You were hurt on the job and filed a workers’ compensation claim. After you file a claim you will be contacted by an adjuster. The workers’ compensation adjuster will need to speak with you about your injury to obtain information and get answers to questions. Many times these conversations are recorded and they will serve as a reference later in the case. If there are problems or discrepancies later your conversation may be crucial in deciding your claim.
How to Communicate with an Adjuster
The adjuster will typically have a list of questions prepared for the interview. If you are unsure of a question do not provide an answer until you get clarification. If you don’t remember or don’t know the answer, don’t speculate.
Don’t try to second-guess the adjuster. You don’t know where the questions are leading so it is best to simply answer them as truthfully as possible. The most important questions will likely revolve around your medical treatment. The adjuster will try to find out whether you had an existing condition that would keep you from being awarded a workers’ compensation claim.
It is often best to seek legal representation from a qualified workers’ compensation attorney. Your lawyer will help guide the process and will advise you about how to answer questions regarding your case. You may want to seek guidance from an attorney to help you through the workers’ compensation process.
What do I do if my Benefits Stop?
Sometimes a case doesn’t progress as it should. When there are questions or problems that remain unanswered, the adjuster may decide that the case is taking too long and will stop your benefits. If this happens you need help quickly. Your lawyer will determine what has caused the problem and will then work to resolve the situation so that your case reaches a favorable conclusion.
An adjuster may stop your benefits if he or she wants to end the case more quickly. The adjuster knows that when the benefits stop you will be more likely to accept a settlement, even if it is too low. Do not accept a low settlement until you talk to your attorney first. Your lawyer will try to get you the money you deserve for the injuries you suffered while on the job.
Know That an Adjuster Isn’t on Your Side
The first and most important thing to note is that a claim adjuster is not on your side, even if they appear to be very friendly. An adjustor works for an insurance company that is in business and wants to make profits. Their end goal is to minimize the amount of money they pay you as much as possible.
An adjuster may not be a bad person, but their objective doesn’t play to your advantage. Their job is to pay you the lowest amount of money or even deny your claim to save the insurance company cash. So, be very cautious when dealing with them and giving them information that may jeopardize your claim.
If you consult a Georgia personal injury lawyer before talking to an insurance adjuster, you may have a better hand at the negotiations. The attorney will analyze the facts of your case and guide you on what to answer and avoid answering during a discussion with an adjuster.
Here are several do’s and don’ts when speaking with a claim adjuster to ensure you don’t jeopardize your chances of getting compensated:
The first discussions about your accident and compensation claim may be difficult, but you need to remain calm through the process. It’s possible to hear from several insurance companies and adjusters, so make sure that the facts you give don’t contradict each other.
Here are a few things that you should do when the adjuster calls you up:
Note Down the Details of the Adjuster
The first step you should take before discussing anything with the insurance adjuster is to write down their information. Ask for their full name, name of the insurance company they work for, address, contacts, and name of their business if they’re an independent claim adjuster.
Give the Adjuster Limited Details of Your Personal Information
The adjuster will ask you for some personal information like your full name, address, and contacts. It’s okay to give them that. But don’t go as far as to provide them with details about your work, income, or personal family information.
Take Notes of the Conversation
Have a book and pen ready to scribble down details of the conversation between you and the adjuster. It’s imperative that you do this in case the adjuster says something else later on, and you’re not sure if that’s true or false. Note the questions they ask you and if possible the replies you give.
Even if you’re angry about the accident and the circumstances surrounding its occurrence, don’t pour out your anger on the claim adjuster. It will not help in winning your claim. Most adjusters have come across fuming claimants, and it doesn’t always end well.
But remember to keep in mind that an adjuster isn’t on your side. Being nice has its perks. The adjuster may expedite your compensation claim just because you’re friendly to them.
Ask them Questions
Don’t let the conversation be one-way. Also, ask questions like whether the adjuster is aware of any witnesses and if they can send you a copy of your employer’s first accident report. If you have not yet seen a doctor, ask for a list of the insurance company’s recommended physicians.
It’s good to know what questions you can ask a claim adjuster. An Atlanta workers compensation lawyer can help you draft several questions.
