The Role Of Private Investigators In The Workers’ Compensation Claims Process

Oftentimes when an injured employee files for workers’ compensation, the employer’s insurance company will hire a private investigator to investigate the employee’s claims. This is typically done to confirm the extent of the employee’s injuries and to uncover any fraudulent claims. Ultimately, the goal in these investigations involves finding evidence to reduce the amount of compensation that the insurance company has to pay. This article will provide more information about the role of private investigators in the workers’ compensation claim process.

What is considered “off limits” for private investigators?

Private investigators have great leverage to obtain evidence regarding the claims made by injured employees. For example, they are able to take pictures of you or even record you in public spaces and can also speak to your friends and neighbors about your injuries. However, private investigators are not allowed to engage in any illegal activities. This means that they cannot engage in the following:

1. Trespassing onto your private property
2. Entering your home without your consent
3. Hacking into your email or mobile phone
4. Putting a tracking device on your vehicle
5. Impersonating law enforcement officers

What are some red flags that private investigators are looking for?

Private investigators look for particular red flags that might support the idea that your workers’ compensation claims are fraudulent. Some of these red flags include:

1. There are no witnesses to the accident, or the only witnesses to the accident are the employee’s close coworkers.
2. The statements made by the employee and witnesses offer conflicting information.
3. The report of the injury is not filed in a timely manner.
4. The employee cannot recall specific details about the accident.
5. The employee has a poor attendance record at work.
6. The employee has a history of disciplinary issues.
7. The accident occurs immediately before or after a vacation.
8. The employee is injured after receiving a disciplinary action, such as a demotion or termination.
9. The incident report and the medical evaluation offer conflicting information.
10. The employee refuses or delays treatment to diagnose the injury.
11. The employee is never home or won’t answer the door or phone.
12. The employee frequently misses physical therapy, occupational therapy, or other medical appointments.
13. The employee is going through a divorce or child custody battle.
14. The employee is having financial difficulties.
15. The employee’s lifestyle is incompatible with his reported income.
16. The employee changes physicians frequently.
17. The employee and other coworkers use the same attorney, doctor, chiropractor, or clinic.

Do You Have Additional Questions about the Workers’ Compensation Claim Process? Our Firm Can Help

If you need further information regarding the workers’ compensation claim process, The Musleh Law Firm is prepared to assist you. Our experienced Ocala workers’ compensation attorneys will make sure that you fully understand the process and will answer any questions you may have.