and $2,600 if they were not. Similarly, workers with denied claims received $18,200 on average if they hired an attorney and $12,400 if they did not.

There’s also information that supports better outcomes for attorney-supported workers in workers’ compensation hearings. While not on quite the same level as a trial, these hearings require some legal legwork. In these cases, the average award for those represented by an attorney is at $27,400, much higher than the $15,700 taken in by those who represented themselves.

This data showing that attorney involvement boosts benefits received is supported by data from the Insurance Information Institute, which shows a 12- to 15-percent increase when injured workers hire legal help. It’s also worth noting that these figures do not account for the time saved or frustration avoided by workers not having to navigate all of these processes on their own.

A closer look at the differences

When looking at studies with a more narrow scope, the idea that injured workers with legal representation have better financial outcomes in their claims than those without representation holds true.

According to figures from the Colorado Department of Labor and Employment, 5,603 work-related injury cases were settled for a total of $186,206,929. Of those cases, 1,216 claimants represented themselves while 4,387 maintained legal counsel. The average award for those who represented themselves was $16,671. For those who hired counsel, it was $37,837. On average, that’s about a $21,000 difference, and still almost doubles the unrepresented sample, even if the attorney takes a 20-percent contingency fee. The Minnesota Department of Labor and Industry conducted a study from 2008 to 2010 on the workers’ compensation settlements and hearings. The findings showed that of the 68,983 indemnity claims closed in that timeframe, the 16,126 that included attorney fees had an average of $49,560 indemnity paid while the average across all cases was $15,308. Even with attorney fees averaging $7,490, that’s a huge difference.

Between 2010 and 2011, California courts saw 30,701 civil cases, according to research by Kaire & Heffernan, LLC. Of those cases, 37 percent chose to represent themselves. The data included a survey of 61 chief justices, where 58 percent of respondents felt that people representing themselves “lacked law knowledge sufficient to help their cases,” and 53 percent felt that they “actually failed to understand the consequences of their own actions or inactions.”

Significant individual cases

There is no shortage of examples to animate this point, but a few cases stand out as instances where injured workers’ claims benefitted considerably thanks to legal assistance.

In 2011, a Pennsylvania worker who was left quadriplegic after a work-related accident, was awarded $3 million in a settlement with his employer’s workers’ compensation carrier in addition to tens of millions in other settlements surrounding the injury. According to his workers’ compensation attorney, Samuel Pond of Pond Lehocky Stern Giordano in Philadelphia, negotiations began at $750,000. Pond was able to secure four times that amount for his client.

Attorney Christopher Asvar was able to get a $8.9 million settlement for a California painter who suffered a brain injury after falling from a scaffold. The case was settled in 2012, five years after the injury and three years after Asvar had taken over. Asvar said his client had suffered from depression, anxiety, psychosis, a psychiatric diagnosis of multiple personality disorder and other disabilities. He was able to negotiate a settlement that was one of the largest in the state’s history.

In these examples, the injuries were severe and life changing, but they illustrate the difference an attorney can make in workers’ compensation claim on any level.

What does this mean?

Most workers’ compensation claims do not involve a catastrophic injury. As stated before, the average claim sits around $21,800, regardless of a claimant’s legal representation. Especially as state legislatures continue to cut their workers’ compensation benefits, it’s important that people have the support to successfully operate within a system that is increasingly working against them.

Most claims will not be worth millions of dollars, but legal representation can improve outcomes significantly. Lawyers can look at a case and estimate the settlement between $20,000 and $35,000, for example. The goal probably is not to get $75,000, but to get as close to that $35,000 as possible. These are things that people who represent themselves may not know, and they are integral to achieving the best outcome for claimants. Often it can be the difference between having your medical bills paid and being compensated for time missed, and struggling with thousands of dollars of debt over the next several years of your life.