Games Workers’ Comp Adjusters Play & How to Beat Them

If you have been injured at work, you are eligible to file a workers’ compensation claim to pay for your medical expenses and lost wages. All employers in Georgia are required to have workers’ compensation coverage for their employees. Despite the workers’ compensation system being created to help you, it can be difficult to get the compensation you deserve for your injuries.

Sadly, the main goal of workers’ compensation adjusters is to save the insurer and your employer money. There are many games workers’ compensation adjusters play to lower the amount of compensation paid out in your claim. However, our Atlanta workers’ compensation lawyers at John Foy & Associates are knowledgeable regarding the adjusters’ tactics and how to beat them.

Georgia Workers’ Compensation Basics

Workers’ compensation is an insurance program paid for by your employer to cover accidents that happen on the job. Most companies with three or more employees must have workers’ compensation insurance. Failure to obtain this coverage can result in fines and civil penalties.

As an employee in Georgia, you are eligible for these benefits beginning the first day you work. The benefits pay for authorized medical bills, physical therapy, prescription medication, rehabilitation, and lost wages. You can receive two-thirds of your average weekly salary, up to $800 per week.

You are entitled to workers’ compensation benefits and medical treatment for up to 400 weeks. You may be entitled to lifetime benefits for catastrophic injuries. You could potentially receive disability compensation, as well, depending on the type and extent of your disability.

Tips for Beating the Games Played by Workers’ Compensation Adjusters

As previously mentioned, the goal of insurance companies is to pay out as little compensation to employees as possible. As such, they use a number of tactics to avoid paying you the maximum amount you deserve. Common games played by workers’ compensation adjusters include the following:

Asking You to Sign a Statement Immediately

Workers’ compensation adjusters know that you are dealing with a lot right after your injury. Because of your vulnerability and physical limitations, they may request that you sign a statement immediately after your accident. As a result, they will use your statement to claim that your injuries are not related to your work accident or, quite frankly, to get you to accept an unfairly low offer.

How to Beat This Game: You are not required to give or sign any statements. Do not say anything to the adjuster. Direct them to speak with your workers’ compensation attorney in Atlanta before you do anything.

Requesting a Recorded Statement

Workers’ compensation adjusters often want you to give a recorded statement. They want to use your words against you down the road in your claims process. They can take your words out of context to minimize the seriousness of your claim.

How to Beat This Game: Decline the adjuster’s request for a recorded statement. Tell them that you will provide a written recollection of your accident instead. Then, consult with your workers’ compensation attorney prior to providing them with your statement.

Offering You a Quick Settlement

Workers’ compensation adjusters know you are probably faced with increasing medical bills and the inability to work. As a result, they will often offer you an unreasonably low settlement, knowing you will likely be happy for any financial relief. However, if you accept a quick settlement offer, you will not receive the benefits you actually deserve.

How to Beat This Game: Do not accept any settlement right away. Discuss the first offer an adjuster gives you with your workers’ compensation lawyer. We can negotiate a higher settlement for your injuries.

Requesting that You Sign Medical Authorizations

Workers’ compensation adjusters may ask you to sign a medical authorization form giving them the right to access your medical records. They will then review your medical history to identify your pre-existing conditions. They will use these illnesses against you and claim that your injuries are not related to your work accident but are from pre-existing conditions.

How to Beat This Game: Do not sign any medical authorization forms. You are not required to do so for your workers’ compensation claim. Direct them to send any such requests to your Atlanta workers’ compensation attorney.

Minimizing Your Injuries

Workers’ compensation adjusters will often downplay the severity of your work-related injuries. They will do this to justify offering you a lower settlement amount. They may also claim your injuries are a result of a separate incident and are not work-related.

How to Beat This Game: Keep a record of all your medical records relating to your work accident. Be sure to reference your work-related accident in all your medical visits with your doctor. Consult with your workers’ compensation lawyer if you have questions about your medical records or doctors’ notes.

Questioning Your Medical Treatment

Workers’ compensation adjusters may question whether the medical care you are receiving is necessary. Again, they will do this to assert that your treatment is not related to your work injuries. They may also claim that your treatment is excessive.

How to Beat This Game: Consult with your healthcare providers to confirm their recommended treatment is necessary. Keep records of all your treatments and the medications prescribed to you. Also, keep detailed notes of all your doctors’ visits so you have evidence to support your claim.

Having You Followed by an Investigator

Sometimes, workers’ compensation adjusters will go to great lengths to have you followed by a private investigator. The investigator will take photographs and videos of your daily activities. The adjuster will try to use this evidence, along with interviews from your neighbors or friends, to prove your injuries are not legitimate and to deny your workers’ compensation claim.

How to Beat This Game: Assume you are always being watched. Do not participate in activities that could compromise your claim of injuries. Tell your family and friends to be aware of private investigators who may want information from them.

Delaying Your Benefit Payment

Workers’ compensation adjusters may delay your benefits payment. They will often do this because they know the financial bind you are likely in after your work accident. They are hopeful that you will become desperate for economic relief and will accept a low settlement amount.

How to Beat This Game: Question the adjuster about why your payment has been delayed. Insurance adjusters are required to adhere to certain timelines and rules for workers’ compensation payments. Also, let your workers’ compensation lawyer in Atlanta know that your payment has been delayed so they can question the adjuster on your behalf.

Pressuring You to Return to Work Too Quickly

Many workers’ compensation adjusters will pressure you to return to work, even if you are not medically ready. They do this so they do not have to continue paying you benefits. The less they have to pay you, the more they save the insurer.

How to Beat This Game: Always follow your doctor’s orders and recommendations for returning to work. Communicate with your medical professionals about your symptoms and how you are feeling. Share with them any issues that may affect your ability to return to work.

Telling You that You Do Not Need a Lawyer

Many workers’ compensation adjusters will try to tell you that you do not need a workers’ compensation attorney. They know that by hiring a lawyer, the chances of your claim being approved and receiving a higher payment increase substantially. Adjusters may tell you that hiring an attorney will cost you too much money and that it is not worth it, but our lawyers at John Foy & Associates only get paid if you do.

How to Beat This Game: Do not believe the lies many insurance companies and workers’ compensation adjusters tell. You should absolutely consult with a workers’ compensation lawyer in Atlanta for help with your claim. Our workers’ compensation attorneys at John Foy & Associates can help you get your claim approved and obtain the maximum compensation possible for your work-related injuries.

Getting Help from an Atlanta Workers’ Compensation Attorney

To maximize your workers’ compensation payout, it is important that you are aware of the games adjusters play and how to beat them. Your best chance of having your workers’ compensation claim approved and receiving the maximum compensation possible for your injuries is by retaining a workers’ compensation lawyer in Atlanta. 

Contact our workers’ compensation attorneys at John Foy today for a no-obligation consultation so we can review your accident and help you get the compensation you need until you are physically able to return to work.