What Happens When an Adjuster Says a Case Isn't Compensable? skip to content

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What Happens When an Adjuster Says a Case Isn't Compensable?

Do you still have a case?

Yes, you might. Not every injury that happens at work or on the clock is the responsibility of your employer. But just because you are off the employer’s premise or off the clock doesn’t automatically mean that your employer is not responsible for the injury.

There are many things that must be taken into account when addressing whether an injury is work related. Yes, the two obvious things they look at are whether you were on the employer’s property and on the clock. But that doesn’t end the analysis. Take the following for example: I had a client who had clocked out of work and was walking to their vehicle. They slipped and fell in the parking lot on ice. The insurance company said that since they had “clocked out”, the injury was their problem. They were wrong. Since the employee parked in a spot directed by the employer, the employer was responsible.

Another client had traveled out of town for work. After finishing his work, he went to a restaurant for dinner before going to the hotel. He was in a motor vehicle accident on his way to the hotel. Just because he was “off the clock” and not driving to or from the job site, doesn’t mean the employer wasn’t liable. This was a work related injury.

One last example was a client that had a pre-existing heart condition. He suffered a heart attack while at work. Nothing about the job environment caused or triggered the heart attack (although sometimes the environment or work you are doing can cause one which is a compensable work injury). The client fell to the ground and, on his way, hit his head on a metal table. The employer wasn’t liable for the heart attack, however they were liable for the injury to his head.

So don’t fall for the insurance adjuster telling you that just because your injury was not on site or was not on the clock that it isn’t their problem. Talk to the experienced attorneys at Black & Jones to find out how your injury may be work related.