I share my experience with workers' compensation cases in order to help others avoid my mistakes.
My Workers' Compensation Lessons in a Nutshell
Read on below to hear in detail about my workers' compensation case and how it all panned out. However, here are the main nuggets that you should be picking up from my story if you're involved in your own workers' compensation dispute:
- Settling a workers' compensation case without an attorney is possible. Make sure you do the proper research early on.
- Ask the right questions! Know about apportionment and getting lump sum payments based off a financial hardship.
- If you decide to hire an attorney, make sure that you shop around carefully for one.
Want to know my story? Read on.
My Workers' Comp Story: How and Why I Fired My Attorney
It’s been nearly a year since the resolution of my workers’ compensation case, and I’m sad to say, I still don’t feel like I have closure. I realized early in life the therapeutic value of journaling, and since I can't afford therapy, this is my way of attempting to process the events that transpired in my life. I came up with the idea to write this article last year and made a post just to test the waters. Unfortunately, even though I’m a former journalism major and have written on a business level, I’ve never been one for discipline.
Since then, I've quickly come to the conclusion that if I don’t commit to blogging, I’m going to need to be committed! So here I am, spilling my guts.
Summary of What Happened to Me
I was previously engaged in a long, drawn-out workers' compensation claim that I’d been fighting ever since July 2003. Although the primary part of my case settled fairly early on (with a less than happy outcome), the other issues that remained kept me engrossed in litigation until December 2007! In addition to that, at one point, it became necessary to fire my attorney and represent myself during the proceedings.
Oddly enough, when I began representing myself, I won as many battles as I had lost. I wish I had done the legwork that I ultimately ended up doing myself earlier on in my case. If I had known half the information I eventually learned, I would have never hired a lawyer in the first place! In fact, as far as my particular case went, having an attorney is what first got me screwed!
I’ll start at the beginning, but I promise to make it short and sweet.
How I Sustained My Injury
I worked for the County of Los Angeles Department of Children and Family Services. Having been a product of the foster care system as a child myself, I knew firsthand what the consequences of doing your job poorly could mean to a child’s life. A simple piece of misfiled paperwork could actually mean the difference in a child receiving foster care placement. It might represent a voucher for school clothing, or a crucial court date, or a number of other equally important things. That is why I always performed my work efficiently and with pride.
For some time, I worked alone in a large room full of case files. My job required me to receive, update, and maintain boxes and boxes of files on a daily basis. Many county employees viewed the job as grunt work, and my supervisor had been having a lot of trouble keeping someone in the position before I came. Although it was a laborious job, and I could have later transferred to something less physical, I stayed and did the job that no one else wanted to do.
Hardly a day went by that someone didn’t commend me for the new appearance of the file room, thanks to me (no more unsightly boxes all over the floors and tables). I made things run much more smoothly for myself and my coworkers. I personally created an organized system of storing the files that required temporary housing, and my former department uses that system to this day.
I shared the above paragraphs with you only to show that my diligence and dedication to my job was something that I put a high value on. My only crime was approaching my job with more energy and enthusiasm than the former employees, but unfortunately, that is what led directly to my work-related injuries. The daily packing up and breaking down of boxes, coupled with the bundling, taping, lifting, and carrying of cases, eventually took a toll on me physically. I also did data entry, so that meant even more repetitious work, which didn't help my condition any. At age 45, I ended up with Carpal Tunnel Syndrome of the right wrist and Median Epicondylitis of the right elbow.
How My Claim Process Went
In the beginning, I didn’t have a clue on what to expect from the claim process. I hired an attorney and filed a worker’s compensation claim after a physician diagnosed my symptoms. The doctor took me off work and my employer honored my claim with no dispute. Even though my attorney had a tendency to evade answering some of my direct questions, either verbally or written, I thought the case was progressing okay and there would be a decent financial outcome.
While portions of the worker’s compensation case did go relatively smoothly, there were some snags along the way. The doctors concurred on the type of surgery that I needed, but did not agree on the medical rating, with reference to the percentage of disability. Both the attorneys negotiated and came to a compromise.
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The only problem was that by the time that the primary part of the case had actually settled (September 2004), there was nothing left of the funds that my attorney had negotiated for me. It had been eaten up when I was paid small monthly checks by the insurance company over the course of time. These meager payments had been sucked up as my living expenses while the case was pending! Imagine my disappointment to find that there would be no lump sum payment, even though the case had settled.
