Information Options for the Employer

Monday, September 2, 2002 | 0

Articles in this column have in the past discussed how to obtain important medical information on a workers' compensation claim without violating the law. Most companies don't realize that they can also get important information on the progress of pending or past workers' compensation claims direct from the California Workers' Compensation Appeals Board. This article will explore what kind of information is available, what is important, and what can (or can't) be done with this information.

Every employer that has a workers' compensation claim pending against it should be concerned with the progress of the case, regardless of whether the claim is perceived as large, or whether the claimant is a 'good' or 'bad' employee. All claims, no matter how minor, have the potential to seriously affect the employer experience modification factor, and once a claim is reported to the insurance company the employer essentially loses all control over the claim, including receipt of any information that may be important to management. The employer has the ultimate responsibility to ensure that workers' compensation matters that are reported are properly handled, and the best way to do that is to have as much information as is legally permissible that will permit informed decision making.

One method to stay on top of pending claims without having to rely on the insurance company to communicate to you in California is EDEX (acronym for Electronic Data Exchange). Other states have similar information systems.

EDEX is access to the official CA Workers' Compensation Appeals Board database. Attorneys, insurance companies, and medical providers all use the system routinely to find out what is going on in a case, to find out if a claimant has other cases pending or has filed in the past, get hearing and case event notices, and to submit legal documents to the WCAB (such as medical provider liens).

Searches on EDEX are done with either a social security number or a WCAB case number. Searching by social security number will provide information on all cases pending, or in the past, filed under that SSN. Case information revealed will be the name of the person using that SSN for the claim (identity theft is a significant problem in workers' compensation cases), the date of injury claimed, date of birth of the claimant, current case status, body parts allegedly injured, recent case events (such as dates of hearings, dispositions, filing of legal documents), names and addresses of parties (including attorneys, insurance companies, and medical providers that have filed liens against the case to secure payment). An example of what a search might provide can be found at https://www.workcompcentral.com/edex_sample.htm.

The information provided by EDEX is public record, meaning that anyone can obtain this information. However, in order to ensure that the information is used only for legal purposes, the Department of Workers' Compensation requires that non-parties (i.e. those who are not attorneys or insurance companies) acknowledge that they have been advised of the legal and illegal uses of the information.

In short, information gleaned from an EDEX inquiry cannot be used to discriminate against anyone, be it the injured employee, a witness or anyone else affected by the filing of the case. EDEX information cannot be used as the basis for denying a job applicant a position on the basis that the applicant has had a prior workers' compensation case.

However, EDEX information may be useful to ensure that you are apprised of when a case is set for hearing in the event that you may wish to participate in the hearing. You will also be alerted to prior claims that your insurance company may not be aware of. In addition, if the employee consents, you may be able to make inquiry of physicians who have attended the employee to determine whether the employee can return to work, can perform the necessary physical attributes of a job, and other information relevant to the employee's status.

More importantly though, is that EDEX data will arm you with the information you need to make informed decisions about the handling of workers' compensation cases on your behalf. You will know when key events occur, such as settlement conferences. You will be able to determine if prior workers compensation cases may have a bearing on the current case, or at least be able to intelligently discuss the prior cases in an audit.

EDEX is just one of many tools available to the employer to keep track of claims made against it, or to review a claimant's workers' compensation history. This service is available to paid subscribers of workcompcentral.com. For more information, click on the EDEX link at the upper left of most primary site pages in the orange horizontal menu.