Who is your workers comp adjuster?
The workers' comp adjuster is the representative of the workers' comp insurance company that communicates most frequently and directly with you or your workers' comp attorney.
The whole reason they are employed is to help the insurance company make money - that's what insurance companies do.
Think about it -- simply by the name "adjuster." They adjust your claim to try and save money -- simple as that.
Many times adjusters do this by trying to delay and deny your legitimate claim. They receive training on how to minimize the benefits you should get, and they are often so overworked, handling so many cases, that they can't even get to yours. They are there to save the insurance company money, and if that means you get less in benefits and medical treatment, that's just the way it is.
We don't let our clients get taken advantage of by workers' comp adjusters.
Our clients don't talk to adjusters, case managers, insurance nurses - we do.
There are some tricks that we see often that you might be experiencing while dealing with your workers' comp adjuster. Watch out for them.
Here's a list of the top five workers comp adjuster dirty tricks.
1) Recording a statement while you are in pain or under the influence of strong pain medications. After a serious work accident, of course you are in pain due to your injury, plus you're probably uncertain, stressed out and not sure what you need to do in the workers' comp system. You are not alone. Many adjusters know this is the worst time (for you - but its the best time for the workers comp insurance company) to get a recorded statement, knowing that you are now more likely to say something that they can use to delay or even deny their claim. Don't let this happen to you.
2) Misrepresenting the benefits you can receive under the law - this is a big one. Because they know some injured workers don't have an attorney (or worse - have the wrong attorney), they make it seem like you can't get certain benefits when they know you can, or they never tell you about the workers comp benefits you are entitled to.
Protecting you and providing for your family IS NOT not the insurance company's job. Educating you on the workers comp system (there are 58 chapters of regulations interpreting the statute) IS NOT their problem. You may not know what to ask for, and they won't tell you.
3) Intentionally not returning your calls - Not hearing back? It's a tactic to make you frustrated. They ignore you or play phone tag as a way to delay and deny your medical treatment and benefits. We have professional, full-time staff to make sure your adjuster is not ignoring you.
4) Wanting to settle too quickly - some adjusters, if they have a sense that the injury is serious but there isn't enough documentation readily available, will try to settle your case before you know the extent of the injury and what you're entitled to, just so that they can "low-ball" you. Be wary if they offer you money but don't know everything that happened. You may be taking way less than you deserve. An experienced attorney will be able to evaluate your claim and project the type of settlement you may be entitled to.
5) Advising you not to get an attorney - this one we see often, and can be the most damaging. Imagine being questioned without having a lawyer present - it makes it easier for them to take advantage of you if they know you don't know the law and don't know how much you deserve. They can more easily (and legally) give you less than what you rightfully deserve under the law if you don't have a lawyer. Insurance industry studies routinely show they pay more on cases to people who have lawyers.
Don't make these mistakes! If you've been seriously hurt, get all the information you can before trying to handle your claim by yourself. Make sure you contact us at 202-393-3320 so you can begin the process of getting representation if you truly need it. Click here to see why else you shouldn't handle your serious injury workers comp claim alone.
Now that you know some of the common traps, tricks and strategy they use against you, you'll be ready if they ever happen to you. And remember, when we talk about your adjuster, he/she has a whole team of insurance company lawyers, doctors, nurses, case managers, and other specialists. They've handled thousands of cases just like yours for the insurance company. You may not realize it, but they are there, working against you, literally from the moment you get hurt. That's a lot to go up against.
The best way to protect yourself is to know the system, and have someone fighting on your side. The first thing you can do is order our free book on workers' compensation in D.C. Protect Your Rights: The Ultimate Guide to D.C. Workers' Compensation. You can order it here on our website, or call us at 202-393-3320 to get your free copy mailed right to your doorstep.
By the way, this book is only available to injured workers in the DMV, its not available to employees of insurance companies, their law firms or vendors - because it's the book they don't want you to read.
And if you need to, give us a call at 202-393-3320 when you want to talk about your specific situation - you'll get a live person here - someone who can start helping you right away.