When the Insurance Adjuster’s Actions Can Hurt Your Virginia Workers’ Compensation Claim
After a workplace injury, most communication about your claim will go through the insurance carrier’s adjuster. While adjusters are responsible for managing the claim, their role is not to advocate for you—it is to protect the interests of the insurance company.
Understanding how an adjuster may handle your claim—and where issues can arise—can make a significant difference in whether you receive the benefits and medical care you are entitled to under Virginia law.
The Adjuster May Not Take All Required Steps
One of the first issues that can arise is whether the claim has been properly reported to the Virginia Workers’ Compensation Commission.
In some cases, the adjuster may delay or fail to formally report the claim. This can create problems later, particularly when it comes to documenting your entitlement to benefits. If your claim has not been properly reported, it may not be recognized or tracked by the Commission.
It is important to confirm that your claim has been filed and, if necessary, follow up to ensure it is properly documented.
You Have the Right to Choose Your Treating Physician
Another common issue involves medical treatment.
Adjusters may attempt to direct you to a specific physician. In Virginia, however, unless it is an emergency situation, you are generally entitled to select your treating doctor from a panel of three physicians provided by the employer or carrier.
This choice is important—especially if your injury requires specialized care such as orthopedics, neurology, or pain management. The doctor you select will play a central role in:
- Diagnosing your condition
- Establishing work restrictions
- Determining your ability to return to work
Accepting treatment without understanding your rights can impact the course of your claim.
Be Cautious About Recorded Statements
It is not uncommon for an adjuster to request a recorded statement about how your injury occurred.
While this may be presented as a routine step, you are not required to provide a recorded statement. Statements given early in a claim—especially while you are injured, medicated, or uncertain about details—can later be used to challenge your credibility or the circumstances of your accident.
If a statement is requested, you should proceed carefully. In many cases, it is advisable to speak with an attorney before agreeing to provide one.
Medical Record Releases Are Often Unnecessary
Adjusters may also ask you to sign broad medical authorization forms.
In Virginia workers’ compensation claims, medical records related to your injury are generally accessible to the carrier through your treating providers. This means you are often not required to sign an unrestricted medical release.
Signing overly broad authorizations can give the carrier access to unrelated medical history, which may later be used to dispute your claim.
Do Not Overlook the Importance of an Award Agreement
If you are already receiving medical treatment and wage loss benefits, it is important to ensure that your claim is formally documented through an Award Agreement filed with the Commission.Once that Award Agreement is signed by the injured worker and the adjuster and filed with the Commission an Award Order will be entered.
Without an Award Order:
- Payments may be considered voluntary
- Benefits may be stopped without formal proceedings
- Your long-term rights may not be fully protected
If an Award Agreement has not been issued, you should raise that issue promptly.
Recognizing When to Take Action
Most adjusters handle claims routinely, but when delays, denials, or pressure tactics arise, it is important to recognize the situation early.
Warning signs may include:
- Delays in approving medical treatment
- Pressure to accept certain doctors or provide statements
- Lack of documentation with the Commission
- Requests for broad or unnecessary authorizations
Addressing these issues early can prevent complications later in your case.
Speak With a Virginia Workers’ Compensation Attorney
Insurance adjusters play a central role in your claim, but their priorities are not always aligned with your best interests. Knowing your rights—and asserting them appropriately—can help ensure you receive the benefits you are entitled to.
If you have concerns about how your claim is being handled, or if you feel that your treatment or benefits are being delayed or restricted, it is important to get guidance.
The attorneys at Inman & Strickler P.L.C. have extensive experience dealing with insurance carriers and adjusters in Virginia workers’ compensation cases. They can help protect your rights, address improper handling of your claim, and guide you through the process from start to finish.
Contact their office today to schedule a consultation and ensure your claim is being handled correctly.