You report your work injury and then start getting letters and calls from the adjuster. But who is an adjuster?

An adjuster is an individual assigned to a workers’ compensation claim by the insurance carrier — they are responsible for your claim at the insurance company. It is the adjuster’s job to follow the legal guidelines and requirements, but that person is also there to keep costs down for the insurance carrier and ensure proper handling of the claim.

Working With An Adjuster

A workers’ compensation adjuster is responsible to review the claim file and will investigate your claim for medical treatment authorization and benefits. Of course, it is also the adjuster who sends requests for treatment for Utilization Review, acceptance, denial, modification, etc.

An adjuster will investigate your claim; this could be by requesting a recorded statement or sending you forms for release of medical information; this is standard practice. You should carefully read and consider any forms before signing and returning them.

Let Your Attorney Do The Talking

A benefit of working with an attorney is that you no longer have to speak with the adjuster yourself. Once you have representation, the adjuster is not supposed to have contact with you, even though he/she did in the beginning. However, you will still send your medical mileage logs to the adjuster for consideration of reimbursement as may be appropriate.

While adjusters are not bad people, it’s important to know that they are there for the insurance company’s bottom line. Claims cost them money every day they remain open. This is why it’s important to have qualified legal representation.

If you have any questions about your workers’ compensation claim, contact RP Law Group at (951) 394-3640 and speak with an attorney right away for a free consultation.