When you file a workers’ comp claim, it’s but natural for the insurance company to want to know if you’re telling the truth. If your case is airtight and they have no reason to question your claim, then the insurance company will have no choice but to pay your benefits.
But sometimes, the insurance company sees something that makes them doubt your claim. Or they just want to avoid paying you so they’ll make sure that your claim is denied. In either case, they will most likely hire a workers comp investigator to follow you.
Workers comp investigators are, in essence, insurance investigators. It’s just that they specialize in workers’ comp claims. They are hired by the insurance company to check if the claimant is really injured. But since they are employed by these companies, most of the time, their primary aim is to gather evidence to disprove your claim.
But not all workers comp claims require the services of a workers comp investigator. Hiring them can be costly for the insurance company. So they’re usually just deployed if
- the claim involves a large sum
- the employee has filed workers comp claims before
- the employee’s injury claim is doubtful
- the claim is taken to court
Why Workers Comp Claims Are Investigated
It’s no secret that workers’ compensation is often abused by people who want to take advantage of the system. This, in turn, takes away benefits from those who rightfully deserve it. So you can’t blame the insurance company nor the state if they just can’t take your word for it.
If the insurance company finds out that you’re lying in your claim, you can be charged with workers’ comp fraud. The punishment for which differs from state to state. But in general, it includes jail time, penalties, and restitution to the employer or insurance company.
Tactics Often Used By Workers Comp Investigators
A workers comp investigator uses pretty much every trick in the book to do their job. But some of their most common methods are:
Interviewing Your Neighbors and Family Members
If there are people who may know anything about your injury and health condition, it’s your neighbors and family members. So they’re usually a workers’ comp investigator’s primary source of information.
So if you’re curious whether a workers comp investigator is after you, ask your family and neighbors if someone’s been asking about you recently.
Social Media Monitoring
In this digital age, if you want to know anything about anyone, you’ll just have to search them on social media. Just a few clicks and your workers’ comp investigator will know where you went on holiday, what you did yesterday, or who you’ve been with. It’s basically a goldmine of information that can be used against you.
Unfortunately, there is no way to know if you are being investigated on social media.
Video Surveillance
Aside from checking your social media and talking to your friends and family, they may also use video surveillance to spy on you. Unfortunately, there isn’t yet any law that protects your right to privacy against public surveillance cameras. So yes, they can legally use CCTV footage or even film you while in public places.
Just like social media monitoring, it’s difficult to determine if someone is secretly filming you while in public. Plus, you really have no control over who gets to have a copy of the CCTV footages especially if its from a private establishment.
Direct Interview
Sometimes, the workers’ comp investigator will also call you directly and ask for information. They may ask you about how you’re feeling or if you’ve been to the doctor recently. If they call your home phone and you’re not at home, they may still attempt to get information from whoever will answer the phone.
What to Do If You Are Being Investigated
If you’ve determined that a workers comp investigator is on your tail, here are some things you can do:
Don’t Give Out Information
When a workers’ comp investigator calls you and asks for information, remember that you are not legally obliged to answer them. But don’t flat out refuse to give any information. They may think that you’re being intentionally uncooperative because you’re hiding something. And raising more suspicion is the last thing you want to do.
Instead, tell them that you need to talk to your lawyer first. It will convey the message that you don’t want to give out any information without appearing uncooperative.
Talk to Your Lawyer
Fighting for your workers’ comp benefits and knowing that you’re under surveillance can be nerve-wracking. Even if you’re not hiding anything, it can still cause anxiety and sleepless nights. An experienced workers compensation lawyer can help you navigate this uncertain and complicated path. They know the law and the ins and outs of the system. So you’ll have the best chance at proving that you really deserve workers’ comp benefits.
Be Careful With Social Media Interactions
As mentioned, it’s hard to determine if a workers’ comp investigator is spying on you in social media. So the best way to thwart them is by being careful with any information you give out on any platform – even in private messages.
Follow Doctor’s Restrictions
If you’re already receiving workers’ compensation, then you probably know that going against the doctor’s orders may cost you those benefits. Once the investigator gets wind of you not following doctor restrictions, they can use it as a basis to dispute your claim.
VICTOR MALCA – Florida Workers Compensation & Social Security Disability Attorney
Victor Malca P.A. has over 27 years of litigation experience in Workers Compensation and Social Security Disability lawsuits. His experience and continued success when fighting for his clients puts him among the most trusted workers’ compensation attorney’s in Florida. He specializes in representing injured workers on compensation benefit cases and disabled individuals claiming lost social security disability benefits.
Book a free consultation today. Our unwavering advocacy for employee rights and privileges are recognized by our past clients across South Florida.
About The Author
Judy Ponio is a writer and editor for the Victor Malca Law P.A. website and blog. She enjoys helping people in need with questions about social security disability and workers compensation law. She has a passion for helping those in need and the elderly with accurate legal information that can make a positive difference in their lives.