Working with a Claim Adjuster

A woman sits politely at a desk and looks into the camera.

To offer a different perspective on the topic of claim adjusters, we turned to our Legal Analyst with the firm, Vanessa Washington. Vanessa has extensive experience in the insurance industry with a focus on workers’ compensation. Vanessa’s primary role with Meuser, Yackley & Rowland, P.A. is to support the attorneys by analyzing the value of each case, providing case law research, and facilitating negotiations.

As a former claim adjuster, I can tell you not all claim adjusters are bad people. They are there to help you as best they can. There are ways that you can help your claim progress more smoothly.

Be honest with your claim adjuster, it’s ok if you have a pre-existing condition. Pre-existing conditions may not necessarily exclude you from being eligible for benefits.

Help them help you by giving them the information they need to make an informed decision on your case.

Another big item that came up in the many years working as a claim adjuster is medical bills. If you receive a medical bill at your home, it is important that you do not ignore that medical bill. Chances are, if you’re getting it at home, the adjuster has not received it in their office. The first time you receive a bill at your home, it is important that you contact your adjuster or simply mail or fax the bill to the adjuster’s attention with your claim information, so that your adjuster can properly process the medical bill and get it taken care of for you.

It is so important that you keep all scheduled medical appointments. Not only to make the claim adjuster’s life better but to help you progress and heal from your work injury. It is important that you do not shop doctors. There are strict rules in work comp as to when you can switch doctors and whether or not a referral is necessary. If you are uncomfortable with your physician, make sure you contact your adjuster and have the conversations that are necessary in order to better understand your rights in terms of future medical treatment.

It is important that each time you go to the doctor, you obtain a Report of Work Ability form. It’s not necessarily required that you contact your adjuster by phone to notify them of your work ability unless there has been any change in your work status. The most important step after you’ve received a Report of Work Ability from your physician is to communicate with your employer. Your employer may or may not have light-duty work available for you; however, it is your responsibility to make sure that you are facilitating that communication with your employer.