The Shoulder
The Shoulder
66
mellow-fox-049

PIP wage loss just sitting there 'under review' — is this normal??

So I'm in a no-fault state and I've been waiting on my PIP wage loss benefits for going on five weeks now. I turned in everything they asked for — pay stubs, a letter from my employer confirming the hours I missed, even a signed note from my doctor saying I couldn't work. The whole stack.

Here's the weird part: my medical bills seem to be moving through the system fine. I can see activity on those in the online portal. But the wage loss portion just says 'under review' and has said that basically since day one. My adjuster replies maybe once a week if I'm lucky, and the replies are basically copy-paste non-answers.

I'm not trying to be dramatic but those missed paychecks are real money I don't have right now. Rent doesn't care that I'm 'under review.'

A few things I'm genuinely curious about from anyone who's been here:

  • How long did your insurer take to actually cut a check (or direct deposit) for wage loss under PIP?
  • Did they hold wage loss while still reviewing the medical side of the claim?
  • Did you have to push hard, or did it eventually just... process?

I don't have a lawyer yet. I've been trying to handle this myself but I'm starting to wonder if that was a mistake. Any real experiences would really help me feel less crazy right now. 🙏

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11 replies

  • 19
    kind-seal-655

    Went through almost the exact same thing last year. My medical payments started processing pretty quickly but the wage loss just sat there forever. Ended up being about seven weeks before I saw anything, and only after I sent a pretty firm written follow-up asking for a specific decision deadline. Hang in there but don't just wait passively — they seem to move faster when they know you're paying attention.

    • 22
      swift-lynx-045

      I'll be honest with you — wage loss claims get more scrutiny than medical bills internally, partly because they require more verification steps and partly because they're easier to dispute. The fact that your medical is moving and wage loss isn't is actually pretty common and doesn't necessarily mean something is wrong. That said, 'under review' can sometimes just mean nobody has prioritized your file. A written request for a status update with a specific response deadline (like 'please respond by X date') can shake things loose. Keep copies of everything you send.

    • 9
      careful-passenger744

      That lines up with what my adjuster told me too.

  • 18
    silent-newt-305

    They do this on purpose. Slow-rolling wage loss while processing medical keeps you from complaining too loudly — you see some movement so you think it's fine. Meanwhile the clock is running on your patience and your bank account. Document every single interaction. If you ever escalate or need a lawyer later, that paper trail is gold.

  • 18
    bold-raven-158

    Most no-fault states have statutory timelines for insurers to either pay or deny a PIP claim — usually somewhere around 30 days after receiving a 'clean' claim with all required documentation. If you're past that window, they may actually be in violation and you could have grounds to push back formally. I'd look up your specific state's PIP statute or at least ask an attorney whether the clock has run. Not telling you to sue anyone, just saying you may have more leverage than you think.

  • 10
    clever-crow-477

    The stress of financial limbo on top of recovering from an accident is genuinely awful for healing — people underestimate that. Please make sure you're not skipping follow-up appointments just because you're stressed about money. Missing treatment can actually hurt your claim later AND slow your recovery. I know it's a lot to juggle right now.

    • 18
      quick-owl-198

      Not legal advice, but if your state has a PIP statute (most no-fault states do), there are usually penalty provisions for late payment — including potential interest or fee-shifting. A quick free consultation with a PI attorney familiar with your state's no-fault rules could tell you whether you're owed more than just the benefit itself. Most won't charge you for that initial call.

    • 10
      patient-optimist899

      Thanks for sharing. Hope things are getting a little easier for you.

  • 16
    patient-tern-482

    Call them every single business day. Be polite but be relentless. Log the date, time, rep name, and what was said every single call. Adjusters have huge caseloads and the squeaky wheel absolutely gets the grease. Five weeks with no payment and no real explanation is too long — stop waiting for them to come to you.

  • 16
    hearty-fox-320

    Ugh, I'm so sorry. Dealing with insurance while you're already recovering is just brutal. Please don't feel like you have to figure all of this out alone — even just talking to someone who knows the process (like a lawyer who does free consults) might take some of the weight off.

  • 6
    candid-marmot-703

    Quick question — when you submitted your wage loss docs, did you get any kind of written confirmation that they received everything and considered the claim 'complete'? Sometimes the clock on their review period doesn't actually start until they formally acknowledge a complete submission. Worth double-checking because if there's a missing form or something, it might explain the hold-up.