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It really depends on the type of case. For things like malpractice, an attorney is almost always needed because you have to find and present expert witnesses, and they know how to do that. For cases where only a few thousand dollars is at stake, the lawyer will cost you more than the recovery, so there's often no need (and many lawyers won't take those cases).
When there is a statute that authorizes a winning plaintiff to recover attorney's fees, like with discrimination cases, it is usually best to have an attorney because the chances of winning the case are higher and many will agree that you don't have to pay if you lose (that needs to be in writing).