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Dealing With the Insurance Adjuster After a Workers’ Compensation Injury

After an injury at work, you will usually be contacted by an insurance adjuster.  The adjuster works for the workers’ compensation insurance company.  Instead of using the term “adjuster”, this person may refer to himself or herself as a case manager or some other job title.

You may receive a letter from the insurance adjuster.  It may be a phone call or an email.  Insurance adjusters will often ask you to provide information about your injury.  They want you to sign documents authorizing them to get your medical records and other information.

You probably have questions.  Should you trust this person? Do you have to provide this information? Here are some answers to some of those questions.

Middle aged man talking on cell phoneShould I trust the insurance adjuster?

The insurance adjuster works for the insurance company.  The insurance company is a business that wants to make money.  Your case costs them money.  So, they generally want to try to pay you as little as possible.

This does not mean that the insurance adjuster is a bad person.  In fact, the insurance adjuster may be a very nice person.  But their job is usually to pay you as little as possible on your case.  You should be very cautious about believing that they are your friend or that they are on your side.  They are not on your side.

Do I have to give a recorded statement to the insurance adjuster?

You do not have to provide a recorded statement to the adjuster.  In fact, you do not have to speak to the adjuster at all.

It is important to know that the adjuster is going to do an investigation of your injury.  The adjuster usually makes the decision about whether to pay you workers’ compensation benefits or deny your claim.  The adjuster may want to take a statement as part of that investigation.  If you do not provide information to the adjuster, it is certainly possible that the adjuster might just deny your claim.

It is also important to know that information you provide to the adjuster may be used against you to deny your claim.  If you do decide to give a recorded statement, be sure you tell the truth and be sure to carefully consider your answers.  Many people get tripped up by rushing through a recorded statement and leaving out something important.

Do I have to sign the forms the insurance adjuster sent me?

The insurance adjuster often will send you forms to sign.  You should read over and carefully consider any forms before signing them.

The most common form that an adjuster will send you is a medical authorization.  A medical authorization allows someone to get your medical records.  Under Georgia’s workers’ compensation laws, you do have to provide the insurance company with a certain type of medical authorization when requested.

The Georgia State Board of Workers’ Compensation actually publishes the medical authorization form that you must sign.  That form is a Form WC-207.  This form authorizes the insurance company to get medical records for conditions or complaints that are “reasonably related” to your work injury.

You do not need to sign a blank Form WC-207.  Only sign forms that designate the specific medical providers who have provided treatment for your injury.  If you have previously received treatment for condition or complaints that are reasonably related to your injury, you should also sign forms that designate those specific medical providers.

For example, suppose you suffered a back injury in 2016.  If you had treated with Dr. Smith in 2011 for back pain, you would need to sign a Form WC-207 for Dr. Smith.

What if I have other questions about workers compensation?

Georgia’s workers compensation system can be very confusing.  You have to worry about getting the treatment you need and paying your bills while also worrying about not missing any deadlines that could cause you to lose your right to receive workers compensation benefits.

If you have questions, I would recommend that you try to get answers.  To find out more about how to schedule a time to talk to me about your workers compensation questions, just read this short article.

Jason Perkins is an attorney who specializes in representing injured workers.  He regularly publishes videos and write blog articles about Georgia’s workers compensation system and issues that are important to injured workers and their families. To be notified of Jason’s new workers compensation videos, subscribe to his Georgia Workers Compensation Video Series channel on YouTube by clicking the subscribe button below.

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Jason Perkins

Workers' Compensation Attorney

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