We’ve seen it many times. A good employee lifts something heavy at work and feels a pop in one of his or her shoulders. The employee promptly reports the injury, and a few days later an insurance adjuster calls up and wants to set up a recorded statement to “investigate the claim.” The adjuster is real friendly on the phone. She just wants to “get the facts” she says. During the recorded statement, she asks, “were you doing your usual job in the usual way?” The employee answers, “yes,” not thinking to add important details. A few days later, a denial letter shows up the mail.
The employee wonders, “What happened? I got hurt at work. I reported my claim. Why am I being denied?”
Unfortunately, North Carolina workers’ compensation law is a legal minefield, and the employee above has just stepped on one. In North Carolina, if you do not describe specific facts about your work injury in a way that tends to show the event was an accident, the claim can be denied. The specific details you provide can make all the difference. Because the employee did not know to give the relevant accident details to the adjuster in the recorded statement, the employee has given the workers’ compensation insurance company a strong defense to the claim.
Don’t let this happen to you. The adjuster is not your friend. Her questions are designed to trick you into giving the workers’ compensation carrier a defense to your claim. Call us, and let us guide you through the minefield. The consultation is free, and even over the phone, we can help identify danger areas in your case.