Whatever Happened to Workers Comp Recorded Statements?
Not too long ago, workers comp recorded statements appeared in every file where the injured worker received any type of weekly comp benefits – a mailed check.
Workers Comp Recorded Statement Requirements
Some of the requirements were:
- a recorded statement of the injured employee within 24 hours (even weekends) of receiving the First Report of Injury – unless they were represented by an attorney. I even took them with the attorney on the phone or in-person
- preferably in-person if you were a local on-the-road adjuster
- a recorded or written statement by any witnesses of the accident as soon as possible (72 hours maximum)
- the adjuster used a guide provided by the TPA or insurance carrier. I still have a flipbook guide somewhere. I took statements for any type of claim, not just WC.
- do not make them confrontational or accusatory
- a more involved statement if there was any subrogation potential such as an auto accident
- not for medical only claims in most cases
Written statements were also allowed but they usually ended up being so time-consuming. When the accident occurred in another state, you could assign an outside firm’s adjuster to take the statement for you if an in-person statement was required. In-person statements turned out to be much better than over the phone.
Recorded Statements Faded – 1990s
Workers comp recorded statements reduced quickly in the 1990’s – as did most other lines of insurance. The last time I remember recorded states being taken was when I consulted for a health and workers comp insurer. The statements, though, were too accusatory – a written guide and standards were needed at the time. This was 1996 – yes, 24 years ago.
Some forward-thinking employers and governmental organizations heavily investigate any type of accident or insurance claim. I have seen a few written statements taken by these groups.
Now that I consult on files, I never see recorded statements taken by the adjusters. Yes, the good adjusters still verify the accident with the employer, employee, and medical treatment facility. Their three-point contact is performed ASAP. After all, a claim is basically over in 48 hours – check the link.
Legality of Recorded Statements
Many times, when I bring this up at conferences or a presentation with claims or risk management department personnel, some of them have responded with recorded statements being frowned up or illegal in their respective adjusting states.
I usually respond back – then why is a guide for taking written or recorded statements still in your claims adjusting manual provided to adjusters the first day on the job?
If any carriers or TPA’s are still taking workers comp recorded statements, please let me know in the comments section or let me know at the contact us page. Thanks.
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4 Responses
Hi James, I stumbled onto this excellent article. I was a Field Investigator for State Fund for 29 years until they outsourced the job.
The art of investigation and taking a good thorough recorded is just lost. The insurance companies used to do these in-house but outsourced them to PI firms that had no idea how to do it properly and professionally. Most of the PI’s frankly had poor skills in writing, questioning and thinking things through. They would fail to ask appropriate questions and follow up was not existent.
Also taking statements served many other purposes. I think statements should be in person. How can you make a decision on case that can be worth a lot of money without meeting the parties in person is unfathomable. You can observe the claimant and witnesses. You often can obtain information about safety or numbers of employees. I can’t tell you how many times i found out we were able to catch fraud by getting out of the office and taking statements.
I could go on fir awhile but the truth is the truth:statements are important and should be reemphasized in Work Comp.
Randy, I agree with you wholeheartedly. I am reviewing 30 files for an insurance agency – lost time Workers’ Comp. Five of them have subrogation potential – no recorded or written statements on any of them. Hopefully, we will return to taking recorded statements someday. Thanks for your timely comment. I worked for the State Fund in the early 2000s reviewing litigated files.
Recorded Statements are absolutely necessary and pre-COVID-19, my company did them in person. We specifically see the value in statements form the injured employee, witnesses, including supervisors. We have two outside field adjusters on the ground in our Southeast footprint. I used to be in that role and loved it. I always viewed it as the best opportunity to verify the facts, get a feel for the character and credibility of the injured worker, take photos and or record an reenactment of what happened. It really helped to clarify and bring to life a loss description and support or rule out compensability.
The true art is in how you get the information. The style you use to get the answers without making people feel interrogated but willing to give you more than you asked. You have to know when to veer off script and follow verbal leads and get back on script. Always recommend reviewing each claim to develop additional questions or what you what to clarify. Really cover prior history and medical treatment, always get a signed medical release.
Our defense counsel does use our recorded statements to defend us and they find them invaluable. They do make or break the case sometimes. Truth is the claim is open for ongoing investigation until it is closed!!
Diana, thanks for your great insightful comment. In-person statements are the best way to find out what happened – phone statements work well if the interviewer is properly trained. I still have a statement guide here somewhere that covered so many facets of the claim. You are correct – the off-script questions and answers usually are the most valuable. I have not seen a recorded or written statement in any of the files that I have reviewed over the last 10 – 15 years. That is in a way – sad.