If you’re dealing with a workers’ comp claim, there’s a good chance you’ve had to talk to an adjuster.
And let’s be real – those conversations don’t always go smoothly. Maybe they’ve been slow to respond. Maybe they’ve flat-out denied something your doctor said you need. Or maybe you’re just stuck, feeling like no one’s on your side.
It’s frustrating. You might even be wondering if you can sue them for the stress they’ve caused.
In this post, we’ll explain if you can sue your workers comp adjuster.
Can You Sue A Workers’ Comp Adjuster Personally?
No, you can’t sue the workers’ comp adjuster personally. They’re usually protected because they’re just doing their job on behalf of the insurance company.
That doesn’t mean they can treat you however they want, though.
Most adjusters follow guidelines from their employer and the state. As annoying or even wrong as their decisions may seem, suing them individually usually won’t go anywhere.
But here’s the thing: that doesn’t mean you’re out of luck.
You can go after the insurance company itself if they’re acting in bad faith or dragging their feet on your claim. So you might not be able to name the adjuster on a lawsuit, but there are still ways to hold the whole system accountable.
Also Read: What Benefits Can You Get From Workers’ Compensation?
When Legal Action Is An Option
So when can you take legal steps? You’ve got a few possible paths.
If your workers compensation benefits are delayed for no good reason, or if your claim gets denied unfairly, that might be a red flag. The same goes for being ignored when you’re asking for help, or if medical bills aren’t being paid on time.
You can’t just sue because the process is slow or because the adjuster is rude.
But if they (or the insurance company) cross certain lines, then it becomes a different story – especially if you can show they’re purposely making things harder for you.
It’s called acting in bad faith, and courts tend to take that pretty seriously.
What Counts As Bad Faith In A Workers’ Comp Case?
Bad faith is basically when an insurance company or adjuster doesn’t play fair.
They might ignore evidence, deny a valid claim, or delay things for no reason. They might refuse to approve treatment that your doctor clearly says you need. Or just ghost you when you’re trying to get answers.
Here are some classic bad faith behaviors:
- Denying your claim with no real explanation
- Dragging out the process even after you’ve provided everything they asked for
- Ignoring your doctor’s recommendations or forcing you to see one of theirs
- Not returning your calls or leaving you totally in the dark
None of this is okay. And if any of it sounds familiar, it’s probably time to take a closer look at your options.
What To Do If You Suspect Bad Faith Or Mistreatment
It’s easy to feel powerless in these situations. But there are things you can do to protect yourself and push back. Here’s exactly what you should do:
#1 Document Everything
This step might sound boring, but it’s one of the most important things you can do.
Start a file where you keep everything related to your claim. Every phone call, email, denied form, doctor’s note, or update from your adjuster should go in there.
And don’t just save the big stuff. Write down dates and times you called, what was said, and if someone promised to follow up. If you’re told one thing on the phone and another in writing later, that kind of inconsistency can be useful.
It’s also helpful to keep track of how long things are taking. If they’re dragging their feet, this will show it.
Build a timeline that proves you’ve been doing your part – and they haven’t.
Also Read: Can Workers Comp Tap Your Phone?
#2 File A Formal Complaint With The State Board
If you’ve been dealing with constant delays, ignored calls, or questionable denials, it might be time to go over their head.
Every state has a workers’ comp board or agency that oversees how insurance companies handle claims. These boards exist to make sure people like you are treated fairly.
Filing a complaint is usually pretty straightforward.
Most states have online forms you can fill out. You’ll explain what’s going on, share any documents that back it up, and submit the complaint for review.
It won’t always fix the problem overnight, but it puts your case on the radar.
And if the board sees a pattern of bad behavior, they may step in to investigate or even penalize the insurance company.
#3 Consult With A Workers’ Comp Attorney
You don’t have to figure this out on your own.
A good workers’ comp attorney can look at your case and tell you what your options are. They’ve seen it all before – bad adjusters, slow payments, denied claims, and everything in between.
And most of them won’t charge you upfront. It’s usually a percentage of what you win, so there’s not much to lose by reaching out.
#4 Appeal Denied Claims
If your claim gets denied, you can file an appeal and have someone else take a look.
Most states give you a specific window of time to appeal (like 30 or 60 days), so don’t sit on it.
You’ll need to file the appeal and probably attend a hearing. This is your shot to show why the original decision was wrong, and it’s where having documentation and maybe even a lawyer can make a big impact.
You might need to provide more medical records, doctor statements or additional evidence.
Also Read: Steps to Take if Your Workers’ Compensation Claim is Denied
How An Attorney Can Help
Lawyers know how the system works – and how to make it work for you.
They can review your paperwork, chase down records, and deal with the adjuster so you don’t have to. They can also spot bad faith tactics and help you build a case around them.
Here’s what they bring to the table:
- They’ll handle the paperwork and deadlines
- They can help you file complaints or appeals
- They’ll negotiate on your behalf
- They’ll push for the benefits and compensation you actually deserve
Sometimes just having a lawyer on board is enough to get the insurance adjuster and the company to take you more seriously.
Final Thoughts
Nobody wants to deal with legal drama when they’re hurt and trying to recover. But if you’re getting the runaround from a workers’ comp adjuster, you don’t have to just take it. You’ve got rights. And there are ways to fight back when things aren’t fair.
You might not be able to sue the adjuster personally. But that doesn’t mean you’re stuck.
Keep records. File complaints. Get a lawyer in your corner if things aren’t moving. You deserve to be treated with respect, and to get the benefits you’re owed.
Need help figuring out the next step? Reach out to a workers’ comp attorney. It’s worth it.