Describe Your Injuries Inclusively
When the adjuster asks about your injuries, describe them in an overly inclusive manner. You must ensure that every part that’s injured will be covered. If you fail to mention any area, the adjuster will be very happy not to pay for it.
For example, your leg could be hurting in the knee and ankle areas only during your conversation with the adjuster. But a week later, the pain spreads to your pelvic bone. In such a case, you should tell the adjuster that the injury is on your whole limb instead of giving specifics.
Tell the adjuster that you will provide them with a detailed and conclusive medical report once the doctors have done a full check-up on you.
As you speak to the claims adjuster, avoid doing the following. They could affect your chances of getting compensated:
Don’t Give Details of the Accident to the Adjuster
When discussing your claim with an adjuster from the worker’s compensation insurance company, politely refuse to give the details of the accident. They may try to engage you in such a conversation without you knowing. Just give them the general information about the accident like where, when, and nature of the occurrence.
Tell them that you’re still investigating the matter and will provide better details at the right time.
Don’t Agree to an Audio Tape or Document Signing
You don’t have to provide a recorded statement to the adjuster. If the claim adjuster sends you forms to sign, only do so after your Georgia personal injury lawyer has reviewed them.
The most common document that an adjuster will send you in Atlanta is the medical authorization form. This allows them to obtain your medical records. You’re obligated by the Georgia workers’ compensation laws to give some type of medical authorization to an insurance company if you’re making a claim and they request it.
Tactics Adjusters Use to Reduce Your
Dealing with an injury is never easy, but when you were hurt at work, the situation becomes more involved. When you file a workers’ compensation claim you will need to talk to the insurance adjuster throughout your case. It is important to understand that the insurance adjuster, or your employer, may try to utilize some common tactics during the claims process that could impact your claim. Call an experienced workers’ compensation attorney in Rome to help you avoid some of the pitfalls of the procedure.
Refusing to Approve a Referral Physician
The authorized treating physician (ATP) is your primary doctor when you first get treatment for a work injury. Once your doctor evaluates your condition, he may find that you need to see a specialist or another doctor. In some instances, the insurance company might not approve the referral. This could delay your treatment and make the situation more difficult. The insurance company should not do anything that may negatively affect your medical care.
Waiting Too Long to Approve Your Claim
Workers in Georgia are entitled to workers’ compensation benefits if they are out of work for longer than a week with a work injury. Unfortunately, the insurance adjuster may take a long time to approve your claim in the hopes that you will simply recover and go back to work and they won’t need to make a payment. Consult with your attorney if your claim is delayed.
Employer Offering Light Duty
Sometimes an employer may informally tell you that if you return to work they will provide you with a light duty job. If you don’t take the offer, the insurance company may try to say that you were unreasonable and that you did not want to go back to work. Unless the employer goes through the correct process and gets the light-duty job approved first, you are not required to accept this offer.
Taking Recorded Statements
The insurance adjuster will speak to you to discuss the details of your accident and injury. Be aware that the statements they take will be recorded. Recordings allow them to use your own words against you later in the workers’ compensation case. For example, if you leave out some important details, the adjuster may say that your statement is inconsistent with your injuries. Therefore, do not speak to an adjuster before you talk to your workers’ compensation attorney.
Not Allowing You to Change Doctors
The Georgia Workers’ Compensation laws allow you to make one change to your primary physician or panel of physicians. You are within your rights to request a change; however, sometimes an employer may not allow you to do so. This is something you should immediately bring to the attention of your workers’ compensation attorney.
Get Help From a Workers’ Compensation Attorney
Workers’ compensation cases can be very complicated. Even those that seem straightforward can be complex and difficult to resolve. You need help from an experienced workers’ compensation lawyer. Your attorney understands how to resolve even the most difficult cases in a favorable way. Sometimes there is a simple fix to your situation that your lawyer will facilitate. Keep in mind that the adjuster works for the insurance company and therefore wants to provide the lowest compensation possible. Regardless of the complexity, a lawyer will ensure that your rights are protected. He will answer your questions and guide you through the entire process.
When you have been injured at work, don’t delay. Contact the compassionate legal team at Bader Scott Injury Lawyers to discuss the details of your case today.