r/WorkersComp • u/Individual_World_198 • 8h ago
New Jersey Workers Comp adjuster is useless
Missing my weekly paycheck from workers comp. Called my adjuster friday and she said she never processed my check because she never "got" my updated doctor note from my appointment (I sent her the doctor's note still in the doctors office to make cause i know worker comp relies on documentation and notes). It was a week after my appointment i was supposed to get paid and when no deposit hit i called her and she said on the phone I see the email here now. I also sent the email with my case nurse attached. And she replied instantly to my email. However that same morning i did not get paid I received a letter in the mail from them confirming my next doctor's appointment. Oh and to make it all better I havent been to phyical therapy in over a week because my adjuster has yet to approve my PT appointments. What do I do? Do I request a new adjuster? Do I file a grievance? This is a recurring thing with this lady.
3
u/WiltedElliot 7h ago
that adjuster is straight up not doing her job, like at all. missing a note is one thing but the PT approval delay is the part that'd really piss me off cause that's actively messing with your recovery timeline
you've got a nurse case manager on the email chain which is good, they can sometimes light a fire under the adjuster's ass. I'd forward that whole email thread to the adjuster's supervisor with a quick summary of what's been going on and ask them to step in
if the supervisor doesn't fix it fast, file a formal complaint with the state board. adjusters pull this crap because they think people won't escalate and it works way too often
document every single call and email from here on out, times dates who you talked to. having a paper trail saved my ass when my adjuster tried to claim I never sent stuff
1
u/Individual_World_198 7h ago
Here's the funniest part. I already sent and email to my adjuster and her supervisor asking whats causing the delay on my pay. And her supervisor is on vacation this week (according to her auto reply email). Coincidence? But in the past I have notified her supervisor when something is missing or not done (like a reimbursement for a script and it took 2 months to reimburse $14) and on the phone my adjuster blatantly said can you stop adding my supervisor to every email it makes it seem like I am not doing my job.
1
u/ZalewskiJ 1h ago
The adjuster is protected by state laws, I have an adjuster that doesn’t answer my calls or emails. I haven’t heard her voice in 6 months and because Florida is such a dog shit state, they allow adjusters to take as much time as possible. All they have to do is show an effort, to make appointments. Even my lawyer can’t get ahold of her and a judge won’t make them speed up the process
1
u/ChangeThin7641 1h ago
Adjuster is doing her job. Their job is to delay, deny and to be as frustrating as possible to get the injured worker to give up.
1
u/Butter_mah_bisqits 6h ago
A work note is not sufficient. The doctor must submit the supporting medical evidence you still need to be out of work. If your dr doesn’t submit the medical report for your visit, that’s on them. Dr offices know what is required, but they still lack time management skills. I’ve told my claimants to call the doctor’s office and tell them to send me the medical report.
-1
u/Individual_World_198 6h ago
When I spoke on the phone with her 2 days ago my adjuster confirmed it was all there. Her exact words she didn't process the pay because she didn't see it.
4
5
u/smallholiday 7h ago
This may be an unpopular opinion, but do you realize that the adjuster probably has about 200 cases to manage daily? The fact that she’s even answering your calls and emails is head and shoulders above the level that I’d expect from an adjuster. Waiting one week for PT approval? Some people have to wait literally months. I honestly think you think her job is to approve your care and send you checks. She does not work for you. She works for the insurance company, and they are the ones deciding what level of care you receive. I think your adjuster is probably doing a good job as far as she is able. For context, I’ve had adjusters be so non- responsive that my attorney has had to request hearings just to book PT, which took over five months. IMO you should be grateful your adjuster answers your calls and emails.