I’m sure I’ve posted about this before, but the injured person is not in the best position to advocate for him or herself. Lawyers have an old joke which, unfortunately, is mostly correct:

“A lawyer who represents himself (or herself) has a fool for a client.”

I remember many, many years ago I was involved in a motor vehicle accident that was very clearly somebody else’s fault. I wasn’t seriously injured, but I hired a very good friend of mine to represent me on the case, rather than try to do it on my own. The reason was that I didn’t want a fool for a client.

The same is certainly true for an injured worker who tries to represent himself or herself in the claim. What usually ends up happening is that the injured worker makes decisions based upon discussions that they have with the claims adjuster.

It is important to remember that the adjuster’s job is to save the insurance company money, and not to help the worker.

If your claim gets closed and you call up the adjuster and complain about it, the adjuster is likely to say something like, “you need to request reconsideration.” What they don’t tell you is that if you want any evidence in the record, it can only go into the record at reconsideration and not after reconsideration at a hearing. If your doctor wants to perform surgery and the insurance company refuses to allow that, and the injured worker calls the adjuster to complain, the adjuster may say something like, “We haven’t accepted that condition, and you need to ask us to expand our acceptance to include that,” and then you get into a very expensive fight with the insurance company once they deny that additional claim.

In the workers’ compensation system, it is important to understand that this system is extremely confusing. Most lawyers can’t find their way around the workers’ comp system if they aren’t experts at it. The adjuster is not your friend, and the adjuster is not really going to help you. The lesson, unfortunately, is that you’re better off to hire the lawyer early, remembering that it is not going to cost you any money unless the lawyer gets something for you.



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