Have you ever found yourself in a situation where your doctor orders time off work but the insurance adjuster delays payment for you? It can be frustrating and confusing, especially when you’re already dealing with an injury or illness.
But don’t worry, you’re not alone. Many people have experienced this same situation, and there are answers to your questions.
In this article, we’ll explore why your workers’ compensation adjuster might not be paying you yet, what your options are, and how you can take action to get the benefits you deserve.
Why Is Your Adjuster Not Paying You Yet?
There are a few reasons why your adjuster may not be paying you yet. First, they may not have received all the necessary documentation from your doctor to verify that you are unable to work. This can include medical records, treatment plans, and work restrictions.
Another reason could be that your claim is still under investigation. Adjusters need to gather all the necessary information to determine if your claim is valid and if you are eligible for benefits. This can take time, especially if there are discrepancies or inconsistencies in your claim.
It’s also possible that there is a delay in processing your claim due to administrative issues or a backlog of claims. Adjusters may have a large volume of claims to process, and yours may not be prioritized until they have more information or resources available.
Can Adjusters Not Pay You Immediately?
One of the laws that Gov. McCrory enacted prohibited the Industrial Commission from forcing an employer to decide to accept or deny the claim within a month of having actual written knowledge of the claim. Thus, the adjuster has thirty days within which to hold back on all payment without any repercussions against her whatsoever.
It is our observation from speaking with a lot of claimants with modest injuries that they are sorely tempted to give up their claim and beg the doctor to return them to full duty because they cannot afford to go a whole month without pay. While some adjusters may dispute the insinuation that this is a goal of theirs, the fact that it occurs is beyond dispute.
If you do not have a note from a doctor taking you out of work, and if the doctor wasn’t one the adjuster or the employer sent you to, then you can be assured that the checks are going to be a little slower getting started. And if you have a note returning you to work but you haven’t gone back because it hurts too much – without another out-of-work note from the doctor it’s going to be difficult. It can be done but it often requires an attorney’s help in doing so.
What Are Your Options If Your Adjuster Is Not Paying You Yet?
If your adjuster is not paying you yet, it can be frustrating and stressful. However, there are several options you can take to resolve the situation:
1. Contact Your Adjuster
The first step is to contact your adjuster and ask for an explanation as to why you have not received payment yet. They may have encountered a delay or require additional information from you.
2. Contact Your Employer
If your doctor has taken you out of work, your employer may have information that can help you get paid. They may be able to provide documentation or communicate with the adjuster on your behalf.
3. File a Complaint
If your adjuster is not responding or taking too long to pay, you can file a complaint with your state’s insurance department. This can help speed up the process and ensure that your claim is handled properly.
4. Hire an Attorney
If all else fails, you may need to hire an attorney who specializes in workers’ compensation cases. They can help you navigate the process and ensure that you receive the compensation you are entitled to.
Remember, it is important to stay calm and persistent when dealing with an adjuster who is not paying you yet. Keep detailed records of all communication and take action as needed to protect your rights.
