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What Not To Say To A Workers’ Compensation Adjuster

WC_Claim

If you work in the state of Maryland, you are likely familiar with the concept of workers’ compensation insurance. When this insurance functions the way it is meant to, it ensures that employees who were injured in the course of their employment will receive medical care and paid time off to recover. You may take this to mean that your workers’ compensation adjuster is on your side. However, that is not the case. The nature of the insurance industry means that you and the insurance adjuster have opposite goals. If workers’ compensation insurance paid out every injury for which they received a claim, they would go out of business. For this reason, workers’ compensation adjusters are more gatekeepers than customer service representatives, and it is important to maintain that perspective. The primary goal of any workers’ compensation adjuster is to avoid paying out claims whenever possible, and minimize the payout on unavoidable claims to the greatest degree possible. Any information they get from you can also be used against you, so it’s critical to understand what you are and are not obligated to provide, and how to avoid sharing anything that will unfairly cost you the legitimate coverage you are entitled to.

What to Say and Not Say to Workers’ Compensation Adjusters

Keep in mind that the information below is not intended to be comprehensive, but rather to give you an idea of what information you should generally be aware of. The best way to ensure that you present your strongest possible claim and avoid any possible workers’ compensation pitfalls is to hire a lawyer to help you navigate the process and ensure that your rights are protected. When it comes to the workers’ compensation process, it is far easier to play offense than it is to play defense.

  • Do not consent to recorded calls. It is important to understand that you do not have to consent to your call being recorded if the workers’ compensation adjuster asks. You may feel like you have to be polite or like it’s not actually a question, or you may want to seem cooperative, but you are under no obligation to agree to a recorded call. These recordings are not for your benefit and are generally used to find nit-picky phrasing that can be used to poke holes in your claim.
  • Do not exaggerate your pain, but definitely be thorough in explaining it. Exaggerating your symptoms can work against credibility, but trying to be stoic and underplaying your pain, or waiting to see if a certain injury gets worse before mentioning it, can backfire and result in an inability to get coverage for those injuries. For instance, if you hurt your lower back and it is sending shooting pain down both of your legs, be sure to also mention the pain in your legs.
  • Do not discuss family or financial obligations. This one is tricky because it may not always be overt. Be careful of insurance adjusters trying to make small talk by asking about your family or finances as this information can be used to try and prove a motive for faking a claim.
  • Stay focused on the facts. As noted above, small talk with insurance adjusters is often a trap. You can remain polite while keeping the conversation focused on the facts of the accident and your injuries. You do not owe the adjuster any additional information.

Schedule a Consultation

If you have been seriously injured in a workplace accident and are struggling to get the workers’ compensation benefits that you are entitled to, contact the experienced Maryland workers’ compensation attorneys at Berman | Sobin | Gross LLP today and schedule a free consultation.

Resource:

wcc.state.md.us/gen_info/faq_employees.html

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