To make matters worse, two new areas of dispute arose. 1. The issue of vocational rehabilitation, as well as the matter of an 2. Available modified or alternative job position.
How My Attorney Screwed Me Over
Keep in mind that I am stating very simply the events that occurred, as I now understand them. However, at the time I didn’t know what the hell was going on. Why? Because I was kept in the dark. My attorney told me only what he wanted me to know, while withholding vital information that I should have been privy to. For example:
- Apportionment. A primary issue regarding the medical rating had to do with apportionment, or how much of my condition was attributed to the job. Both doctors agreed that the condition was solely job-related. If my attorney had not continually rejected my choice to have a hearing on the matter, I believe I would have received a higher rating. Instead he shrugged me off, and managed to manipulate paperwork and get around my decision not to settle.
- Lump sum available. While he was representing me, there came a point when I was so financially strapped that I was in danger of having my car repossessed. My doctor had already determined my condition to be at a Permanent and Stationary stage (which meant no future change in my condition was expected, so a rating could be determined). This would mean a transition in the type of benefits to be paid. I started receiving small permanent disability payments. However, they weren’t enough to save my car from being repossessed. If my attorney had informed me that I could have requested a lump sum of my permanent disability, based on my financial hardship, instead of small monthly stipends, I wouldn’t have lost my car!
That situation, as well as others, began to make my blood boil. You would think that at the top of the list of my grievances would be the ruthless insurance company. Actually, not so. Given the nature of insurance companies, plus the fact that they’re representing the opposing party, it’s almost understandable that they would behave in the way that they do. What’s not understandable, and makes me sick to my stomach is the fact that I got screwed not just by someone that I trusted, but by someone I actually paid to help me.
In the End
I know now that I should have followed my instincts about my attorney and dropped him sooner. I fault myself for that. I’ll never forgive myself for being so blind and totally relying on someone else to look out for my best interest. Represented or not, it pays to know as much about a situation as you possibly can. At the very least, learning the right questions to ask can mean a world of difference!
This article is accurate and true to the best of the author’s knowledge. Content is for informational or entertainment purposes only and does not substitute for personal counsel or professional advice in business, financial, legal, or technical matters.
Mario on September 17, 2019:
Well i got injured at work back in 2010 with 1 Emergency knee surgery 2 weeks after my injury and 3 back surgeries that followed im still in alot of pain insurance pretty much denies what ever meds i need and has and been denying my pain meds in whitch 8ve been paying outta pocket myself now these past few years. Ive ask my lawyer evey every month if there has been any luck settling and i get the same answer all the time saying that the insurance company hasnt offered or any settlement offer yet and now its been 9 years since my accident at work here in California any ideas on why it could be taking so dam or anything that i can and should do to speed it up. Thanks
William Dorsey on December 01, 2018:
Well I was let go of being accused of being sleep on the work place and I was not sleep at all and lost my job and became homeless and on Nov 13th on my third appeal from the state of NJ said that my misconduct had nothing with me getting let go so I feel as sought I won my appeal I should get my job back
F.B on November 29, 2018:
I got hurt on the job, with a back injury, 01/2018, I did receive Workman comp, check weekly but not much. Treatment was very slow and refusing some treatment by the the insurance company. I got upset and hire a lawyer, the lawyer started pushing for settlement, which wasn’t looking right for me.I told my lawyer that iam still taking treatment, but she insisted that my dr said that surgery was off the table. Look injury workers out there, be aware of bad lawyers who are just there to take advantage of distress and pain and frustrated workers. As I said this money grabber lawyer took my case, and mess me up, just for little money. The injury left me depression and stress pain and confuse and this lawyer took advantage of me signed for settlement that doesn’t have any medical to continue my treatments. I never knew that what she agrees to until I came home with the paper work, and call her after two days she call back and said yes that what I signed for. Look this lawyer will get a very bad hit in her life if she continues doing this kind evil to injury hard working workers. She will meet the wrong one down the road. I am left with no medical treatment and for my injury and little settlement. Iam a father of four little children to take care off, and don’t know what to do, still in pain daily and frustrated and depressed. Can someone give me some advice.
