When you get injured on the job, the workers’ compensation insurance company will usually ask you to give a recorded statement. While they may tell you that the purpose of this statement is “to investigate” and “to determine whether your claim is compensable,” what really happens is they are looking for a way to deny your claim.
Because the recorded statement is so important to your workers’ compensation claim, never let the insurance adjuster control the process of recording your statement. Instead, a better option is to meet with an experienced attorney from our law firm, who can carefully review your case and help you thoroughly prepare a statement that fairly shows your side of the story.
An “accident” in workers’ compensation terminology is “an unusual or unexpected interruption of the normal work routine.” That means that something you didn’t expect to happen, did happen. The accident must then have caused your injury.
Insurance claim adjusters are trained to identify when this has occurred. Unfortunately, if you do not clearly describe your accident, your claim will probably be denied. A skilled adjuster may also ask leading questions that could lead to a denied claim, such as:
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 that caused you injury.
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 explain this important part of your story, insist on telling your side of the story before they turn off the tape recorder. That’s because, if you simply say you were walking down some stairs and injured your knee, there is a good chance that the adjuster will deny your claim because nothing unusual happened.
Always tell the truth about the accident and your injuries. Don’t exaggerate the facts, but never forget to state all of the details that show your injury came from something unusual or unexpected.
Do not be concerned about whether fault will play a role in your claim. Many times, injured workers are all too quick to say that nothing unusual happened even if it did because they are afraid this could be considered fault on the worker’s part. Remember: workers’ compensation in North Carolina 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. Though no defined accident is required for back injuries and hernias, 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, for example, carpal tunnel syndrome or a condition linked to contact with asbestos or other harmful substances, a completely different set of requirements apply.
If you have concerns about providing a recorded statement to an insurance adjuster, contact our law firm located in Hickory, North Carolina. Send us an email or call 828-328-9966 (toll free at 888-321-0494) to set up a free initial appointment with a lawyer.