Navigating the workers' comp subrogation dance

One of the most common pitfalls in a claim organization is having the same person fill the role of claim specialist and subrogation specialist. (Photo: vchalup/Adobe Stock)

Workers’ compensation subrogation is an area of claims practice requiring the marriage of multiple disciplines. To succeed, the workers’ compensation subrogation specialist must be adept at understanding the file, so there are coordinated efforts and organization of the settlement plan when the files converge. This team member must also be well-versed in liability review and the statutes regarding workers’ comp subrogation in each state. This is in addition to possessing a working knowledge of the negotiation process and anticipated response and application of the law in various situations.

While at times there may be a minimal connection between workers’ compensation and the subrogation portions of the file, they can both be active at the same time. This may happen when the employee’s medical condition requires a lengthy recovery. For example, when the employee isn’t at a maximum medical improvement for several years, there is a situation where the claim and subrogation specialists are both working the file. At the time of settlement, the two specialists need to work together to make sure all of the elements are addressed and the result is appropriate for the employee, as well as the employer/carrier.