Shabrami Law

Why Initial Investigation is Critical

Workers’ compensation claims begin when an employee reports an injury that is alleged to have arisen out of and occurred in the course of employment. Once a claim is filed, employers and their insurance carriers must evaluate the circumstances of the injury, review medical documentation, and determine compensability under California workers’ compensation law. Early investigation and strategic claim assessment are critical to managing exposure and controlling unnecessary costs.

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In my practice, an effective defense begins with securing and preserving evidence before it is lost. Witness statements, video footage, photographs, and other contemporaneous documentation should be obtained promptly, while recollection is fresh and physical evidence is still available. Delay can result in compromised information, making it difficult to build supporting case defense.

I advise employers to rely on individuals with firsthand knowledge of the incident rather than secondhand reports, and to conduct an independent evaluation of the claim. Medical providers at industrial clinics typically document reported symptoms, but do not conduct a comprehensive compensability analysis unless obvious concerns are present. 

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Making the correct decision on whether to accept or deny a claim is often the most important decision. Not performing a good faith investigation and denying a case prematurely, without employing reasonable due diligence, may expose employers, carriers, and TPAs to penalties.

A disciplined approach involves developing a clear plan of action early in the claim, building a factual foundation, and establishing a defensible theory of the case. When the initial investigation is thorough and strategic, the defense is positioned to move forward with greater control, credibility, and efficiency.