When dealing with the workers’ comp claims adjuster after an injury on the job, it’s important to remember that the adjuster is there to save the insurance company, not to make sure you get everything you deserve. And although chances are that your meeting will be the first time you have ever dealt with an adjuster sent out by the worker compensation insurance company, the adjuster will have a lot of experience interviewing injured workers and steering the conversation in ways that minimize the amount the company will need to payout.
Don’t let the adjuster trick you out of the benefits you deserve. Here are the things you need to avoid when dealing with the insurance adjuster.
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Never agree to have your conversation recorded
It’s never a good idea to allow the adjuster to record your interview. You should never agree to taping a conversation without talking to a personal injury lawyer specializing in workers’ compensation attorney first — and this attorney should be representing you, not your employer.
Insurance adjusters may tell you that they just want to record the conversation to make sure they don’t forget anything; there are no misunderstandings later, but adjusters are trained to ask you leading questions that get you to lower your guard. If you aren’t careful about what you say, you may say something that can be interpreted out of context to lower or even deny your workers’ compensation claim.
You are never required to allow your interview to be recorded.
Never give the adjuster a blanket release for all of your medical records
The insurance adjuster is entitled to see and ask your doctor about the medical records that back up your claim. The insurance adjuster is not entitled to see and ask your doctor about all the records in your file. Adjusters may try to convince you that signing a medical authorization form that releases all of your medical records will speed up the resolution of your claim, but the truth is that they help the insurance company have a chance
HIPAA rules do not allow your doctor to disclose any part of your records without your permission. If you sign a blanket release, however, the adjuster can try to convince the doctor that some pre-existing condition affected your medical outcome, and that your injury was not really related to your injury on the job.
Don’t fall into the trap of guessing, speculating, or contradicting prior statements
Insurance adjusters will try to poke holes in your story. Even if you do not consent to have your interview taped, they may attempt to get you to say something that contradicts your earlier statements or can be caught with video evidence. Even an innocent mistake can result in a denial of your claim.
Stick to the facts; don’t exaggerate; don’t speculate
When you don’t know something, don’t guess. Just admit that you don’t remember. Memory loss is compensable anyway, after all.
Stay on topic. The adjuster is not your friend.
Conversations about sports, current events, hobbies, friends, family, and recent activities may give the adjuster rationale for denying your claim.
Exercise caution when you are being examined by a “company doctor”
Workers’ comp insurance companies generally can require you to submit to a second medical examination by a physician of their choice. Consulting doctors are bound by professional ethics to give you an accurate diagnosis, but the simple truth is that they work for the insurance company. Since they are paid a flat fee, they may not take time to give you a thorough exam that bolsters your claim.
