Worker’s compensation coverage is supposed to protect employees who get injured on the job. All employees in New York are entitled to worker’s compensation, but recovering these benefits is not always easy. Unfortunately, there are several common workers comp adjuster tricks that insurance companies use in attempts to limit payouts or deny claims.
If you have recently suffered a work-related injury and are struggling to secure your worker’s comp benefits, you should be aware of your legal rights. The Albany worker’s comp law firm of Paul Giannetti helps injured upstate NY workers fight for the benefits they deserve. Contact us today at (866) 868-2960 to learn more about your legal options in a free consultation.
Most Common Workers Comp Adjuster Tricks
When going through the workers’ compensation claims process, it is important to remember that you are dealing with an insurance company. These companies make huge profits, and much of their business model is based on limiting and denying payouts. Workers’ comp adjusters use several common tactics to minimize the insurance company’s payouts.
Delays in the Claims Process
If you have suffered an injury that is keeping you out of work, you are likely relying on your workers’ comp payments to continue paying your bills. Sometimes insurance adjusters will unnecessarily delay their payments in an attempt to pressure workers to accept unfair settlement offers out of desperation or return to work.
Workers comp insurance adjusters are required to send documents and begin issuing weekly payments once you have shown that your injury is covered by the Workers Compensation Act. If you believe your claim has unjustly been delayed, you should consider speaking with workers comp lawyer Paul Giannetti.
Making Lowball Offers
Adjusters are aware of the time-sensitive nature of workers’ comp claims and the fact that most injured workers need these payments quickly. Some adjusters make very quick but unfairly low settlement offers hoping that the worker will accept the offer. Accepting this offer saves the insurance company money and allows them to close out the claim.
However, you should be aware that these quick settlement offers are rarely in the injured worker’s favor. If you accept a low settlement offer, you may not receive adequate compensation to pay for your medical bills and lost wages.
Asking For Signed or Recorded Statements
An insurance adjuster may ask you to give a signed recorded statement after you have filed a worker’s comp claim. In New York state, there is no legal requirement to comply with such a request. Insurance adjusters are trained to ask questions that could jeopardize your workers’ comp claim, so it is usually best to refuse to give a statement.
The insurance adjuster may frame the statement as a way to ascertain the facts and move the claim along quickly. However, some insurance adjusters may engage in certain tricks designed to deny your claim, such as:
- Pressuring you into agreeing to incomplete or false statements
- Attempting to elicit discrepancies between your recorded statements and the information found in other documents, such as medical records and accident reports
- A defense lawyer for the insurance company could use parts of a recorded statement to question your credibility
- Fishing for a statement regarding a preexisting condition related to the accident
- Seeking information on your current financial situation to see if you might accept a lowball settlement offer
These are just a few of the ways that giving a recorded statement to a workers comp adjuster can hurt you. In most situations, these statements will do little to help your claim, but can significantly hurt your chances of getting the coverage you deserve.
Insurance companies are legally permitted to hire private investigators to monitor people who have filed workers’ comp claims. Private investigators may observe you from outside of your home and follow you when you leave to make sure your injuries are consistent with your claims. They may also monitor your social media accounts and speak with friends, family members, and neighbors about your injuries.
If the investigator witnesses something that they believe contradicts what you have claimed about your injuries, the insurance company may use their findings to justify denying your claim. In some cases, the Office of the New York State Worker’s Compensation Inspector General may open a fraud investigation.
Independent Medical Exams
You have the right to consult your own medical doctor after suffering a work-related injury. However, insurers may request that you undergo an independent medical exam by a physician that works for the insurance company. Your insurance adjuster may request this so that the company can get a second medical opinion regarding your injuries.
Independent medical exams are often requested when the insurer disputes the severity of a claimant’s injuries. In New York and most other states, you are required to undergo an independent medical examination if your insurer requests one, and refusing to do so could hurt your case. However, your workers’ comp attorney can help prepare you for these evaluations.
How to Protect Yourself When Filing a Workers Comp Claim
The workers’ comp claims process can vary significantly from case to case. While some insurers will quickly pay out claims without any workers comp adjuster’s tricks, others make the claims process more difficult. However, workers can protect themselves from receiving an unfairly denied claim by approaching the process in the right way.
Here are some simple steps to follow to maximize your chances of success when filing for workers comp:
- Report your injuries to a manager or supervisor immediately and request paperwork.
- Seek medical attention as soon as possible.
- Be detailed when discussing your injuries with your doctor.
- Continue to see a doctor as needed.
- Make a written record of all of the facts related to your injury.
- Fill out all required workers’ comp forms accurately.
- Keep copies of all correspondence with your, doctor, insurer, and employer.
- Consider contacting an Albany workers comp lawyer.
The Role of Legal Representation
When to Seek Legal Assistance
In some cases, the complexities of a workers’ compensation claim may require legal intervention. Consider consulting an attorney if:
- Your claim has been denied.
- You’re facing retaliation from your employer.
- Your injuries are severe and require ongoing medical treatment.
- You believe you’re not receiving fair compensation.
Contact Workers Comp Lawyer Paul Giannetti
The workers’ comp claims process can be, especially if a powerful insurance company is attempting to unjustly deny your claim. Fortunately, injured workers who are being treated unfairly during the claims process can fight back by seeking guidance from an experienced workers comp attorney. Albany workers comp lawyer Paul Giannetti is prepared to help you seek the compensation you deserve: contact Paul today at (866) 868-2960 to learn more.