The first call from an adjuster can make or break your claim
You just hurt yourself at work. You sent in your workers’ compensation claim form (DWC-1), and now the insurance adjuster for the employer is calling. They seem nice when they ask how you’re doing, what happened, and if you have any past injuries. But what you say could really hurt your case.
A lot of workers in California hurt their claims without meaning to during these early interactions. A casual remark like “I’m feeling better” or “maybe it was my fault” is recorded and used later to deny medical care, cut disability payments, or lower settlements. If you’ve been injured at work in California, knowing how to deal with adjuster communications is very important to protecting your rights.
In this article: What to do when the adjuster calls you, what you should never say, common adjuster tactics, and why you should call a California workers’ compensation lawyer as soon as possible to protect your claim.
Why the Adjuster from Your Insurance Company Is Calling You
The claims adjuster for workers’ compensation is the insurance company’s person in charge of handling your claim. The California Department of Industrial Relations looks over your DWC-1 claim form, decides if you can get medical treatment, checks to see if you qualify for disability benefits, sets up Qualified Medical Evaluator (QME) exams, and works out settlements.
Important fact: The adjuster is not your employee; they work for the insurance company. They are judged on how well they keep costs down, close files quickly, and make the least amount of payments.
What they want from first calls: Detailed accounts of the injury that can be used to argue that it isn’t work-related, medical history about previous conditions that can be used to argue that the problems aren’t work-related, statements that downplay the injury, like “I’m fine” or “it’s not that bad,” and recorded statements that lock you into certain versions before you know how bad your injuries are or get legal advice.
Why workers are vulnerable: First calls come when workers are in pain, don’t understand the process, don’t know their rights, and are afraid that not cooperating will lead to denial or retaliation.
The Most Important Rule: Adjusters Are Not Your Friends
They work for the insurance company: The insurance company pays adjusters and they answer to them. Their employer’s goal is to pay as little as possible, which is the opposite of what you want, which is full care and maximum benefits.
Everything is written down: Adjusters write down everything that is said in detailed claim notes, whether it is written down or not. These notes go with your file through every choice about treatment, disability benefits, and settlements. These internal notes are not often seen by workers.
Trained to close claims cheaply: Common tactics include downplaying the severity of injuries, discouraging legal representation (“you don’t really need a lawyer”—a major red flag), pushing for an early return to work, delaying medical authorizations, and misrepresenting legal rights about provider networks and evaluations.
What to Do Right Away When the Adjuster Calls You
Stay calm: Be polite when you answer, but don’t offer a lot of information about the accident, your pain levels, your medical history, or other details until you know your rights.
Only confirm basic information: Your name and contact information, the name of your employer, the date and general location of the injury, and that you reported it. Don’t talk about: blame, past injuries, guesses about what caused them, detailed pain descriptions, or how long it will take to get better.
Get everything in writing: Ask the adjuster for their full name, phone number, email address, address, insurance company name, and claim number. Request that all important messages be sent in writing so you have a record of them.
Politely say no to recorded statements: Most of the time, California law doesn’t require recorded statements. Safe response: “I’m still getting medical care and advice about my rights. I’m not ready to give a recorded statement right now. Please send your questions in writing.”
Call a lawyer right away: AB 1870 (effective January 1, 2025) says that employers must make it clearer how workers can talk to lawyers. Before you say anything important to the adjuster, you should talk to a workers’ comp lawyer. This will keep your claim from being permanently damaged. Early representation costs nothing up front (on a contingency basis) and makes things much better.
Things You Should Never Tell a Workers’ Comp Adjuster
Don’t downplay your pain: “I feel fine,” “it’s not that bad,” or “I’m sure I’ll be fine” are all things that can be used to argue that your injury wasn’t that bad or that you have healed. A lot of serious injuries don’t show their full extent for days or weeks.
