Legal Question in Workers Comp in North Carolina
I am self employed and cover myself on workers comp. I broke my arm on the job. WC says told the doctor they are not 100% sure they will pay for my necessary surgery. Should I talk to a lawyer before giving my statement to them.
2 Answers from Attorneys
Absolutely. You can be 100% certain that the insurance adjuster handling your case is getting advise from a lawyer and you should do the same. I advise every client before they make a statement to the insurance company. The information is for "investigative purposes" to determine whether they will accept or deny your case. I always assume that the carrier is seeking any scrap of information they can hang their hat on to deny your right to benefits. An attorney will help guide you through the process, explain how to really listen to the questions you are asked and an attorney can also ask some questions when the adjsuter is finished with his or her questions to help clarify any ambiguities and shore up the facts that support your claim.
I would recommend that you find a certified specialist in your area. Here is a link to the website with that information.
http://www.nclawspecialists.gov/results.asp?SpecialtyID=1111
Yes, you should. The reason for the recorded statement is to give the adjuster a chance to develop the evidence they need to deny your claim, and to make that denial stick if you challenge it. I try to avoid letting my clients give those statements whenever possible. You definitely need to talk to a work comp lawyer before you discuss what happened with the adjuster.
Over the years I have seen many injured workers talk the insurance company into denying their cases even though they had good cases, because they gave a recorded statement thinking that the adjuster is operating in good faith. The adjuster usually is not the least bit interested in finding a way to pay your claim.