Don’t Say Or Email Anything To A Claims Examiner You

Don’t Want To Read On The Front Page Of The Newspaper

By: Joyce Kostenbauer, RN

Workers’ Compensation Insurance carriers have become increasingly vulnerable to the opening of computer system claims data, emails, and internal work products to workers’ compensation and labor attorneys. Successful requests for the viewing of this important claims management data are increasing, so employer be careful what you say or email to that claims examiner!

As part of the claims process most examiners have computer screen note systems and they are instructed to enter all claim activities and interactions into this system. Conversations with the employer, interactions with the injured worker, and emails with the employer are examples of interactions being entered in these notes fields.

Open communication between employer and examiner is necessary for a successful claims process. However, I cannot tell you how many times I have read computer claim notes to find that an employer “doesn’t want the injured worker back…..will be terminating the worker because he will just get hurt again….. this is the third time he has gotten hurt….. he is accident prone….we’re firing the worker because he is a predator,” etc. It is in the record for EVERYONE, including the worker’s attorney, to see.

Some examiners will advise you to avoid email and to just make a phone call so the information remains “off the record.” It may remain protected until the examiner is sitting in a deposition.

Please communicate fully to claim examiners, but avoid personal opinions, disparaging characterizations, or frivolous gossip. Remember that anything you say or write may lay the groundwork for a successful discrimination or wrongful termination lawsuit, or a retaliation lawsuit.

The best communication is brief, clear, OBJECTIVE, and to the point.