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In this episode, we talk to Kirsten Kaiser Kus. She is a defense attorney and an equity owner at Downey & Lenkov LLC, leading their Indiana practice. She brings deep experience from both the plaintiff and defense sides of workers’ compensation. She shares how her involvement with CLM and litigation education shaped her expertise and helped grow her professional network.

We explore the many stakeholders in the workers’ compensation system. Kirsten discusses distinctions between plaintiff-side and defense-side stakeholders and how they interact—or clash—within systems that vary state by state.

On the plaintiff (applicant) side, she highlights challenges such as unrealistic expectations, lack of understanding of legal metrics, and client control issues. Then she systematically breaks down the far more complex defense side, detailing the roles of carriers, TPAs, hearing members, medical providers, mediators, ombudsmen, vendors, brokers, excess carriers, self-insured clients, and even how politics play out in our system.

Throughout our conversation, Kirsten emphasizes one central principle: communication is critical. Where, oh where have we heard that before? Whether navigating expectations, coordinating stakeholders, or managing the risk of expensive cases, clear, proactive, and coordinated communication is what drives effective outcomes.

Stakeholders in the Workers’ Comp Ecosystem:

Injured Worker
The employee who was hurt at work and seeking benefits.

Applicant’s Attorney / Claimant’s Attorney / Plaintiff's Attorney / Petitioner’s Counsel
The lawyer representing the injured worker (term varies by state).

Defense Attorney
The attorney representing the employer or insurance carrier.

Employer
The company where the injured worker is employed; also referred to as "the insured."

Insurance Carrier
The insurance company providing workers’ comp coverage to the employer.

Third-Party Administrator (TPA)
An outside company that manages the administration of claims on behalf of self-insured employers or insurance carriers.

Broker
An insurance advisor who helps employers obtain and manage coverage.

Self-Insured Employer
A company that pays claims out-of-pocket, often with excess insurance coverage.

Excess Carrier
The insurer that covers costs beyond a self-insured employer’s retention layer.

Hearing Member / Judge / Commissioner
The official who hears and rules on workers’ compensation disputes.

Ombudsman
A state-provided guide who assists unrepresented workers.

Mediator
A neutral party who helps both parties involved in a litigated case try to settle the case before trial.

Medical Provider
Doctors and other clinicians who treat the injured worker.

Nurse Case Manager (NCM)
A licensed nurse who helps coordinate medical care and communicate with all stakeholders. NCMs are often called in to help coordinate more complex claims. 

Vendors
Service providers such as interpreters, transportation, Medicare compliance experts, durable medical equipment (DME) suppliers, and home modification specialists.

Subrogation Counsel / Third-Party Recovery
Attorneys or departments pursuing reimbursement when a third party (not the employer) caused the injury.

Family Members
Often involved in influencing the injured worker’s decisions and expectations, an important perspective to keep in mind througho

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