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How to Deal with a Workers Compensation Claims Adjuster

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If you have been injured on the job, one of the most important people you will deal with is the workers’ compensation claims adjuster. This individual will be responsible for handling your claim and getting you the benefits you deserve. It is important to understand how this process works and what you can expect from the adjuster.

If you or a loved one has been injured in a work-related accident in North Carolina, you are not alone. To help you through this tough time, turn to knowledgeable and compassionate workers’ compensation lawyers. At Collier Law, our workers’ compensation attorneys will help you deal with claims adjusters and help take the burden off you and your family during recovery.

What Does a Workers’ Compensation Adjuster Do?

A workers’ compensation adjuster is responsible for investigating your claim and determining whether or not you are eligible for benefits. The adjuster will also determine how much you should receive in benefits. This process can be complex, so it is important to have an experienced attorney on your side.

Workers’ comp claims adjusters will:

  • Review the workers’ comp insurance policy
  • Gather medical records related to your injury
  • Gather information from your employer about the accident
  • Confirm that you filed your claim within the time limit
  • Interview witnesses
  • Approve medical care, treatment, surgeries, etc.
  • Determine whether your claim will be accepted or rejected

The insurance adjuster will first look at the facts of your case and determine whether or not you were injured on the job. If the adjuster determines that you were injured on the job, they will then look at the severity of your injuries and determine how much you should receive in benefits. If the adjuster determines that you were not injured on the job, your claim will be denied.

What Will a Workers Compensation Adjuster Ask Me?

The adjuster will likely ask you several questions about your accident and injuries. It is important, to be honest with the adjuster and provide as much information as possible. The adjuster may ask:

  • How did the injury occur?
  • Are there any witnesses to your accident?
  • When did you go to the doctor?
  • How long does your doctor say you need to recover?
  • What kind of medical treatment are you getting?
  • What were you doing before the accident?

Additionally, you will have to fill out an accident report with your employer. The report should include information about what happened and what part of your body was injured.

What Should I Expect From the Workers Compensation Adjuster?

The adjuster’s ultimate goal is to close your case quickly and cheaply. The insurance company does not want to pay out more benefits than necessary. For this reason, you should expect the adjuster to be friendly but firm.

The adjuster may try to get you to settle your case for less than you deserve. It is important to have an experienced attorney on your side to help you navigate the workers’ compensation claims process and get the best results for your case.

Recorded Statements

In most workers’ compensation cases, the adjuster will ask you to give a recorded statement. The adjuster will ask you questions about your accident and injuries. It is important to be honest in your answers but remember that anything you say can be used against you later.

For example, if you tell the adjuster that you are not injured, the insurance company may use this statement to deny your claim. Or, if you give a detailed description of your injuries, the insurance company may try to prove that your injuries are not as severe as you claim.

It is important to have an experienced attorney on your side before giving a recorded statement. Your attorney can help you prepare for the questions you will be asked and ensure that your rights are protected.

What Are Independent Medical Examinations?

The workers’ compensation insurance company may also require you to attend an Independent Medical Examination (IME). This is a medical examination with a doctor chosen by the insurance company. However, injured workers have the right to have their chosen physician at the exam as well.

The IME doctor will ask you questions about your accident and injuries and then give their opinion on whether your injuries were caused by the accident. It is important to remember that the IME doctor’s opinion is not binding.

You should still seek treatment with your own doctor and follow their recommendations. Additionally, you should have your own attorney to protect your rights during the IME process.

What Are Workers’ Compensation Benefits?

If the adjuster determines that you were injured on the job, they will then look at what benefits you are entitled to receive. The most common workers’ compensation benefits are:

Your attorney can help you understand what benefits you are entitled to and ensure that you receive them.

What If the Adjuster Denies My Claim?

If the adjuster denies your claim, you have the right to file a request for a hearing before a deputy commissioner for a determination as to whether your claim should be covered. Your attorney can help you navigate the appeals process and get the best results for your case.

What Are the Deadlines for Filing a Workers’ Compensation Claim?

It is important to note that there are deadlines for filing a workers’ compensation claim. In North Carolina, you have 30 days from the date of your accident to notify your employer.

You then have two years from the date of your accident to file a claim with the workers’ compensation insurance company. If you do not meet these deadlines, you may be barred from receiving benefits.

Tips When Dealing With a Workers’ Comp Claims Adjuster

When dealing with a workers’ comp claims adjuster, it is important to keep the following tips in mind:

  • Hire an Attorney: An experienced attorney can help you navigate the workers’ compensation claims process and get the best results for your case.
  • Be Honest: It is important to be honest in your answers and keep in mind that anything you say can be used against you later.
  • Know Your Benefits: Your attorney can help you understand what benefits you are entitled to and ensure that you receive them.
  • Appeal If Denied: If the adjuster denies your claim, you have the right to file an appeal.
  • Meet Deadlines: There are deadlines for filing a workers’ compensation claim. In North Carolina, you have 30 days from the date of your accident to notify your employer and then two years from the date of your accident to file a claim with the workers’ compensation insurance company.
  • Make Sure Your Injury Form is Complete: Most injured workers may overlook some fields on their injury form. If you fail to list all of your injuries on the initial report or injury form, the insurance company may argue that your other injuries are not work-related. It is important to have an experienced attorney review your injury form before submitting it to make sure that all of your injuries are properly documented.
  • Don’t Settle Without Your Attorney: The workers’ compensation insurance company will likely try to pressure you into settling your claim quickly and for less money than you are entitled to. Do not sign anything or agree to settle your claim until you have consulted an experienced workers’ compensation attorney. An attorney can help you understand the value of your claim and make sure that you are fairly compensated for your injuries.

What If My Employer Does Not Have Workers’ Compensation Insurance?

If your employer does not have workers’ compensation insurance, you may still be able to recover benefits through the North Carolina Industrial Commission. You should contact an experienced attorney to discuss your options.

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Contact Collier Today For Help With Your Workers’ Compensation Claim

If you have been injured on the job, it is important to understand your rights and how to protect them. An experienced workers’ compensation attorney can help you navigate the claims process and get the best results for your case.

Contact us today for a free consultation. We value the attorney-client relationship and will review your claim and determine how we can help you.