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  • Writer's pictureJohn Larrimer

What Do Workers' Comp Investigators Look for in a Claim?

After injured employees file for a workers' compensation claim, an insurance company will expend resources to determine whether their injuries are serious since the sustained work injury prevents them from returning to work. The insurance company will hire private investigators to determine if the said worker is faking injuries to build fraudulent claims. Moreover, not all workers' compensation claims would require investigations.

Injured workers with minor injuries will need time to recover and return to work promptly. In such situations, insurance companies wouldn’t need to hire private investigators to determine workers' compensation fraud, as it wouldn’t be cost-effective. An employee with a history of filing a workers' comp claim or a large claim will probably have an investigator monitor their recovery. Even when the workers' compensation claim is denied, the private investigator may still monitor an employee to bolster any chances of an appeal.

Therefore, a workers' compensation attorney from Larrimer & Larrimer Law Firm would come in handy, as they can advise injured victims on how to protect their right to workers' comp benefits when they suffer serious workplace injuries.

Tactics Insurance Company Investigators Use to Determine Workers' Compensation Fraud

Tactics Insurance Company Investigators Use to Determine Workers' Compensation Fraud

Workers' compensation investigations may seem like an invasion of privacy, but the investigation is legal in some states. One is not automatically investigated when they suffer workplace injuries. An injured worker is under investigation only when the employer believes the employee is faking, malingering, or exaggerating their injuries. Here are some tactics investigators uses in their investigations.

Video Surveillance

Hired private workers' compensation investigators may often conduct surveillance while they gather evidence. Is the injured worker still recovering as they claim to be? They may also make use of videos to prove workers' compensation fraud claims.

A perfect site for such surveillance is outside a medical provider's office. Under workers' compensation law, insurers are the ones who make appointments for the treating physicians of a claimant.

The stamped time on videos can help establish that the employee's injuries are not as severe as previously claimed. Injured workers should, therefore, keep in mind that the insurer can use surveillance.

Non Video Surveillance

Injured victims should also know that there are other forms of monitoring the insurance companies can incorporate apart from videos. Under workers' compensation jurisdiction, the insurer can use standard investigative techniques to monitor an employee’s condition.

It can include asking neighbors and people who’ve been in the employee’s home about the gravity of their physical disabilities and conditions. Moreover, they can make phone calls at the employee’s home while conducting workers' comp investigations.

Online Surveillance

Investigators conducting workers' compensation investigations can also monitor activities on an injured worker's social media accounts. They’ll use their posting against them if the settings are permitted. An injured victim posting on hikes can hurt the workers' comp claims as many insurance companies usually use them against the worker to deny them their workers' compensation benefits.

Sometimes, such postings are misconstrued; therefore, it's wise for individuals with a work-related injury pursuing injury claims to refrain from posting on social media.

Actions a Workers' Comp Investigator Can’t Do

Workers' comp investigations must follow the law. They can’t entrap the worker by impersonating other people. An investigator can’t pose as a delivery guy to quickly take pictures of the victim while they try to answer the door.

Moreover, they can’t use fraudulent names to obtain information from the worker. Additionally, these investigators should not trespass on an individual property to determine workers comp fraud.

Workers' compensation investigation might sometimes bend the rules of law to attain evidence. When an individual suspects their workers' comp investigation is breaking states' laws, they should contact work injury lawyers in Columbus from Larrimer & Larrimer Law Firm at (614) 820 1855. Through their free consultation, the lawyers will offer guidance on what steps to take next and provide a free case evaluation to determine if one stands a chance to win the case. They can help address all aspects of issues and concerns relating to workers' comp, such as helping you determine who is exempt from workers compensation.

What Injured Employees Can Do After Filing a Workers' Compensation Claim

Employees should always assume they’re being monitored after filing a claim. They must sit tight and follow the healthcare providers' or doctor’s orders while recuperating. If an employee is directed not to walk, they shouldn’t do so, even for a short distance.

Employees Must Seek Legal Advice for Workers' Compensation Claims

This legal process is complex and sometimes discouraging, especially if an employee is dealing with uncooperative employers (Learn why employers fight workers comp claims). The best way to handle every aspect of a workers' comp case is to hire reputable lawyers from Larrimer & Larrimer Law Firm. They help employees understand all aspects of worker’s comp investigations through a free consultation.

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