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Claim Suppression of Washington State Workers’ Compensation Claims
What Is Claim Suppression?
Claim suppression occurs when employers try to keep workers from reporting injuries on the job. RCW 51.28.010(4) Claims suppression means intentionally:
- Inducing employees to fail to report injuries;
- Inducing employees to treat injuries in the course of employment as off-the-job injuries; or
- Acting otherwise to suppress legitimate industrial insurance claims.
Why Do Employers Suppress Claims?
To save money; a claim not filed keeps experience ratings and thus Washington L&I premiums relatively low.
History of Claim Suppression
Claims suppression has previously been discouraged, by statute in Washington. Some employers ignored the law and suppressed claims. They got away with this. Those days should be over. There is a new law in Washington state which puts some teeth into preventing claim suppression.
RCW 51.28.025 – defines the penalties against the employer and other remedies for claim suppression:
- A penalty of at least two hundred fifty dollars, not to exceed two thousand five hundred dollars, for each offense.
- Waive the time limits for filing a claim, if the complaint or allegation of claim suppression is received within two years of the worker’s accident.
- When a determination of claim suppression has been made, the employer shall be prohibited from any current or future participation in a retrospective rating program. If self-insured, the director shall withdraw certification as provided in RCW 51.14.080.
Section (c) is an effective penalty because it is aimed at the pocket book of the employers who suppress claims. The retrospective rating program and the ability to self insure are big dollar privileges. Employers do not want to lose their ability to self insure or participate in retro, so maybe they will be careful to not suppress claims.
Has The Employer Said the Following or Something Similar?
- You didn’t really hurt yourself on the job.
- Didn’t you hurt your back at home last weekend?
- If we keep our work place accidents down, employees will receive an incentive bonus. If you file a claim you will cause all your co-workers to lose their bonus.
- If you hurt yourself at work, you won’t be called out for another job with this company.
- Employees who hurt themselves at work have a hard time around here.
- You’ll be fired if you file a claim.
- You don’t need to file a claim. We’ll take care of it…
- Why don’t you put this on your health insurance?
If so, that employer is trying to suppress a claim.
What Do You Do If You Know of Claim Suppression by your employer?
- File your workers’ compensation claim
- Talk your situation over with a Washington workers’ compensation (L&I) lawyer.
- Go Online and File a Complaint against your employer – Claim Suppression Complaint Form. See also RCW 51.28.025(4).
- DLI has Investigation and Subpoena Power: The Director of the Department, or the Director’s designee, must investigate reports or complaints that an employer has engaged in claim suppression. Any complaint must be received in writing and must include the name or names of the individuals or organizations submitting the complaint. In cases where the Department can show probable cause, the Director is granted the authority to subpoena records from the employer, medical providers, and any other entity that the Director believes may have relevant information. The Director’s investigative and subpoena authority is limited solely to investigations into allegations of claim suppression or where the Director has probable cause that claim suppression might have occurred.
The Problem Of Company Doctors and Nurses or Work Clinics That Have Close Relationships With Employers
Most doctors and nurses are good persons who genuinely try to help their patients. However, company doctors and nurses or drop in clinics that cater to employers may have an incentive to downplay their role in reporting injuries. Their statutory obligation is clear.
RCW 51.28.020 provides, among other things:
“…The physician or licensed advanced registered nurse practitioner who attended the injured worker shall inform the injured worker of his or her rights under this title and lend all necessary assistance in making this application for compensation and such proof of other matters as required by the rules of the department without charge to the worker…”
Doctors and nurses who contribute to claims suppression are unethical and should be reported to their licensing boards for their unprofessional conduct. There is no legitimate excuse for any medical professional to use their position of influence and power to harm their own patient. To report a medical professional who is doing the wrong thing complete the appropriate complaint form.
Claims Suppression is Against the Law.
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Source by Christopher Sharpe
