Attorneys Blog – Personal Injury – Accident Law

Category Archives: workers comp

Can I Sue My Workers’ Comp Adjuster?

This post was brought to you by Munley Law® –  Personal Injury Lawyers

Can I Sue My Workers’ Comp Adjuster?

Many workers are unaware that they can take legal action against their workers’ compensation adjuster, but there are certain situations where this may be possible. Workers’ compensation is meant to support injured employees, but complications can arise when adjusters engage in practices that delay or deny benefits. In this article, we’ll explore the circumstances under which an injured worker might consider taking action against a workers’ compensation adjuster. More about our workers’ comp lawyer here.

Can You Sue Your Workers’ Comp Adjuster?  

You can sue your workers’ compensation adjuster under certain circumstances. 

Workers’ compensation adjusters are responsible for evaluating and processing claims. If they mishandle your claim or act in bad faith—such as delaying payments, making lowball settlement offers, or denying necessary medical treatments—you may have grounds for legal action. If you believe the adjuster’s actions are unlawful, you can seek assistance from an attorney to file a lawsuit or take other legal steps to protect your rights and secure the compensation you deserve. 

Understanding Workers’ Compensation Adjusters

A workers’ compensation adjuster is responsible for managing claims, determining eligibility, and ensuring that injured workers receive the benefits they are entitled to, all while protecting the insurance company’s interests.

Adjuster’s Dual Role

The adjuster’s role is twofold. On one hand, they aim to ensure that the injured worker receives appropriate compensation. On the other, they protect the insurance company’s interests by minimizing payouts. This balance can lead to conflicts of interest, with adjusters sometimes prioritizing cost savings over fair compensation for injured workers.

Common Tactics Employed by Adjusters

Adjusters may use various tactics to limit claims, including:

  • Delays: Prolonging the approval process to pressure workers into accepting less compensation.
  • Lowball Offers: Offering settlements that are much lower than the worker’s actual needs.
  • Recording Statements: Getting recorded statements from workers that can be used against them later.
  • Hiring Private Investigators: Monitoring workers to find evidence that contradicts their claims.

Reasons to Sue a Workers’ Compensation Adjuster

Improper Claims Handling

An adjuster’s mishandling of a claim can significantly impact the injured worker. Common examples include:

  • Delayed Payments: Payments that are made late or never issued, causing financial distress.
  • Missed Deadlines: The failure to process claims within legally required timeframes.
  • Disregarding Medical Advice: Ignoring or refusing to honor the worker’s doctor’s recommendations, leading to inadequate treatment.
  • Denial of Necessary Treatments: Refusing to cover treatments that are essential for recovery, despite medical documentation.

Bad Faith Actions

Some adjusters engage in unethical behavior to reduce payouts. Examples include:

  • Intentional Misrepresentation: Adjusters may intentionally distort facts or manipulate evidence to lower the settlement offer.
  • Manipulating Statements: Misusing recorded statements or other communications to weaken the worker’s case and justify a reduced payout.

Retaliation

If a worker asserts their legal rights, the adjuster might retaliate by:

  • Coercion: Pressuring the worker to return to work prematurely or accept a low settlement offer.
  • Targeted Actions: Taking steps that harm the worker’s case, such as delaying claims or denying medical treatments.

Can You Sue the Adjuster Directly?

In most cases, you cannot sue a workers’ compensation adjuster directly. However, you can pursue legal action against the insurance company for bad faith practices. If an adjuster acts unreasonably—such as delaying payments or denying necessary treatments—you may have grounds to sue the insurer for acting in bad faith.

The Claims Appeal Process

If your claim is denied, you can file an appeal. The process involves submitting a formal request to have your case reviewed by a judge or board. Working with an attorney can improve your chances of a successful appeal by ensuring that all necessary documents are submitted and arguments are presented clearly.

Filing a Complaint

You can file a complaint against a workers’ comp adjuster with the Division of Workers’ Compensation (DWC). This involves submitting a formal complaint, such as the DWC Audit Complaint Form, detailing the adjuster’s misconduct. Filing a complaint does not immediately resolve your case but helps regulators monitor adjuster behavior.

What Happens After Filing?

After submitting a complaint, the DWC may investigate the adjuster’s actions. This can lead to consequences such as corrective measures, fines, or even termination of the adjuster’s position. However, you may not be informed of the specific outcomes of the investigation.

Understanding Your Options for Suing an Adjuster

If you believe your workers’ compensation adjuster is acting unfairly, there are steps you can take. While suing the adjuster directly may not be possible, you can pursue action against the insurance company for bad faith practices. You also have the option to appeal denied claims and file complaints against the adjuster. Working with an attorney can guide you through these processes and improve your chances of securing the compensation you deserve. If you face unjust treatment, legal action may be necessary to protect your rights. Reach out to a lawyer to explore your options.

Munley Law® GMB – Profile

Munley Law® Personal Injury Attorneys is a Pennsylvania law firm with over 60 years of experience helping families in Workers’ Compensation settlement and personal injury cases. 

Munley Law®’s Google Profile has comprehensive information about its practice areas.

Have questions about workers’ compensation settlements? – Call Munley Law.