A.S on September 25, 2018:
I believe they need to take away the workman's comp claim & return to suing our employer due too them treating the claim like a personal injury claim. Its supposed to be a bargain between employer & employee, but its just an insurance scam.
Josh on August 23, 2018:
I am living a very similar situation in that my attorney originally told me almost nothing when my case was settled. He DID assure me I would have lifetime future medical coverage, and the agreement does show that (a simple check box), but he didn't tell me that every time I needed that coverage, the insurance company would block it. Had I known, I would never have accepted my deal. In fact, neither the employer, nor my attorney told me I had was allowed to retain the right to file civil claim against my employer, and waive Workers Compensation.
If claimants knew that every time they need to utilize future medical coverage from a "future medicals" settlement, they would likely fight many, many months, to get medical treatment they need immediately. In my case I fought for over 15 months before an Administrative Law Judge would hear my complaint, and luckily they sided with me, and I got treatment. However, my original attorney (who also promised to help me in the future) refused, because he wasn't allowed charge a fee after his original fee was paid.
Now I am 20 years post injury, and again need treatment. I have tried in vain for nearly four months to get the the insurer to approve treatment, yet they still scheme to find grounds to refuse treatment. The Workers Compensation /Labor Department of my state is a flippin' joke.
So here's the issue: Attorneys will tell you anything to make a quick down and dirty fee from Workers Compensation claims. Insurance companies will fight you at every stage for future medical coverage, even when they lack any evidence of further injury to your original injury. State legislatures will do absolutely nothing with reform WC to be equitable for the injured claimant. And, the Labor authority presiding over Workers Compensation in your state, will do nothing to assist the claimant, nor to compel crooked insurance companies to cover claims as agreed upon.
In the end, the injured/claimant looses. If you are being offered a WC claim, my advice would be to hire a personal injury attorney to file a civil claim. It is the closest you will ever get to anything resembling an equitable settlement, and you can get treatment as needed, without theses corrupt insurance companies dleaying medical relief for months or even years.
Joyce on August 09, 2018:
I can relate but i still have attorney and still fighting for a settlement after 8 yrs i had 3 surgerys and i need help
Kabotchnik on August 01, 2018:
It's unbelievable that 4 out of 5 'comments' on this blog- can't even spell correctly in a basic way ( from too much 'texting' using slang and super short abbreviations! ).. No wonder this country is split in half voting wise! People write the way they think... Obviously with a huge amount of sheer ignorance. Aside from that, your story was just hat. A 'story' that offered no real idea's to help others...
Richard Doucet Jr on July 06, 2018:
I got hurt in 2002 I had five back surgeries and two neck surgeries in 2006 lwcc filed for second injury fund relief with out my knowledge. So I had only 30 days to appeal it but I had no attorney at the time so they don't bother to tell you that's what there doing so I was put into second injury fund and now they don't even talk to you about settling my case so it's now 17 years old no help in sight to get out of debt they can care less if you have to live in the street. So I don't want to discourage all these people out there but it doesn't get better
Rosa Coutino on May 29, 2018:
My husband got hurt at work 2008 year and we got attorney and my husband died April 20014 so work compensation and my husband attorney drop case he said that my husband died so we didn't get nothing not his job too I need help what I need to do
Elmer Suveges on May 15, 2018:
Glad i listened to what a High School Auto teacher said Someone injury you on the job Ljnch him kn the face ,Be just wrecked your life.
ollie jefferson on May 03, 2018:
Fell your pain, I am going through the same thing right now. Since dealing with the workers comp bureau I have learned the workers comp system has so many flaws, the system and or laws that was put in place over a decade ago is not working. The way the system works is CLEARLY for the employers. Injured workers are VICTIMIZED TWICE, (1) when employers ignores or tries to completely dismiss the on the job illnesses or injury. (2) A system where there is a 95% failure rate for injured workers, and the 95% failure rate is not because injured workers did not get injured on the job , it is simply because the injured worker have no clue about the laws, have to TRY and FIND a Lawyer who will really WORK on the injured workers behalf and a workers comp system that says injured worker is GUILTY until PROVEN innocent a fact that the employer, employer's insurance , and employer's attorneys are banking on. The worker's comp system was created to level the playing field but as an injured worker The system is FLAWED and very much TILTED