What the Adjuster Won’t Tell You: Workers’ Compensation in Georgia

Filing a workers’ compensation claim in Georgia can be complex. When dealing with an insurance adjuster, it’s crucial to understand that their primary goal is to save money for their company, not to ensure you get maximum benefits. There are often critical details that adjusters don’t disclose, and these can impact your claim and your recovery. Knowing what the adjuster might be keeping from you is key to protecting your rights.

Understanding the Role of the Adjuster

What Does an Adjuster Do?

The insurance adjuster manages your workers’ compensation claim on behalf of the employer’s insurance company. Their responsibilities include:

• Investigating the claim: This involves collecting evidence, contacting witnesses, and reviewing medical reports.
• Evaluating benefits: They determine the amount and type of benefits you may receive.
• Approving or denying claims: They have the power to approve or deny your benefits, which can affect your financial well-being.

While they seem supportive, keep in mind they work for the insurer, not you.

What Some Adjusters May Not Tell You About Your Claim

There are several things adjusters might not disclose to you about your workers’ compensation claim. Here are the common ones:

Your Right to Choose a Doctor

In Georgia, injured workers have some control over their medical care. However, adjusters often don’t tell you that you have options:

• Panel of Physicians: You should have access to a panel of at least six physicians, from which you can choose one.
• Changing Doctors: You have the right to switch to another doctor on the list if you’re not satisfied with your initial choice.

Choosing a doctor you trust can be vital to your recovery, so don’t let an adjuster rush your decision.

Pre-Existing Conditions Won’t Automatically Deny Your Claim

Adjusters sometimes imply that a pre-existing condition may disqualify you from workers’ comp benefits. In reality:

• Aggravation of Existing Injuries: If your work exacerbated a previous injury, you may still be eligible for benefits.
• Burden of Proof: The adjuster must prove that your condition wasn’t affected by your work.

Don’t let an adjuster’s suggestions stop you from pursuing a legitimate claim.

Partial Disability Benefits May Be Available

If you’re able to return to work with restrictions but earn less than before, you may qualify for partial disability benefits. However, adjusters may not explain this to you. These benefits:

• Help supplement your income: They provide a percentage of the difference between your former and current wages.
• Can last for a specified period: In Georgia, you may receive these benefits for up to 350 weeks if applicable.

By understanding this, you can secure support even if you’re back on the job with limitations.

Some Adjusters Might Not Mention All Potential Benefits

Workers’ compensation in Georgia includes several types of benefits, but not all adjusters discuss each type. Knowing your options ensures you get the most out of your claim:

• Temporary Total Disability (TTD): This covers lost wages if you’re unable to work for a while.
• Temporary Partial Disability (TPD): For workers who return with restrictions, TPD offers partial benefits.
• Permanent Partial Disability (PPD): If your injury results in a long-term disability, PPD may provide compensation based on the severity of impairment.

Without knowing about these benefits, you may miss out on critical financial support.

They May Not Explain the Importance of Documentation

Keeping detailed records is essential for a successful workers’ compensation claim. However, adjusters may not emphasize this because it can strengthen your case:

• Medical Records: Document every appointment and ensure your doctor accurately records all your symptoms.
• Daily Pain Journal: Keep track of pain levels, limitations, and any physical challenges you face.
• Communication Log: Note every interaction with your employer, adjuster, and medical professionals.

Proper documentation can prevent disputes and ensure you’re fairly compensated.

Beware of Settlement Offers

Adjusters often offer quick settlements to close claims early. While a quick payout may seem tempting, it might not be in your best interest. Here’s why:

• Future Medical Expenses: Settlement offers may not cover future medical costs, leaving you vulnerable.
• Loss of Rights: Accepting a settlement may prevent you from reopening your claim if your condition worsens.
• Underestimated Value: Initial offers are often low, as the adjuster aims to save money for the insurer.

Before accepting any settlement, consult a workers’ compensation attorney to evaluate your long-term needs.

Surveillance and Investigation Tactics

Adjusters sometimes investigate claims to find reasons to deny or reduce benefits. They may:

• Use Surveillance: This includes video footage or social media posts to argue that your injury isn’t severe.
• Interview Coworkers: Speaking to people at your workplace may reveal information they could use against you.
• Monitor Your Medical Records: Adjusters look for inconsistencies in your records that they can use to dispute your claim.

Being mindful of these tactics can prevent misunderstandings that could harm your claim.

Protect Your Rights with The Law Offices of T. Andrew Miller

The workers’ compensation process can be challenging, especially when dealing with adjusters who prioritize insurer profits. At The Law Offices of T. Andrew Miller, we advocate for your rights and provide comprehensive guidance throughout the claims process. Here’s how we can help:

• Evaluate your claim: We review your case in detail, ensuring you understand all potential benefits.
• Negotiate with insurers: Our experience allows us to challenge low offers and fight for fair compensation.
• Guide you through appeals: If an adjuster denies your claim, we’re here to guide you through the appeal process with confidence.

With our team by your side, you can focus on recovery while we handle the complexities of your claim. Contact us today for a free consultation and protect your right to fair compensation.