Don’t talk about your medical history freely: Adjusters will ask about past injuries and conditions to try to show that your current problems aren’t work-related. Don’t answer detailed medical questions without first talking to a lawyer.
Don’t guess: If you’re not sure about the exact times, weights, movements, or order, say “I don’t remember exactly” instead of guessing. People who guess and then change their minds are seen as inconsistent or dishonest.
Never say you’re wrong: Most of the time, California workers’ comp is no-fault under California Labor Code. Saying things like “it was my fault” doesn’t help and hurts your credibility.
Never agree to return early: Only return when your doctor gives you clear written permission to do so. Returning too soon can hurt your health, stop temporary disability payments, and make it seem like your injury wasn’t that bad.
Things to Watch Out for When Dealing with a Workers’ Comp Adjuster
“Friendly conversation” trap: Comments like “I’m so sorry you were hurt” make you let your guard down so that people can say things that hurt you.
“Quick recording” trick: Calling recorded statements “routine” or “just a formality” hides their real purpose: to lock you into statements before you know how bad your injury is or have legal advice.
“You don’t need a lawyer”: When adjusters tell you not to hire a lawyer, they’re showing you their plan. If lawyers didn’t help, insurance companies wouldn’t tell people not to hire them.
Minimizing injuries: Saying that ibuprofen is enough, calling fractures “just sprains,” or suggesting that pain will go away quickly sets low expectations for care and benefits.
Delaying authorizations: Workers get frustrated and quit or go back to work early when treatment requests take too long to process or require too much paperwork.
Why You Should Let an Attorney Talk to the Adjuster
When you hire a California workers’ comp attorney, they tell the insurance company that all important communication must go through their office. This protects you right away from pressure tactics and false statements.
Attorneys control the flow of information: The adjuster only gets the right and necessary information. They stop people from saying things that could hurt their case, like who was at fault, their medical history, or how bad their injury was.
Ensures consistency: Lawyers help make sure that descriptions are clear and consistent in all forms of communication, medical appointments, and evaluations. For a claim to be believable, it has to be consistent.
Gets better medical care: Under California Division of Workers’ Compensation rules, experienced lawyers can navigate Medical Provider Networks (MPNs), ask for changes in doctors, and demand QME/AME exams.
Protects against denial: Attorneys fight unfair denials, wrongful benefit terminations, and use DWC dispute resolution to make sure insurers are held responsible. Recent changes in 2025 raised disability rates and made supervision stricter. Lawyers make sure that carriers follow the rules instead of underpaying.
How Talking to Your Adjuster Affects the Outcome of Your Claim
Early mistakes lower settlements: Your file will have initial statements that downplay the injury, admit fault, or suggest a quick recovery during settlement talks. Adjusters use them to explain why their offers are low.
Misstatements limit care: Saying that some body parts weren’t hurt or that the pain is mild can lead to partial approvals that leave out needed treatment.
Notes from the adjuster affect decisions: Internal notes have an effect on every decision that comes after them, including surgery approvals, temporary disability amounts, permanent disability ratings, and future medical care. These notes are not often seen by workers.
Protecting wage benefits: Saying you can work, want to work, or plan to return to work quickly can lower or end your temporary disability (TD) benefits and argue for lower permanent disability (PD) ratings. These benefits, which will go up in 2025, protect a lot of income.
Frequently Asked Questions About Getting in Touch with a Workers’ Comp Adjuster
Q1: Is it against the law for me to talk to the adjuster?
You need to help with the claim process, but you don’t have to give detailed, unsupervised recorded statements. You can give basic claim information and ask that any important questions be sent to you in writing so that you can answer them with legal advice.
Q2: Should I give a statement on tape?
In most cases of California workers’ compensation, recorded statements are not necessary and can often do more harm than good. Politely say no and explain that you are still getting care and looking for advice about your rights.
Q3: What information can I safely share?
It is usually safe to give your name, contact information, employer name, date and type of injury, and proof that you told your employer about it. Stay away from long descriptions of the accident, talks about medical history, and statements about who was at fault or when they will get better.
