When you get injured on the job, the workers' compensation insurance company will usually ask you to give a recorded statement. They tell you the purpose of this statement is "to investigate" and "to determine whether your claim is compensable." What really happens is they're looking for a way to deny your claim. Because the recorded statement is so important to your workers' compensation claim, never let the adjuster control the recorded statement. We meet with our clients before the recorded statement to do thorough preparation so that our clients are given a fair chance to state their side of the story.
An "accident" in workers' compensation terminology is "an unusual or unexpected interruption of the normal work routine." That means something you didn't expect to happen, did happen. The accident must then cause the injury.
Adjusters are trained how to do this. If you do not clearly describe your accident, your claim will probably be denied. A skilled adjuster will ask leading questions: "Nothing unusual happened, did it? You were doing your regular job, weren't you? This kind of situation happened all the time, right?"
Be sure you can explain what interrupted your normal work routine. It doesn't have to be a slip, trip, or fall. It just has to be an interruption of the normal work routine.
For example, if you are walking down some stairs at your workplace and injure your knee because you missed a step, be sure to say so. If the adjuster doesn't give you a chance to say so, you must insist on telling your side of the story before they turn off the tape recorder. If you just say that you were walking down some stairs and you injured your knee, there is a good chance that the adjuster will deny your claim because nothing unusual happened. You should always tell the truth. Don't exaggerate, but never forget to state all of the details that show your injury came from something unusual or unexpected.
Many times injured workers are all too quick to say, "No nothing unusual happened," even if it did. Sometimes the injury occurs because the injured worker was being careless. Remember, workers' compensation is a no-fault system. In most cases, even if an injured worker got hurt due to their own negligence or carelessness, they can still recover workers' compensation benefits.
There are a few exceptions to the "injury by accident" requirement. For back injuries and hernias there need not be "accident," but you still have to prove that the back injury or hernia happened at work at a definable time. If you have an occupational disease such as carpal tunnel syndrome or asbestos, a completely different set of requirements apply.
