What to Do When Your Workers’ Compensation Adjuster Is Not Responding?

Being injured on the job can be highly stressful. A workers’ compensation adjustor’s failure to respond promptly can make you feel more overwhelmed. Timely communication during this time is crucial because delays can mean a delay in medical care, wage replacement, and overall resolution. This guide will help you learn how to address this issue.

Understanding the Role of a Workers’ Compensation Adjuster

A workers’ compensation adjuster, also known as a claims examiner, is responsible for:

• Investigating the specific circumstances of your work-related illness or injury
• Determining how valid your claim is
• Assessing the extent of the injuries and required medical treatment
• Calculating and authorizing workers’ comp benefit payments
• Coordinating with medical providers and employers
• Negotiating settlements if applicable in your case
• Recommending further medical evaluations

With the responsibility on their shoulders, timely communication is a fundamental aspect of managing your claim effectively. When they don’t respond promptly, it can pose huge issues for you regarding medical care, receiving lost wages, and putting the incident behind you.

Common Reasons for Lack of Communication

As frustrating as not hearing from your adjuster can be, there are common reasons why you might not have heard from them yet. These include:

• Internal Issues: The insurance company might be experiencing staffing challenges, system updates, or other internal changes.
• High Caseloads: Many adjusters have several cases on their plate at once, which can cause delays in hearing from them.
• Incomplete Information: Your adjuster might need more information and documentation before they can respond with accurate information or updates.
• Miscommunication: Sometimes, miscommunications happen. They might not have your best contact number or haven’t received your calls.
• Claim Complexity: The more complicated your claim is, the longer it might take to hear from your adjuster.

While these reasons don’t excuse the lack of communication from your workers’ compensation adjuster, they offer an explanation that might help ease the stress of waiting.

Initial Steps to Take When Your Adjuster Is Silent

If you’re dealing with an unresponsive workers’ comp claims adjuster, there are some steps you can take initially:

• Review all the correspondence you get from them to ensure you haven’t missed anything
• Check the timelines for when you’re expected to hear from your adjuster based on state workers’ compensation systems
• Double-check that all your contact information with the adjuster is correct
• Offer multiple channels of communication to ensure there’s no missed communication
• Always be patient when waiting for insurance adjusters to reach out, but be persistent if they haven’t

How to Follow Up Effectively

Just because you’re being patient doesn’t mean you don’t have to reach back out to your workers’ comp claims adjuster. Whether you prefer to email, call, or do both, some strategies you should consider are:

Email Template

Make sure that you make your subject includes the word “urgent” and then follow up with your workers’ compensation claim number. Address the adjuster by name, and then ensure they know you’re writing to follow up on your specific claim.

Let them know you’ve made several (be specific) attempts to contact them. Then, pose your questions or concerns to them. Ensure you let them know you’ll be taking further action if you haven’t received a response by a specific date.

Phone Call Tips

If you plan on calling adjusters, always prepare your questions or a script for your words. Ensure you’re polite but clear about what you’re looking to discover. Request a specific date or time when you should hear back about your requests.

A good rule of thumb regarding follow-up messages is to wait three to five business days, then call the adjuster. You might want to escalate the situation if you haven’t heard back after a week.

Documenting Your Attempts to Communicate

Anytime you speak to your workers’ comp adjuster, you’ll want to ensure you keep detailed documentation of every attempt. Even if you don’t speak with them, document your attempts to reach them. Some things you should document are:

• Dates and times of all your emails, phone calls, and letters you sent
• Summaries of all the conversations or messages sent
• Names of all the people you send messages to or speak with
• Copies of all correspondence
• Notes on any deadlines or promises the insurance company’s adjuster has made

When to Consider Escalating the Issue

If you cannot get ahold of your insurance adjuster and they don’t respond, it might be time to escalate the issue. Here are some steps to consider taking:

• Reach out to your insurance adjuster’s supervisor for a response
• File a complaint with your state’s workers’ compensation board
• Reach out to your employer and pressure them, which might make our insurance company more responsive
• Consider contacting an experienced Chicago workers’ comp attorney from our team for advice and guidance

The Role of Your Attorney in Communication Issues

If you’re trying to decide whether to hire a workers’ compensation attorney, they can be highly beneficial, especially when your insurance adjuster isn’t replying. A workers’ compensation lawyer can help by:

• Your attorney communicates directly with your insurance company and their adjuster.
• An attorney can help motivate the insurance company to respond and be more diligent with your claim.
• Workers’ compensation attorneys are there to help protect injured workers’ rights.
• They can help you navigate complex issues with your employers and insurance company.
• Workers’ compensation attorneys are there to escalate issues to litigation if necessary.

Understanding Your Rights as a Claimant

As someone who suffered a workplace injury, you have certain rights when handling your claim:

• Right to timely claim processing
• Right to information
• Right to appeal
• Right to medical treatment
• Right to benefits
• Right to legal representation

The Impact of Delays on Your Claim

Unresponsive workers’ compensation adjusters can cause extensive delays and severely impact your claim. This can cause:

• Delayed medical treatment can impact your overall life and recovery
• Delays in wage reimbursement can cause financial hardship
• Increased stress
• Issues with the statute of limitations in your state
• Claim denial

Secure Expert Legal Counsel!

The workers’ compensation claim process is already stressful enough without having to deal with an unresponsive insurance company adjuster. If you’re waiting long to hear from your adjuster, you have rights as an injured worker.

Working with the experienced legal team at Rosenfeld Injury Lawyers is a great way to understand the challenges and have an ally in your corner who can help you navigate them. Contact us today by calling (888)-424-5757.

All content undergoes thorough legal review by experienced attorneys, including Jonathan Rosenfeld. With 25 years of experience in personal injury law and over 100 years of combined legal expertise within our team, we ensure that every article is legally accurate, compliant, and reflects current legal standards.