- Workers' Compensation
Tricks Workers’ Comp Adjusters Use Against Florida Employees
Filing a workers’ compensation claim after a work-related injury can be daunting. You may assume that the insurance adjuster will treat you fairly, but unfortunately, this isn’t always the case.
Many adjusters use tactics to delay benefits or pressure workers to accept low settlements. Understanding these workers’ comp adjuster tricks can help you navigate the claims process more effectively.
In this blog, we will discuss twelve common tricks that workers’ comp adjusters use. We’ll also explain how our Florida workers’ compensation attorneys can help you protect your rights.
1. Workers’ Comp Adjusters Pretend They’re on Your Side
Building False Trust
When you first speak with the person handling your workers’ comp claim, they may pretend to be on your side. Early in the process, many claims adjusters treat you like a friend, empathizing with your injuries and the frustrating workers’ comp process.
This is a strategic move designed to make you feel comfortable and less guarded during your interactions.
The Real Motive
Do not fall for this approach. The insurance adjuster’s job is to pay as little as possible. Their goal is to find a reason to delay or deny your claim. Remember, their primary responsibility is to the insurance company, not to you.
Let your workers’ comp attorney deal with the insurance company. Your lawyer can handle communications and protect your best interests.
2. The Adjuster Asks for a Recorded Statement
The Purpose of a Recorded Statement
In the days following your workplace accident, the insurance company will ask you to provide a recorded statement. They do this for two reasons. First, they’re hoping you will admit to something that could jeopardize your claim. Second, they will ask trick questions that you don’t know how to answer properly.
This recorded statement can be used against you later. Workers’ comp adjusters scrutinize your words for inconsistencies or admissions that weaken your case. These tactics can undermine your claim, potentially reducing benefits or leading to a denial.
Protecting Your Rights
This can be a tricky situation because the insurance company has a right to ask for your statement. However, your attorney may be able to review a typed version of the statement before you sign off that it is true and accurate. This can help you avoid unintentionally harming your case.
3. Watching Your Social Media After a Work Injury
What Workers’ Comp Adjusters Look for on Social Media
Many adjusters check injured workers’ social media accounts. They may look at your Facebook, Instagram, TikTok, and other accounts. They look for photos, videos, check-ins, or comments that make your injury seem less serious than you say. Even posts from friends and family that tag you can be used.
The Risks for Injured Workers
Workers’ comp adjusters may use a picture of you holding your child to downplay your back injury. A post about yard work, the gym, or a trip could be used to claim you can return to work.
In Florida, if the insurer believes you lied or exaggerated to get benefits, it may accuse you of fraud. Under Florida law, knowingly making false statements can cost you your workers’ compensation benefits.
Tips for Protecting Your Claim
- Stay off social media as much as possible while your claim is open.
- Do not post about your accident, your injury, your claim, or your activities.
- Set your accounts to private, but assume the insurer may still see anything you share.
- Ask friends and family not to tag you or post photos of you.
- Do not delete old posts without first talking to a workers’ compensation lawyer.
Deleting social media posts could look like you are hiding evidence. A workers’ compensation lawyer can help you avoid mistakes and respond if the insurer tries to use your posts against you.
4. Hiring a Private Investigator to Follow You
Surveillance Tactics
If your claim is large, the insurance company may hire private investigators to follow you. Their mission is to secure proof that you exaggerated or lied about your workplace injuries. The workers’ comp adjuster may argue you aren’t seriously injured because you engaged in certain activities, such as playing sports.
This surveillance can include photographing or videotaping you without your knowledge.
Staying Vigilant
The insurance company can legally hire a private investigator. Be careful and consult your workers’ comp attorney if you suspect you are being followed. They can offer advice on what to do if you believe you’re under surveillance.
5. Insurers May Argue You Were Not Hurt on the Job
Blaming Pre-Existing Conditions or Injuries Outside Work
One of the most common ways insurance companies deny workers’ compensation claims is by saying your job did not cause your injury. The workers’ comp adjuster may blame a pre-existing condition, such as an old back injury, arthritis, or normal wear and tear from aging. They may also claim you got hurt outside of work, such as playing sports, doing chores at home, or in a past car accident.
Steps You Should Take After a Work Injury in Florida
Report your injury to your employer as soon as possible, and no later than 30 days after it happens. Missing this deadline can put your benefits at risk. Put your report in writing and keep a copy. Write down what happened, when, and where, and get the names of any coworkers who saw the accident.
Take photos of the area and anything that caused your injury. When you see a doctor, explain clearly that you were hurt at work and describe exactly how it happened. If the insurer disputes the cause of your injury, talk to a workers’ compensation lawyer who can gather medical evidence and fight the denial.
6. Workers’ Comp Adjusters Minimize Injuries and Limitations
Claiming Treatment is Unnecessary
Workers’ comp adjusters may try to cut costs by questioning the care your doctor recommends. They may deny or delay approval for tests like MRIs, physical therapy, injections, surgery, or visits to a specialist. They may claim the treatment is not medically necessary.
In Florida, the insurance company must provide medically necessary care for your work injury. You can request a one-time change of doctor in writing. A workers’ compensation lawyer can help you request a new doctor, challenge a denial of treatment, and file a petition for benefits so you get the care you need.
Pushing You to Return to Work
Adjusters may pressure you to go back to work before you are ready. They may rely on a doctor’s report that says you can return to work, even if you are still in pain. Your employer may also offer you a “light duty” job. If that job does not fit your doctor’s restrictions, it could cause you to get hurt again.
