What is claim removal?

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

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

Why do employers suppress claims?

To save money; an unfiled claim keeps experience ratings, and therefore Washington L&I premiums, relatively low.

Claim Suppression History

Claim suppression has previously been discouraged by statute in Washington. Some employers ignored the law and suppressed the claims. They got away with it. Those days should be over. There is a new law in the state of Washington that puts some force into preventing claim expungement.

RCW 51.28.025 – defines employer sanctions and other remedies for claim suppression:

1. A fine of at least two hundred and fifty dollars, not to exceed two thousand five hundred dollars, for each violation.
2. Waive the deadlines for filing a claim, if the complaint 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 barred from any current or future participation in a retrospective rating program. If you are self-insured, the director must decertify as provided in RCW 51.14.080.

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

Has the employer said the following or something similar?

• You didn’t really get hurt 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 you will cause all your co-workers to lose their bonus.
• If you get hurt on the job, you will not be called back for another job at this company.
• Employees who get hurt on the job have a rough time around here.
• You will be fired if you file a claim.
• You do not need to file a claim. We will take care…
• Why don’t you put this in your health insurance?

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

What to do if you find out about your employer’s claim 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 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(s) of the person or organization making the complaint. In cases where the Department can show probable cause, the Director is given the authority to subpoena the records of the employer, medical providers, and any other entity the Director believes may have relevant information. The Director’s subpoena and investigative authority is limited solely to investigations of 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 a close relationship with employers

Most doctors and nurses are good people who really try to help their patients. However, company doctors and nurses or employer-serving clinics may have an incentive to play down their role in reporting injuries. Your legal obligation is clear.

RCW 51.28.020 states, among other things:

“…The physician or advanced certified nurse practitioner who treated the injured worker shall advise the injured worker of his or her rights under this title and provide all necessary assistance in filing this claim for compensation and proof of other matters as required by the rules of the department at no charge to the worker…”

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

Claim suppression is illegal.