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Monday, October 26, 2009

Single Point of Contact

This is a related issue to my post about the lack of confidentiality when dealing with an Ombudsman. Workers at the Division of Workers' Compensation are now calling injured workers, represented or not, and telling them that they are the "single point of contact" at the DWC on the claim and that they can answer all of the workers' questions. However, they also ask a lot of questions of the injured worker. ALL OF THESE ANSWERS ARE DOCUMENTED IN THE COMPUTER SYSTEM AND ARE AVAILABLE TO INSURANCE COMPANIES AND EMPLOYERS WHO ARE WORKING AGAINST YOU.

Injured workers routinely tell the DWC information that is used against them at a later time. Always remember that whatever you tell them will become known by everyone involved in your case - adjusters, insurance company attorneys, investigators, nurse case managers, JUDGES. You might not even know that what you are saying hurts your case, but it will. The best practice is to never discuss your case with anyone that calls you on the phone asking questions.

If you need to talk to the Division of Workers' Compensation about your case, then you probably need an attorney. If they call you, then you probably need to consult with an attorney before you answer any questions that you are asked. Even confirming treatment status or work status is not something that you should do.

If a "single point of contact" calls you, politely decline to answer any questions, no matter how hard they try to get you to respond, no matter what threats are made, and go talk to an attorney immediately.

3:53 pm cdt Comments

Tuesday, October 20, 2009

Ombudsman Communications Not Confidential

While reviewing a file today in preparation for a contested case hearing at the Texas Department of Insurance, Division of Workers' Compensation, I came across a copy of the DWC computer file notes that the carrier had obtained simply by asking. You will want to know that anything that is said to a DWC or OIEC employee is documented in these notes.

The claimant that I was representing had previously used the services of an ombudsman. He had a dispute that was very fact specific and required witness corrobaration. The DWC computer notes contained the contents of all of the discussions my client had with the Ombudsman. Everything he said would have been confidential had the remarks been made to me, but because they were made to the Ombudsman, anyone with access to the computer notes could see it. This included the insurance carrier, the very party against whom we were fighting. The notes detailed everything that was going to be done to pursue the case and set up the fight. The carrier had it all along. That just makes my job harder. What's worse, the unrepresented claimant is just hung out to dry by this process. Imagine if the insurance carrier had access to your entire gameplan, all of your thoughts about what was going on and what you intended to do to prove your case. In this case, it contained the identity of a witness that my client had not yet disclosed. He was trying to get a statement from the witness before the employer got wind of it and threatened the witness's job in order to keep the witness from providing the statement. And the carrier (and therefore the employer) knew what was going on the whole time.

Beware who you talk to about your case. This shows that you can't even afford to disclose information about your case to an Ombudsman. It isn't kept confidential and just informs your opponent of your every move. How hard is it to fight a strategic battle when you know your opponents every move? Not very hard. The law is already stacked against the claimant. Don't dig a deeper hole.

11:50 pm cdt Comments

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