If you are injured at work and your employer has a third-party administrator (TPA), you should be very careful about what you say to them. If at all possible, we suggest not talking to them, period. Not every Ohio company has a TPA—in fact, less than half of all Ohio employers have them. If your employer is one of those with a TPA, you need to know that they do not represent injured workers.

What Is a Third-Party Administrator?

Distraught Man on the Phone With a Third-Party AdministratorLet's be clear about what a third-party administrator is. This is a private company hired by your employer to help them manage workers' comp claims. They are not affiliated with Ohio or the Bureau of Workers' Compensation (BWC). Instead, they serve as a representative and advocate for the employer with the BWC. Their only job is to save your employer money. A TPA will:

  • Investigate workers' injury claims
  • Attend Industrial Commission hearings on behalf of the employer
  • Schedule medical exams
  • File motions to terminate treatment and benefits
  • Negotiate claim settlements

If you have reported an injury or filed a First Report of Injury (FROI) form with the BWC, the TPA will likely want to talk to you.

What to Do If You Have to Talk to a TPA

Your company's TPA wants to get information from you that will undermine your injury claim, so they will pull out all the stops to get you to talk. Remember, this person is not on your side. Ignore the sweet talk or the threats they might try on you. If a TPA contacts you, we suggest you:

  • Stick to the basics: where and when the accident occurred, what body part was injured, and who witnessed the accident.
  • Do not tell them about past injuries or other health conditions you may have.
  • Do not comment on your emotional state.
  • Sign nothing and do not allow your statement to be recorded.

Remember, you are under no obligation to work with your employer's TPA. They are not on your side. The only people you need to communicate with are your doctor and your workers' compensation attorney.

Do You Need an Attorney?

Not every workers' comp claimant needs an attorney, but if a TPA is hassling you, it's probably a good idea to talk to one. Monast Law Office is here to help. Please request a copy of our free book, The Worker's Guide to Injury Compensation in Ohio, to learn more about your rights and the workers' compensation system, and then call us. We will help you understand who you should and shouldn't talk to and how we can help you file a successful claim for the benefits you deserve.

 

James Monast
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Fighting for Ohio’s Injured Workers and their Families