Washington State Workers’ Compensation Claim Suppression

What is claim elimination?

Claim suppression occurs when employers try to prevent workers from reporting injuries on the job. RCW 51.28.010 (4) Suppression of claims intentionally means:

1. Induce employees not to report injuries;
2. Induce employees to treat injuries in the course of employment as off-the-job injuries; gold
3. Act otherwise to suppress legitimate industrial insurance claims.

Why do employers suppress claims?

To save money; a non-filed claim keeps the Washington L&I experience ratings and therefore the Washington L&I premiums relatively low.

Claim suppression history

Claim suppression has previously been discouraged by statutes in Washington. Some employers ignored the law and suppressed the claims. They got away with it. Those days should end. There is a new law in Washington state that puts some teeth into preventing claims suppression.

RCW 51.28.025: defines the sanctions against the employer and other remedies for the suppression of claims:

1. A penalty of at least two hundred and fifty dollars, not to exceed two thousand five hundred dollars, for each infraction.
2. Waive the time limits for filing a claim, if the claim or allegation of claim suppression is received within two years of the worker’s accident.
3. When a claim suppression determination has been made, the employer will be prohibited from any current or future participation in a retrospective rating program. If self-insured, the director must decertify as provided in RCW 51.14.080.

Section (c) is an effective sanction because it is directed at the portfolio of employers who suppress claims. The retrospective rating program and the ability to self-insure are great dollar privileges. Employers don’t want to lose their ability to self-insure or engage in retro, so they may be careful not to suppress claims.

Has the employer said the following or something similar?

• You didn’t really hurt yourself at work.
• Didn’t you hurt your back at home last weekend?
• If we keep workplace accidents low, employees will receive an incentive bonus. If you file a claim, it will cause all of your co-workers to lose their bonus.
• If you get hurt on the job, you won’t be called for another job at this company.
• Employees who get hurt on the job have a hard time around here.
• You will be fired if you file a claim.
• It is not necessary to file a claim. We take care of it …
• Why not include this in your health insurance?

If so, that employer is trying to suppress a claim.

What Should You Do If You Know About Your Employer Claims Suppression?

• File your workers’ compensation claim
• Discuss your situation with a Washington workers’ compensation (L&I) attorney.
• Go Online and File a Complaint Against Your Employer – Claim Suppression Complaint Form. See also RCW 51.28.025 (4).
• DLI has investigative and subpoena power: The department director, 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 filing the complaint. In cases where the Department can demonstrate probable cause, the Director has the authority to cite the records of 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 only to investigations into claims suppression allegations or when the Director has probable cause that claims suppression could have occurred.

The problem of company doctors and nurses or work clinics who have close relationships with employers

Most doctors and nurses are good people who really try to help their patients. However, company doctors and nurses or clinics that serve employers may have an incentive to downplay their role in reporting injuries. Your legal obligation is clear.

RCW 51.28.020 provides, among other things:

“… The physician or licensed advanced registered nurse practitioner who treated the injured worker shall inform the injured worker of his rights under this title and render all necessary assistance to make this request for compensation and such proof of other matters as required the rules of the department without charge to the worker … “

Doctors and nurses who contribute to claim suppression are unethical and should be reported to their licensing boards for their unprofessional conduct. There is no legitimate excuse for a medical professional to use their position of influence and power to harm their own patient. To inform a medical professional that you are doing something wrong, please fill out the appropriate complaint form.

Claim suppression is illegal.