Your rights when an adjuster calls matter more than most injured workers realize. An insurance adjuster works for your employer’s workers’ compensation insurance company. The adjuster is not your enemy. However, the adjuster does not work for you either.
Their job is to check your claim, decide what the insurer owes, and keep costs down. That first phone call often comes when you are hurt, tired, and worried about your next paycheck. What you say can shape your claim for months. This guide covers what the adjuster can ask, what you can say no to, and the deadlines they must meet.
Who the Adjuster Is and What the Call Is For
A claims adjuster handles your file for the insurance company. In some cases, the employer is self-insured. Then the adjuster may work for a company the employer hired to run claims. Either way, the adjuster decides whether to accept your claim. They also approve medical care and set your weekly checks.
The first call usually happens within a few days of your injury report. Typically, the adjuster asks how you got hurt, where it happened, and who saw it. They may ask about past injuries, your doctor, and your pay. As a result, this call builds the story the insurer will rely on. Small mistakes, guesses, or offhand comments can end up in your file.
Knowing your rights when an adjuster calls helps you stay calm and accurate. You can be polite and cooperative while still protecting yourself. In most cases, honest, short answers work best.
Your Rights When an Adjuster Calls: What You Can and Cannot Refuse
Here is the core of your rights when an adjuster calls. You must report the injury and cooperate with a fair investigation. However, you do not have to answer every question on the spot. You can ask the adjuster to call back at a better time. You can also ask them to put questions in writing.
Recorded statements. Many adjusters ask to record the call. In many states, you are not legally required to give a recorded statement to the insurer. For example, you can say, “I’d like to talk to someone first before I’m recorded.” If you do agree, you can ask for a copy. Keep answers to facts you know. It’s fine to say “I don’t know” or “I’m not sure.”
Medical records. The adjuster may send a form asking you to sign a medical release. The insurer can typically see records tied to your work injury. However, a broad release could open your whole medical history. You may be able to limit it to the injured body part and related dates. Confirm the rules with your state board.
Choosing your words. Avoid guessing about your recovery. Words like “I’m fine” or “it’s not that bad” can be used to cut benefits later. Simply describe what hurts and what you cannot do right now.
Key Deadlines for You and the Insurer
Your rights when an adjuster calls include time limits the insurer must follow. These rules keep claims from sitting untouched. Deadlines are set by each state, so they vary. The table below shows a few real examples.
| State | Your deadline to report injury to employer | Insurer’s deadline to act on the claim |
|---|---|---|
| California | 30 days | 90 days to accept or deny, or the claim is presumed covered; up to $10,000 in medical care while it decides |
| Texas | 30 days | 15 days to start paying or send a written denial; 60 days to dispute whether the injury is covered |
| Florida | 30 days | Up to 120 days to pay and look into the claim before denying |
| New York | 30 days (in writing) | 18 days after disability begins, or 10 days after learning of it, whichever is later |
Money matters too. Most states pay temporary total disability (TTD) at about two-thirds of your average weekly wage. TTD means weekly checks while you cannot work at all. Your average weekly wage is your typical gross pay before the injury. Texas pays 70% for most workers. Every state also sets a maximum weekly benefit. Note that state maximum weekly benefits change every year. Always confirm the current figure with your state board, such as the California Division of Workers’ Compensation or the Texas Division of Workers’ Compensation.
If the adjuster misses a deadline, write it down. For example, a late payment in many states means the insurer owes a penalty. Your state board can explain how to report it.
What to Do Before and After the Call
Knowing your rights when an adjuster calls is step one. Step two is staying organized. Keep a simple notebook or phone note just for your claim. Write down every call: date, time, adjuster’s name, and what was said. Ask for the claim number and the adjuster’s direct email. As a result, you’ll have a clear record if anything is disputed later.
Before the call, jot down the basic facts. When were you hurt? Where? How? Who saw it? Which doctor treated you? Having these ready keeps your story steady. After the call, send a short email confirming anything important. For example: “Thanks for confirming my first check will arrive on Friday.”
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Later, the adjuster may bring up other terms. MMI means maximum medical improvement. That’s the point when your doctor says you won’t get much better. Next comes an impairment rating, a percentage showing lasting loss of use. That rating often sets permanent partial disability (PPD) pay. PPD covers lasting damage after you reach MMI. The adjuster may also offer a compromise and release. That’s a lump-sum settlement that often closes your claim for good.
Your rights when an adjuster calls include the right to take your time with any offer. You do not have to accept a settlement on the phone. Any settlement numbers are illustrative, and every case is different. Before you sign, many claimants talk with their state’s free ombudsman or information office. For example, New York offers help through the New York State Workers’ Compensation Board. Federal workers can check the U.S. Department of Labor Office of Workers’ Compensation Programs. Confirm your options with your state board and a licensed attorney.
Frequently Asked Questions
Do I have to give the adjuster a recorded statement?
In many states, you are not legally required to give the insurer a recorded statement. However, you still need to cooperate and share basic facts. Knowing your rights when an adjuster calls means you can politely ask to delay the recording until you’ve gotten advice.
Can the adjuster talk to my doctor without me?
It depends on your state. In most cases, the insurer can get records related to your work injury. However, rules on direct talks with your doctor differ, so check with your state board.
What if the adjuster stops returning my calls?
First, send a written email or letter and keep a copy. Typically, insurers must meet state deadlines to pay or deny. If they don’t, contact your state workers’ compensation board. Exercising your rights when an adjuster calls also means following up when they don’t.
Not Sure Where You Stand?
If your claim was denied, your benefits stopped, or a settlement offer feels low, it is worth having a workers’ comp attorney look at it. Most give a free consultation and work on contingency — so there is usually nothing upfront.
Advertising — not a referral, endorsement, or legal advice.
Sources & How to Verify
This guide is built from official government and industry sources. Workers’ comp figures, deadlines, and state rules change every year, so always confirm the exact figure with your state board or a licensed attorney:
- Your state workers’ compensation board / division: the first and most authoritative source for your state’s caps, deadlines, and rules.
- U.S. Department of Labor: dol.gov — the directory of state workers’ comp officials.
- NCCI: ncci.com — workers’ comp rating and benefit data.
- Social Security Administration: ssa.gov — SSDI offset and benefit-cap data.
- Insurance Information Institute: iii.org — neutral coverage and claims data.
Verified September 2026. State maximum weekly benefits change every year — if you spot anything outdated, please contact us.
Related Guides
- The Complete Guide to Workers’ Comp Settlements
- Workers’ Comp Settlements by State
- Workers’ Comp Benefits Explained (TTD, PPD, MMI)
- Your Rights at Work — Common Scenarios
- Plain-English Workers’ Comp Glossary
Disclaimer. This page is for general information only and is not legal, medical, or financial advice, and it does not create an attorney-client relationship. Workers Comp Explained is an independent educational resource, not a law firm, insurer, or medical provider. Benefit caps, deadlines, and rules vary by state and change every year, and any settlement figure is an illustration, not a prediction. For your situation, confirm the exact figure and any deadline with your state workers’ compensation board and a licensed attorney before you act.