When you file a workers’ compensation claim, that claim is sent to a claims administrator for evaluation. That claims administrator will evaluate your claim based on the provided evidence and either approve or deny it. However, in some circumstances, this claims administrator may question the credibility of a claim if they suspect fraud. If the claims administrator suspects fraud, they may authorize a workers’ compensation investigation of your claim.
What Does a Workers’ Compensation Investigation Look For?
When a claims adjuster authorizes an investigation, your employer’s workers’ compensation insurance will likely hire a private investigator to investigate your case. That private investigator will then gather evidence to determine if you knowingly filed a fraudulent workers’ compensation claim. Private investigators have different methods for gathering evidence. These methods are as follows.
Private investigators will conduct online surveillance to find out anything about your personal life which may contradict a workers’ compensation claim. These online factors of your personal life include check-ins, photos, status posts on social media, videos, and more. Private investigators will use your online presence using social media and other aspects of the internet to determine whether your claim is credible. Private investigators use Facebook, Instagram, Twitter, or other social media applications where users frequently post their activities and current situations to investigate claims. If social media evidence contradicts the injuries and effects of a reported workers’ compensation claim, that evidence may be documented and used to prove fraud.
Private investigators in workers’ compensation cases are often found to film video evidence to prove that a claimant is submitting a fraudulent claim. This type of surveillance includes private investigators following individuals and videotaping them while hidden in their cars. Video evidence is then used to verify if the claimant is submitting fraudulent information to collect money from a workers’ compensation claim. It is common for workers’ compensation investigators to follow you and document your movements and daily activities to verify a fraudulent claim.
Interviews or Personal Accounts
Private investigators sometimes gather evidence from personal accounts. Investigators conduct these interviews to obtain information that may be used as evidence against their claims. A private investigator will sometimes confront the person they’re investigating and ask them questions. It is not uncommon for a private workers’ compensation investigator to knock at a suspect’s door and question them or ask for a voluntary interview. Knowing that you’re not legally required to answer these questions is essential. However, it seems that you won’t be able to engage in an interview.
Interviews With Relatives, Friends, or Co-workers
The people around you are also excellent sources of information about your injury. Private investigators will often gather information from friends, family, and co-workers before speaking with you directly. This investigation technique is used to obtain information that may contradict statements given by you before or at a later date. So, expect workers’ comp investigators also to ask them questions.
Suppose you’re the victim of a work-related injury, have had your claim wrongfully denied, and are struggling to obtain the necessary treatment for your injuries. In that case, our expert workers’ compensation attorneys at Stockton Workers’ Compensation Attorneys P.C. want to help you get your life back on track and obtain the legal benefits you deserve. Our workers’ compensation experts have represented thousands of injured workers across California and helped them obtain the necessary workers’ compensation benefits to recover from their injuries. To speak with an attorney member on our team, and seize your FREE no-obligation consultation, call us at (209) 323-5126.