How to Help Yourself – Know the Rules

By knowing the information and following the advice below, you may be able to obtain 100% of your benefits without having to pay a lawyer. We are committed to successfully representing injured workers but we do not want to charge those who could otherwise get their benefits with a little knowledge and effort.

• Workers’ compensation pays wage loss benefits and medical benefits for work related injuries. You do not get paid for pain and suffering. In some cases you may be entitled to special compensation for significant loss of use of a body part.
• Your employer is required to report any injury to its workers’ compensation insurance carrier.
• The workers’ compensation carrier is required by law to investigate your claim. It must decide whether to pay or deny your claim within 21 days of the date of your injury.
• If you have not heard from the insurance company, you should ask your employer for the name of the company and contact information for the company.
• Contact the insurance company and ask to speak with the person handling your claim (called the adjustor). Obtain your claim identification number.
• Record the contact information, name of the adjustor, and claim number for future use.
• Discuss your claim politely with the adjustor and ask for information regarding the status of his or her investigation.
• If the adjustor is waiting for information (such as doctor’s records), obtain that information and send it to the adjustor in a way that you can verify receipt (such as fax, overnight mail or certified mail). Follow up with the adjustor to confirm receipt of the information and ask when a decision will be made on your claim. Follow up at that time. Be persistent and polite.
• Adjustors deal with hundreds of claims. Make their job easy for them and politely remove any excuses they may have for not making a decision.
• Do not antagonize the adjustor.
• You may be experiencing financial difficulty while he or she is evaluating the claim but that is true for most injured workers. Adjustors hear that complaint all the time. Only extreme circumstances of financial hardship are likely to motivate the adjustor to process your claim faster.
• The idea is to do the work for the adjustor so that you help them process your claim as quickly as possible.
• If you have any questions along the way, call us and we will be glad to keep you informed of your rights.
• If you feel that you are being “stonewalled” (the insurance company is unreasonably delaying a decision) or you receive a denial, call us and we will be glad to represent you.
• When you get paid, call us to make sure that you are getting paid the right amount. In most cases, injured workers are paid 2/3 of their average paycheck before taxes are deducted.