What Not to Say to a Workers' Comp Adjuster

Why ordinary answers cause the problem

An adjuster is assembling a file. Everything in it — the first report of injury, any recorded statement, medical notes, your description of what you can and cannot do — becomes the record against which everything later is measured. If your account shifts, even for an innocent reason, the shift itself becomes the issue.

That is why the damaging answers are usually guesses offered in good faith rather than anything dishonest. You were not certain how far you fell, so you estimated. You did not want to seem difficult, so you agreed with a summary you had not read carefully. Months later the estimate is treated as a measurement and the summary as your account.

The answers that cause the most trouble

These come up repeatedly, and each has a straightforward alternative.

• "I'm fine" — said as a greeting, recorded as a report on your condition. Describe what actually hurts and what you cannot do.
• "About six or seven feet, I think" — a guess becomes a measurement. Say you are not sure, and that the site or the incident report will show it.
• "I might have tweaked that shoulder years ago" — speculation about an old injury is the foundation of a pre-existing-condition defence. Say what you have actually been treated for, and nothing beyond that.
• "It was my own fault" — fault is not your assessment to make, and in a handful of states any fault on your part defeats a civil claim entirely. Describe what happened, not who you think is to blame.
• "Yes, that's about right" — agreeing to a summary you have not read. Ask for it in writing and read it before confirming.
• "I can probably manage that" — an aspiration recorded as a capability, which can end wage benefits. Describe what you can do today, not what you hope to manage.

Recorded statements

A request for a recorded statement is normal, but the timing is usually theirs rather than yours. There is generally no need to give one the moment you are asked. Reasonable and uncontroversial requests: ask what it will cover, ask to schedule it, and ask for a copy afterwards.

Distinguish who is asking. Cooperating with your own employer's workers' compensation insurer is generally expected. A third party's liability insurer — a contractor, an equipment manufacturer, a driver's insurer — is a different matter, and you are usually under no obligation to speak to them at all.

What to do instead

• Answer the question asked, and stop there.
• Say "I don't know" or "I'm not sure" when that is the truth. It is a complete answer.
• Describe your condition in terms of specific limitations rather than general adjectives.
• Keep your own dated note of what was discussed, and with whom.
• Read anything before agreeing to it, including your own statement.
• Correct mistakes in writing as soon as you notice them.

Where this matters most

In Maryland, Virginia and the District of Columbia the stakes are higher than elsewhere, because those jurisdictions still apply contributory negligence — any fault attributed to you defeats a civil claim against a third party entirely rather than reducing it. An offhand "I should have been more careful" carries real consequences there. See Maryland, Virginia and Washington DC.