Q4: What if the adjuster pushes me?
Write down the pressure, say you need time to learn about your rights, and call a workers’ compensation lawyer right away. You can also tell the California Division of Workers’ Compensation or the Department of Insurance if an adjuster acts inappropriately.
Q5: If I don’t talk, can they turn down my claim?
No, not for real. Not cooperating at all could cause problems, but refusing to give recorded statements and asking for time to talk to a lawyer are both reasonable and legally protected actions that can’t be used to deny a claim.
Q6: Do I need to hire a lawyer before I talk to the adjuster?
Yes, that would be best. Getting a lawyer involved early on stops mistakes that can’t be fixed. Workers’ compensation lawyers work on a “contingency” basis, which means you don’t have to pay anything unless you get benefits. This makes it easy and safe to talk to them early on.
Q7: Why does the adjuster need to know about my health history?
To find pre-existing conditions, past injuries, or old treatments that they can use to say that your current problems are not work-related. Legal advice on what to say and how to say it correctly is very important in this area.
Q8: What if the adjuster is rude or makes threats?
Write down what happened, stop talking to the person, and call a lawyer right away. Threatening or rude behavior is against California insurance rules and can lead to formal complaints.
Q9: Can the adjuster tell me which doctor to see?
Employers in California must offer Medical Provider Networks (MPNs) that include more than one doctor. You have rights in the MPN, such as the right to switch doctors in certain situations. This is a complicated area, and having a lawyer help you make sure you get the right care is important.
Q10: When is it very important to get legal help?
It is best to do it right after the injury and before talking to adjusters about the details. Also important: when your claim is denied, when your treatment is delayed or denied, when your disability benefits are cut or stopped, or when the adjuster pushes you to settle.
Why Workers Who Are Hurt Choose ODG Law Group
Immediate Protection Against Adjuster Misconduct
From the very beginning, ODG Law Group steps in to help with adjuster communications, making sure that insurance companies follow California law and treat injured workers fairly.
Good at Dealing with Claims That Are Denied or Delayed
The company has a lot of experience fighting wrongful benefit terminations, improper claim denials, and using Division of Workers’ Compensation procedures to make sure carriers are held responsible.
A lot of knowledge about California workers’ compensation law
ODG Law Group keeps up with changes to DWC rules, notice requirements, and benefit rates for 2025 so that clients can get the most out of the law as it stands.
Strong Support for Hurt Workers
The company is not afraid to take disputed claims through the DWC hearing process when settlement offers are not enough. They are also very tough when it comes to negotiating with insurance companies.
Customized Help and Caring Advice
ODG Law Group makes the workers’ compensation process easy to understand, helps clients get the right medical care, and is there for them when things are hard and confusing.
Important Disclaimer: No lawyer can promise exact results. Each workers’ compensation case is different and needs to be looked at based on its own facts and circumstances. Results from the past do not guarantee results in the future.
Don’t Talk to a Workers’ Comp Adjuster Before Calling ODG
If you were hurt at work in California recently and the insurance adjuster has gotten in touch with you, don’t talk to them in detail until you know your rights.
ODG Law Group can help you with:
- Keeping your claim safe from harmful comments and adjuster tactics
- Talking to adjusters and insurance companies for you
- Getting permission for medical treatment and fighting unfair denials
- Stopping early denials of claims and benefits
- Fighting for full workers’ compensation benefits, such as temporary and permanent disability payments and future medical care
- Finding your way around medical provider networks and asking for changes in doctors
- Asking for QME or AME evaluations when there are disagreements
Before talking to the adjuster, get in touch with a California workers’ compensation lawyer right away.
No charge for a consultation. No costs up front. We only get paid if you get benefits.
Don’t let the insurance company take away the benefits that California law gives you. Call ODG Law Group right away to protect your rights and get the medical care and disability benefits you deserve.
