Workers’ Comp Adjuster Tricks You Need To Know

Workers' Comp Adjuster Tricks You Need To Know

Michigan attorney discusses workers’ comp adjuster tricks and how to protect your legal rights.

Workers’ comp is a safety net for employees hurt on-the-job. It pays weekly benefits to employees who cannot work and covers their medical bills. Many of the people who call our office live paycheck-to-paycheck and missing even one check is a financial disaster. Here are some workers’ comp adjuster tricks that employees must know about.

Not calling you back or returning emails

The biggest gripe our clients tells us about is poor communication. Adjusters are bad about calling people back and returning emails. People feel like they are left in the dark and have no idea if they are even getting a weekly check. This frustration extends to doctors who cannot get medical treatment authorized. A lawyer usually can help you avoid these workers’ comp adjuster tricks by cutting through the red tape and get the answers you need.

Rude behavior and bullying

Our experience shows that adjusters are usually friendly, but their attitude quickly changes as time goes on. Watch out for rude behavior or bullying as these are red flags that indicate danger is ahead. This attitude usually triggers more workers’ comp adjuster tricks.

Mandatory recorded statement

Michigan law does not require you give a recorded statement as part of the claim investigation process. Watch out for probing questions about your personal life, finances, and preexisting medical conditions. This information can be used against you in various ways.

Asking for a blank medical authorization

Insurance companies are entitled to review past medical records when you make a claim. They are looking for preexisting medical conditions that might justify a dispute. Giving them a blank medical authorization lets them go on a fishing expedition without any limits. In order to avoid these workers’ comp adjuster tricks ask to limit the medical authorization to specific providers and dates.

Calculating wage loss benefits incorrectly

Our experience shows that insurance companies make mistakes and they are never in your favor. Wage loss benefits are supposed to equal 80% of an employee’s after-tax average weekly wage. This should include overtime, discontinued fringe benefits, and second jobs. Watch out for lazy adjusters who do not get wage records and simply estimate benefits.

Late weekly checks

Disabled employees are supposed to get paid every week. Payment is computerized, but it usually requires the adjuster to manually change dates to keep benefits going. Many people live paycheck-to-paycheck and cannot afford to have late or missing checks. These workers’ comp adjuster tricks are used to force people into settlement.

Not telling you about all legal rights

One of the dirtiest workers’ comp adjuster tricks is to not always tell people about their legal rights. For example, mileage should be paid to and from every doctor appointment. Attendant care should be paid to relatives who hep with activities of daily living. Even home and vehicle modification should be covered when needed.

Not authorizing medical treatment

It can be extremely frustrating when a doctor has recommended treatment, but the insurance company won’t authorize it. These unnecessary delays can make a situation far worse. Do not let the adjuster cause you permanent damage because he or she refused to do their job.

Stopping you from choosing a doctor

Michigan law allows an employee to select his or her own doctor after 28 days from the start of medical care. Watch out for adjusters who refuse to allow this because they want to control medical treatment and costs.

Filing a Notice of Dispute for no good reason

Another one of the many workers’ comp adjuster tricks we have seen is for them to file a Notice of Dispute for no good reason. This is done to punish individuals who they believe are not cooperating. Make sure to contact an experienced attorney if this should occur.

Using a nurse case manager to manipulate restrictions

Insurance companies use nurse case managers as their eyes and ears on the ground. Watch out for nurse case managers who do not have your best interests at heart. This becomes clear when they try to interfere with medical treatment or work restrictions.

Having a defense lawyer review your claim

Did you know that claims are reviewed by defense attorneys even before a dispute has been filed? This is common practice and people get setup all the time. Having a lawyer on your side from the beginning evens the playing field. Do not let minor issues explode into a cut-off.

Sending you to an independent medical examination

Insurance companies use the independent medical examination (IME) to cut-off workers’ comp benefits. Some of these doctors make careers out of testifying against people hurt on-the-job. Avoid these workers’ comp adjuster tricks by never accepting an IME cut-off without speaking with a lawyer.

Forcing you to see a vocational expert

Michigan law allows insurance companies to use post-injury wage earning capacity (PIWEC) to reduce weekly checks. Watch out for vocational experts hired by the insurance company who say you can work in a job never performed before. These workers’ comp adjuster tricks are used so they can pay less on valid claims.

Using social media to cut-off benefits

We have seen adjusters make snap decisions based upon items posted on social media. Avert these workers’ comp adjuster tricks by making sure that Facebook, Twitter, Instagram, and other accounts are shutdown while a claim is pending. Privacy settings can be circumvented so do not take a chance.

Having you followed by a private investigator

Insurance companies hire private investigators to follow people and record video. They will sit outside your house and take pictures of activities. We have seen private investigators lie to medical offices and neighbors just to get information about your situation. Private investigators have even followed people to our law firm parking lot.

Threats to close your claim

A workers’ comp adjuster trick is threatening to close the claim. This is done to force people into settlement. Do not get bullied into accepting a low ball settlement offer. Michigan law requires that weekly benefits are paid for the entire length of disability. All reasonable and necessary medical treatment should also be paid.

Michigan Workers Comp Lawyers never charges a fee to evaluate a potential case. Our law firm has represented injured and disabled workers exclusively for more than 35 years. Call (844) 316-8033 for a free consultation today.

Related information:

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Workers\' Comp Adjuster Tricks You Need To Know
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