Workers’ Compensation

Workers’ Compensation Attorneys Stroudsburg PA

Workers’ Compensation Lawyer Stroudsburg PA

Workers’ Compensation Attorney Stroudsburg PA

Workers’ Compensation Lawyers Stroudsburg PA

Personal Injury

Personal Injury Attorneys Stroudsburg, PA

Personal Injury Attorney Stroudsburg, PA

Personal Injury Lawyers Stroudsburg, PA

Personal Injury Lawyer Stroudsburg, PA

 

https://sites.google.com/compbizblog.com/munley-law-personal-injury/home

https://drive.google.com/drive/folders/1arcr-aFXueC4siaF9KUxVEEeuz9axlwq?usp=sharing

https://docs.google.com/presentation/d/1jFjLRt81Guli-XvldIkYuQk_kvGoRfpFDpKQORDyLtM/edit?usp=sharing

https://drive.google.com/file/d/1DENnBod5xBvPlQ8oMFsz9MnO3LklRVyo/view?usp=sharing

Injured at work in Stroudsburg, PA, and need help? –Contact Munley Law

Attorney Advertising: The information contained on this page does not create an attorney-client relationship nor should any information be considered legal advice as it is intended to provide general information only. Prior case results do not guarantee a similar outcome.

Why You Need Work-Related Injury Attorneys

This Blog was brought to you by the J.A. Davis & Associates, LLP – Accident Injury Attorneys principal office in San Antonio

Why You Need Work-Related Injury Attorneys

The ideal work environment fosters productivity and safety. But accidents happen, and when they occur on the job, the consequences can be devastating. Beyond the physical pain of injuries, medical bills pile up, lost wages create a financial strain, and the complexities of workers’ compensation can leave you feeling helpless. This is where work-related injury attorneys become your champions, fighting for fair compensation and ensuring your rights are protected throughout the recovery process. More about Workplace Accident Lawyers San Antonio here
Beyond Workers’ Comp: Why You Might Need an Attorney

While workers’ compensation exists as a safety net for employees who are injured on the job, it’s not always a guaranteed path to smooth sailing. Here’s why a work-related injury attorney can be your strongest ally:

Fighting Denials: Denials of claims aren’t uncommon, but they shouldn’t be the end of the road. Attorneys can meticulously review your case, gather evidence, and fight denials, ensuring you receive the benefits you deserve.More about Workplace Accident Lawyers McAllen here

Maximizing Compensation: Workers’ compensation covers medical expenses and lost wages, but an attorney can negotiate to ensure you receive the full and fair compensation you deserve, including potential disability benefits if your injury is severe.
Third-Party Liability: If a faulty product from a third-party vendor caused your injury, a work-related injury attorney can pursue a separate personal injury lawsuit to hold the liable party accountable.
Navigating Legal Complexities: Workers’ compensation laws are intricate and can vary significantly by state. Attorneys specializing in work-related injuries possess in-depth knowledge of these laws and procedures, ensuring you navigate the legal landscape effectively.
Protecting Against Retaliation: Unfortunately, some employers retaliate against employees who file claims. An attorney can be your shield against such retaliation and enforce your legal protections in the workplace.
Long-Term Injury Support: Severe injuries can lead to permanent disability. An attorney can fight to secure the long-term financial support you need to manage your disability and maintain your well-being.
Finding the Right Advocate: Expertise Matters

Not all lawyers are created equal. When seeking legal representation for a work-related injury, prioritize these factors:

Proven Track Record: Opt for an attorney with a history of successfully handling work-related injury cases. Look for testimonials and reviews to gauge their effectiveness.
Specialization: Attorneys specializing in work-related injuries have a deep understanding of relevant laws, procedures, and worker rights specific to your situation.
Communication Style: Schedule consultations with a few attorneys to discuss your case. Choose one who explains things clearly, answers your questions patiently, and fosters a comfortable communication style.
Contingency Fee Structure: Most work-related injury attorneys work on a contingency fee basis. This means they only get paid if your case is successful. Fees are typically a percentage of the recovered settlement.
The Road to Recovery: Healing is the Priority

While your attorney fights for fair compensation, prioritize your physical and mental well-being. Seek immediate medical attention for your injuries and diligently follow your doctor’s treatment and rehabilitation plan. An attorney can assist you in ensuring these medical expenses are covered through workers’ compensation.

Empowerment Through Knowledge: Resources at Your Disposal

Here are some resources to equip yourself with knowledge as you navigate the aftermath of a work-related injury:

The National Employment Law Project (NELP): https://www.nelp.org/ offers legal information and resources specifically designed to empower workers.
The Occupational Safety and Health Administration (OSHA): https://www.osha.gov/ enforces workplace safety standards and provides resources for injured workers.
Your State’s Department of Labor: These departments often have information and resources specific to workers’ compensation laws in your state.
The Takeaway: Reclaiming Control After a Work-Related Injury

Work-related injuries can be life-altering. Having a work-related injury attorney on your side empowers you to regain control of your situation. They fight for fair compensation, navigate legal complexities, and protect your rights while you focus on healing. By understanding your options, finding the right attorney, and prioritizing your health, you can overcome this challenge and emerge stronger. Remember, you don’t have to face this alone – work-related injury attorneys are there to advocate for your well-being every step of the way.

More Great Blogs Here:
https://www.bhfltdlaw.com/long-term-vs-short-term-disability/
https://www.pfaltzwoller-law.com/work-injuries-workers-compensation/
https://www.boyerfirm.com/workplace-injury-lawyer/
https://www.bhfltdlaw.com/workers-compensation-defending-nonsubscribers/
https://www.glglaw.net/help-with-workers-compensation-claims/
https://www.sambrandlaw.com/dedicated-to-workers-compensation/
https://www.butlerandprimeau.com/was-your-workers-compensation-claim-denied/
https://www.workplace-accident-claim.net/personal-injury-law-construction-accidents/
https://www.notolawschool.com/on-the-job-injury-attorneys/