What happens if the insurance adjuster said I was overpaid? Sometimes, if the insurance adjuster continues to pay benefits to the injured worker when they are not owed. An example of this would be if an injured worker returns to work and is earning their full wages or partial wages but are still receiving a full workers compensation lost wage benefit check from the workers compensation insurance adjuster. This would result in an over payment and the adjuster will state they have a credit. Paying back the over payment can get a little confusing, so bear with me here:
If you have an Award in place protecting your wages, the insurance adjuster can collect from the injured worker the over payment at a rate of 25% of their weekly lost wage check or out of any lump sum they receive. They may also be able to take some of the owed wages out of any mileage reimbursement or Cost of Living Adjustment that the injured worker qualifies for.
An over payment can also happen if the insurance adjuster paid an inured worker at the wrong weekly rate. An example of this would be if the injured worker should have been receiving $300 a week in lost wages based on their pre-injury average weekly wage but, instead, they were paid at a rate of $375 a week. The injured worker would have been paid $75 too much for every week that the insurance adjuster sent them a lost wage benefit check. Some folks assume that if the insurance adjuster paid them at the wrong rate they don’t have to pay back the over payment. Unfortunately, this is not true.
If you don’t have an Award, the insurance adjuster may just stop your check altogether until the over payment is satisfied. This can be a very difficult situation for injured workers. This is why I always tell injured workers to file their Claim for Benefits form with the Virginia Workers Compensation Commission and get under an Award to protect their benefits so things like this don’t happen!
If you are in this situation or you believe that the rate that you are being paid is incorrect, contact a lawyer immediately to help you figure out the correct rate and whether there is an actual over payment and credit due to the insurance adjuster.