Accepted Claims

Workers might think having an accepted claim means they will receive the benefits they are entitled to (such as “time loss” pay when unable to work, medical care, a disability award and vocational assistance which could include retraining). They are often mistaken.

Claims people at insurance companies and elsewhere usually do not tell workers what they must do to actually get the benefits. Many times the injured worker is taking medication, not feeling well, facing surgery or other drastic measures and just does not have the time and energy (or the kind of personality) to attend to the legal details.

If a worker was hurt on the job, has an accepted claim, is not working and not getting paid “time loss,” something is wrong. The same is true if a worker in these circumstances is not getting medical care. There are some things that cannot be “fixed” retroactively. Injured workers should get legal help as soon as they can.

Many workers do not realize that the claims processor’s goal is usually to “process” the claim for as little money as possible. Rarely does the insurer or employer really want to help the worker recover and get all the benefits he or she needs. Clients often say that the adjuster told them they did not need an attorney. An adjuster has a conflict of interest that might keep them from answering that question honestly.