Worth Paying Attorneys' Fees? You Judge.

This is a real story about a real client.  We will protect his identity by calling him Joe, and by saying only  that he worked for a very large employer.  He hired me near the end of his claim, and after considering what  issues might still come up on his claim,  I agreed to discount my usual fee and represent him for a 20% contingency fee of any permanent partial disability award.

 When the  adjuster would not agree to use one of several rating physicians I suggested, a chiropractor was assigned from the rotating list maintained by DIR to conduct the impairment evaluation. I went with Joe to his rating evaluation, and it was apparent to me that the doctor had not  done very many rating evaluations.  The insurer offered Joe a 13% whole person impairment for his low back injury that included a surgery with a fusion at L5-S1 and ongoing neurological complaints in his legs.    The lump sum equivalent of that award for Joe, given his age and his average monthly wage, was $51,586.

I have advised Joe not to accept the offer, as I think that the AMA Guides call for at least a 20% impairment, and that the correct percentage may actually be over 25%.  I filed an appeal for Joe, and the insurer has agreed to do more diagnostic testing that will help determine whether he is entitled to a 25% PPD award instead of the 13% originally offered.

If the insurer offers a 25% award, the lump sum award will be approximately $99,200.  If that amount is offered, after payment of attorneys fees, Joe will net  about $79,360 for his PPD award.  You can do the math to determine whether it was worth it to Joe to hire an experienced workers' compensation attorney to help him on his claim.

According to DIR, in 2009, there were 6,616 rating evaluations done in Nevada.  DIR employees in the north and south are required to review only 10% of those rating reports for obvious errors or for questions that should be referred to  the panel of six rating doctorss.  It is anyone's guess as to the number of injured workers who should have received a higher PPD but didn't, because of errors by the rating doctors.  If you decide not to have legal representation during the time your claim is open for medical care, at least take advantage of experienced workers comp lawyers who are willing to review your PPD award for free.   

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Comments (2) Read through and enter the discussion with the form at the end
Nat - December 14, 2011 9:55 AM

I was a workers compensation adjuster and many settlements are pretty much cut and dried based on a chart. I am not one any more so I can speak honestly about this as I have no interest in it anymore.

I was shocked how many people got attorneys because I would guess about 75% of the time, I would have given the same settlement amount to the injured party with or without the attorney. Having been on both sides of the fence and no longer working for the insurance industry I would always recommend to NOT GET AN ATTORNEY until you experience a settlement or doctor issue as you lose $$ that should have been yours.

Instead I would go out and get the same WC law guides that the adjuster and attorneys have and read it first. You will be surprised how many things are set by statute and attorneys just take your cash.

Virginia Hunt - December 14, 2011 3:13 PM

Thank you for taking the time to post a comment. I'm wondering if you are a Nevada adjuster, because it truly is not that cut-and-dried for most injuries under the AMA 5th edition in Nevada. You don't mention that most attorneys will offer a free initial consultation, and I would encourage injured workers to take advantage of that, and to directly ask the attorney whether they have the type of injury that is likely to have a clear-cut impairment percentage or not. The other point I want to make is that most people hire me to help them obtain better and faster medical care and to help them when they cannot return to their pre-accident jobs. Obtaining a PPD award is a very small part of what I do for my clients. Finally, there is no good source of information for injured workers to learn about Nevada workers' compensation law and the courts' interpretation of those laws. The DIR website is great, but isn't that easy for injured workers to use. That is why I have written my own guide for injured workers, a guide for medical providers and why I continue to write these blog posts. I appreciate your perspective. Virginia

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