How Third-Party Administrators (TPAs) Handle Your Virginia Workers’ Compensation Claim.

Corey R. PollardWorkers’ compensation attorney · Former insurance defense · $100M+ recovered

The letter came from Sedgwick, so you probably assume Sedgwick is the insurance company covering the employer in your workers’ compensation case. It isn’t. Neither is Gallagher Bassett, Broadspire, CorVel, Landin, ESIS, or any of the third-party administrators that handle workers’ comp claims in Virginia. A third-party administrator, or TPA, administers money that isn’t its own, and many of the frustrations injured workers have with the cold workers’ comp system come from this one fact: the TPA’s strategy prioritizes saving money for the insurance carrier over your long-term health and financial stability.

Why The Third-Party Administrator Strategy Relies on Delay and Denial.

TPAs act as the bureaucratic shield for major insurers like Travelers and The Hartford. They generate revenue by keeping claim payouts low. When you file a claim for a Traumatic Brain Injury (TBI) or a catastrophic construction accident, the TPA immediately searches for reasons to devalue your injury. Every delayed approval for a specialist visit and every disputed medical bill serves a single purpose: wearing you down so you accept a lowball settlement. A claimant who fights this system without insider knowledge risks losing critical financial lifelines.

Three Tactics TPAs Use to Minimize Your Settlement.

Premature Maximum Medical Improvement, Suppressed Impairment Ratings, and Withheld Accrued Benefits.

The TPA playbook relies on three specific operational tactics. First, they push their approved doctors to declare you have reached Maximum Medical Improvement (MMI) before you have actually healed. This premature declaration shuts down your access to ongoing expensive medical care.

Second, they manipulate impairment ratings. Once a doctor declares MMI, the TPA attempts to secure the lowest possible percentage for your Permanent Partial Disability (PPD). A low PPD rating directly slashes the total monetary value of your settlement.

Third, they withhold accrued benefits. TPAs routinely delay issuing checks for the weeks you spent out of work, hoping you will accept a lump sum that fails to account for this back pay. When a TPA executes these three maneuvers successfully, a family facing a life-altering injury loses the financial foundation they need to survive.

How Insider Knowledge Counters the Insurance Defense Playbook.

Defeating a TPA requires anticipating their legal maneuvers before they execute them. Corey R. Pollard began his legal career representing insurance defense firms. He built his expertise on the other side of the table. Corey Pollard Law uses this insider knowledge to dismantle TPA defenses. When an administrator denies an MRI or refuses to authorize a surgery, the firm litigates the issue aggressively. The legal team forces the Virginia Workers’ Compensation Commission to compel the insurer to fulfill their obligations. Litigating to change unfavorable case law creates a structural advantage for the injured worker.

Secure the Financial and Medical Stability You Deserve.

A catastrophic workplace injury creates a permanent shift in your identity and your livelihood. You need an advocate who treats your case as a vital life issue. Corey Pollard Law has recovered over $100 million for injured workers by confronting major insurers and their TPAs in high-stakes litigation. Contact Corey Pollard Law for a comprehensive claim evaluation, and let our team counter the TPA strategy to secure the compensation your family requires.

About the authorCorey Pollard is a Virginia workers’ compensation and Social Security Disability attorney in Richmond. Best Lawyers in America® (2020–2026), $100M+ recovered, and a former insurance defense lawyer — which is the part that matters.