Be careful before turning down a job offer. In Florida, if you refuse work that fits your medical restrictions, you could lose your benefits. On the other hand, if you return to light duty at lower pay, you may still qualify for partial wage benefits. A workers’ compensation lawyer can review any job offer, make sure it matches your restrictions, and protect your benefits if the insurer tries to rush you back to work.
7. Adjusters Delay Your Workers’ Compensation Claim
How Workers’ Comp Adjusters Slow Things Down
Some adjusters drag out claims on purpose. They may take a long time to return your calls, ask for the same paperwork again and again, or keep saying your claim is “still under review.” They may also be slow to approve doctor visits, tests, or treatment your doctor recommends.
Delays Create Pressure
Delays put pressure on you. When you are hurt, out of work, and waiting for checks, you may feel pushed to accept less than you deserve or give up altogether. Waiting for approval can also hold up your medical care and slow your recovery. In some cases, the insurer may hope you miss an important deadline while you wait.
Your Rights in Florida
Florida law sets deadlines for insurance companies. In most cases, the insurer must start paying benefits or deny your claim within 14 days after it learns of your injury. If it needs more time to investigate, it can pay benefits for up to 120 days while it looks into the claim.
A workers’ compensation lawyer can track these deadlines, press the insurer for answers, and file a petition for benefits if adjusters keep stalling.
8. Workers’ Comp Adjusters Offer Lowball Settlements
Tempting with a Quick Payout
One of the most dangerous things a workers’ compensation adjuster will do is dangle a low settlement in front of you. They know you can’t afford to go without benefits and are worried about medical bills. They’ll tempt you with a settlement much lower than what you deserve.
This tactic preys on your immediate need for financial relief.
The Importance of Legal Advice
It’s important to meet with a Florida workers’ compensation attorney before you accept any offer. Your attorney will evaluate the settlement offer. An experienced attorney can negotiate on your behalf to secure a fair settlement that truly reflects the extent of your injuries and losses.
9. Pressuring You to Sign a Settlement Release
Understanding the Settlement Release
Don’t sign a settlement release without consulting a workers’ compensation lawyer. Signing without proper review can cost you significant benefits and rights.
Settlement Term Pitfalls
The claims adjuster may change or omit the terms of the settlement offer. For example, they may not include payment for any time you’ve already missed from work, not list all the body parts you injured, reduce your percentage of disability in the agreement, use the wrong income information when determining your benefit rate, or offer a structured payout when it was supposed to be a lump sum.
For example, they may try any of the following:
- They do not include payment for any time you’ve already missed from work.
- The settlement does not list all the body parts you injured.
- They reduce your disability percentage in the agreement.
- They use the wrong income information to calculate your benefit rate.
- The settlement amount is wrong.
- The terms call for a structured payout when it should be a lump sum.
When your workers’ comp attorney reviews the settlement release, they’ll catch these discrepancies.
10. Using Scare Tactics to Get You to Settle or Back Down
Intimidation Tactics
Throughout the process, the workers’ comp adjuster may try to convince you that it’s easier to settle quickly rather than retain a lawyer. They may tell you that there is an overwhelming amount of paperwork you’ll have to fill out or exaggerate how long it can take to get benefits.
Their goal is to make you desperate enough to settle for whatever amount they offer.
The Role of Your Attorney
An attorney will protect you in this situation. They’ll review any settlement offer. Your lawyer will handle the paperwork and negotiations, allowing you to focus on your recovery. They can also provide reassurance and guidance, helping you navigate the often intimidating claims process with confidence.
11. Workers’ Comp Adjusters Dig Through Your Medical Records
Broad Medical Release Forms
Soon after you file your claim, the adjuster may ask you to sign a medical release form. Many of these forms are very broad. They can give the insurance company access to your entire medical history, not just records about your work injury.
How Insurers Use Medical Records Against You
Workers’ comp adjusters look for pre-existing conditions. This could be a past back injury or arthritis. In Florida, if you had a health problem before your work injury, the insurer only has to pay as long as your work accident is the main cause of your need for treatment.
How Workers’ Comp Lawyers Can Help
Florida law already lets the insurance company get medical records related to your work injury. In most cases, you do not need to sign a form that opens up your entire medical history. A workers’ compensation lawyer can review any form before you sign it, limit what the insurer can see, and fight back if the insurer tries to blame an old condition.
12. They Request an Independent Medical Exam (IME)
What an Independent Medical Exam Is
The insurance company may send you to a doctor for an “independent medical exam.” The doctor may ask questions and watch how you move and act during the visit.
How Adjusters Can Use an IME Against You
The IME doctor may say your injury is not work-related, that you don’t need more treatment, or that you can go back to work. The insurer can use that report to reduce or stop your medical care and wage benefits, even if your own doctor disagrees.
Florida Law and Your Rights
In Florida, both the insurer and the injured worker can request an IME when they disagree about the claim. Do not skip a scheduled IME. A workers’ compensation lawyer can help you prepare for the exam, set up your own IME with a qualified doctor, and challenge an unfair report.
Call Our Florida Workers’ Compensation Attorneys at Work Injury Rights
If you’re hurt on the job, the last thing you need is for the insurance company to take advantage of you. Unfortunately, workers’ comp adjusters use certain tactics to delay, deny, or underpay claims when possible. Adjusters often try to scare or overwhelm employees, hoping they’ll walk away or accept a low settlement. They rely on complex processes and tricks to wear you down.
The best way to combat this is to hire a Florida workers’ compensation lawyer. Our team at Work Injury Rights can guide you through the claim process and pursue the benefits you deserve. We offer a free initial consultation. Contact us using our online form or call 954-388-8616 to schedule your free case review.
