What Is Claim Suppression?
Claim suppression occurs when employers try to keep workers from reporting injuries on the job. Claim suppression is against the law. RCW 51.28.010(3)(4) .
Claim suppression is 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 to suppress legitimate industrial insurance claims. This can include retaliation, discrimination, harassment, and unnecessarily fighting legitimate L&I claims.
Why Do Employers Suppress Claims?
Employers suppress claims to save money. A claim not filed or allowed keeps experience ratings low and thus the employer’s Washington L&I premiums relatively low.
What Happens to Employers Who Get Caught Suppressing Claims?
An employer who violates the law by suppressing claims is subject to penalties and other serious administrative actions. RCW 51.28.025 (2)
- A penalty of at least two hundred fifty dollars, not to exceed two thousand five hundred dollars, will be assessed against the employer for each offense.
- Extra time for the injured worker to file the L&I claim, in the form of a discretionary waiver of the Statute of limitations for filing a claim. This benefit is discretionary and time-limited; the complaint or allegation of claim suppression must be 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. RCW 51.28.025(2).
- When a determination of claim suppression is made, and the employer is self-insured, the director shall withdraw certification as provided in RCW 51.14.080. This statute provides for the withdrawal of self-insured certification when the self-insurer intentionally or repeatedly induces employees to fail to report injuries, induces claimants to treat injuries in the course of employment as off-the-job injuries, persuades claimants to accept less than the compensation due, or unreasonably makes it necessary for claimants to resort to proceedings against the employer to obtain compensation.
These two statutes are very effective deterrents to employer bad behavior because they are aimed at the pocketbooks of employers who suppress claims. The retrospective rating program and the ability to self-insure are big-dollar privileges for self-insured employers. Employers do not want to lose their ability to self-insure or participate in retro.
Has Your Employer Suggested the Following?
- You didn’t really hurt yourself on the job.
- Didn’t you injure 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 your employer has said any of the above or something similar, then your employer is trying to suppress your L&I claim. Employer intimidation, hostility, overt and covert suggestions, or directions not to file L&I claims are illegal. Do not let your employer intimidate you. File that claim. If your L&I claim is suppressed, use the remedies listed below.
Remedies If You Know of Claim Suppression by Your Employer.
- File your workers’ compensation claim
- Talk your situation over with a Washington State L&I lawyer.
- Go online and File a Complaint against your employer— Claim Suppression Complaint Form. See also RCW 51.28.025(4). This complaint is the key move that starts the process of holding the employer accountable for their claim suppression. If you fail to file the complaint, nothing happens.
- The Department of Labor and Industries 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 Problem Of Company Doctors and Nurses or Work Clinics That Have Close Relationships With Employers
Most doctors and nurses are very good people 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 or helping injured workers.
This is just plain wrong. RCW 51.28.020 requires that medical professionals inform the injured worker of his or her rights under this title and lend all necessary assistance… in addition, doctors take an oath to do no harm to their patients.
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 trust, influence, and power to harm their own patient. If your employer or self-insured claims manager sent you to an unethical doctor who they knew would likely suppress your claim, then your employer may have conspired to commit claim suppression.
Report a Medical Professional Who is Doing the Wrong Thing
If you are being cheated or mistreated by a doctor or health professional, you have a right to complain. Contact the people who license them, The Washington State Department of Health.
- Physician Complaint Form
- Nurse Complaint Form
- Health Facility Complaint Process
- Department of Health FAQ regarding Medical Complaints
You can also ask L&I to perform an audit. The Director of L&I has the authority to audit health care providers. Here is the law RCW 51.36.100.
Stand up for your rights!
- Don’t let your employer wrongfully suppress your L&I claim. Take action—file your claim. Tell L&I what your employer did to suppress your claim. Get the L&I benefits you deserve.
- Our Washington workers’ comp attorneys have been helping injured Washington state workers for over 50 years. We’ve built our practice on thoroughly educating, honestly helping, and successfully representing workers throughout Washington State. Could you use some legal advice or more information? Schedule a complimentary consultation today.
