Absolutely not. The adjuster has only one job: to make her company profitable. The way she does that is by limiting how much she spends on your case. This doesn’t mean she’s going to be hateful and evil to you. That rarely works – although they do it sometimes. Rather, she’ll likely be pleasant but doesn’t follow through with things that cost her company money. Things like mileage reimbursements prompt scheduling of medical appointments, and ensuring that you’re weekly checks included credits for overtime, bonuses, and per diems.
What about the adjuster hiring a rehabilitation nurse? Our impression is that this is a calculated maneuver on her part. Yes, the nurse costs money. But if the nurse is effective the doctor may order less treatment and return you to work sooner than he ordinarily would. All of that saves the adjuster money.
Keep in mind that your adjuster is probably under pressure from her supervisors to close out files as quickly as practicable. She’s also probably getting an earful from a lot of injured workers. If she’s been around any length of time she may well be feeling a little burnt out or jaded as to the complaints of workers’ compensation claimants.
The other thing to understand is that your adjuster is a professional. She knows the ins and outs of workers’ compensation. She undergoes rigorous annual training and periodic updates on the law. She is a professional. You are probably very very good at what you do (or did). But you aren’t a workers’ compensation professional. Putting it bluntly: you’re no match for her. You won’t even necessarily know where’s she’s cutting you short if she does. And this is without her even turning to a defense attorney to assist.
The bottom line is that workers’ compensation is one of those areas where you can be underwater without even knowing you are. That’s how complex the law is. It is never ever a mistake to call a lawyer. You may not need to hire one. But you do need to speak with one.
Your weekly checks – if you’re totally out of work – are called temporary total disability checks (TTD). If you think about it this makes sense… it isn’t permanent but you are completely out of work. These TTD check are two-thirds of your average weekly wage (AWW, and subject to maximum amounts for any given year). You’re AWW is the average of what you earned over the last 52 weeks with that employer taking into account overtime, bonuses, absences of less than a week, raises, etc. It’s extremely common for an insurance company to set your AWW at your base pay and ignore any overtime, per diems, etc. But it’s critical to get this figure right. It’s the key to your entire claim. With that in mind, it may not be wise to trust the adjuster to correctly determine the amount.
