Seven Things Which Let a Workers' Comp Adjuster Know She'll Probably Win Your Claim

1. Injured Workers Without Attorneys. This is almost a no-brainer. The Workers' Compensation Act is so complicated and so full of loopholes that it takes a serious professional to know it all. So when a seasoned adjuster goes up against an injured worker without an attorney at his side, it's almost a guaranteed cheap settlement for the adjuster. And saving money for the insurance company is Job #1 for the adjuster.

How OTP works to your advantage. Whether it's getting reimbursements for your mileage; making sure your overtime, bonuses, or per diems were included in your average weekly wage; or demanding the workers' compensation insurance company pay for your yard care or housecleaning if you cannot do it, we never let an adjuster cheap out on your case.

2. Injured Workers With Attorneys Who Aren't Aggressive. Even better than an unrepresented injured worker is one with an attorney who doesn't do anything. Most of their clients don't realize how easy it to switch to an attorney who's going to get things done. If the attorney is too slow-moving to even return phone calls or meet face-to-face with clients, he'll never get the adjuster to back down.

How OTP works to your advantage. We are known widely for being just about the most aggressive firm in North Carolina. Our workers' compensation attorneys take more cases to hearings than any other - and that reputation pays off even for those whose case doesn't need to go to hearing. Adjusters know they'll never get rid of us easily or cheaply.

3. Knowing an Injured Worker Needs the Weekly Checks. Workers' Compensation adjusters know the Industrial Commission lets them withhold checks for no good reason. They can do this for three weeks at a time and as often as they like if an attorney doesn't intervene. If an adjuster can do this a few times, the injured workers will be desperate to settle - and usually for the first or second offer.

How OTP works to your advantage. We move quickly to obtain orders from the Industrial Commission requiring timely payment to you. We've even filed motions to have workers' compensation adjusters held in contempt if they continue to play games with your checks. The result is that most adjusters have learned not to bother our clients.

4. Doctors Who Will Return You to Work Without Restrictions. Experienced adjusters know this is a golden opportunity for them to cut your claim's value immediately. So they hand-pick the doctors in advance to increase the chances this could happen to you. In most cases the Industrial Commission will let the insurance company adjuster cut off your weekly workers' compensation checks, with little advance notice, unless you act fast to prevent it.

How OTP works to your advantage. We've developed a system for combating this. As soon one of these company doctors attempts to release you without restriction, we file a series of legal documents which require the workers' compensation insurance adjuster to hire an attorney, provide you with a visit to a new doctor, and ultimately stall off any attempt to cut your checks off.

5. The Myth That Attorneys Will Take Most of Your Settlement. This myth is spread by adjusters, doctors, and rehabilitation professionals, but it's often far from the truth. The adjusters' own research group found that injured workers with attorneys average settlements that are 2.7 times greater than those without a lawyer. Workers' Compensation Adjusters know that attorneys shouldn't charge more than 25%, so even after paying a fee the average injured worker will get more than twice as much having an attorney as they would otherwise.

How OTP works to your advantage. Note very clearly here: We think it is a complete ripoff for attorneys to charge on ongoing benefits they didn't get for you. We think fees should be limited to 25%. We think fees should be paid only when we win or negotiate something for you. And we don't take cases where you're not going to come out ahead after paying a fee.

6. Employers Who Offer Light Duty. The adjuster just wants to get you off of her payroll and back onto the company payroll as quick as possible. What happens after that isn't her business. In fact, if your employer can find a reason to fire you then you'll be on no one's payroll at all. Best yet, for the adjuster anyway, is that in most situations she won't have to put the injured ex-worker back onto weekly checks.

How OTP works to your advantage. Just as with full-duty return to work notes, we have a system in place which immediately smothers the adjuster and the employer with legal paperwork to make sure that any proposed light duty job is legal, is beneficial to you, and does not jeopardize your claim. This is a highly complex area of the law and it is one where we've seen hundreds of injured workers have their claims go down the drain because they were not protected by tough lawyers.

7. Rehabilitation Nurses and Vocational Rehab Counselors Who Break the Rules. These Rehabilitation Professionals are hired by adjusters to help keep costs down. But the RPs charge as much as $85.00 per hour to do this. How does that save the adjuster money? All too often it's because the RPs are violating the Industrial Commission's Rehab Rules. And they do it in a way which almost always guarantees a win for the adjuster.

How OTP works to your advantage. RPs have a begrudging respect for us. Many of them will privately concede that we make them tow a line that few other lawyers do. We keep databases of rehab professionals from different files and note their strengths, weaknesses, and areas where we've had to back them down. We don't go into dealings with these people without being fully prepared, and we don't let our clients do so either.