Workers Compensation Claim Investigation

Eagle Investigative Services, Inc. generally approaches workers' compensation investigations with a dual-investigative approach. First we determine the validity of the claim itself. This is a low-cost, exploratory investigation, designed to determine whether or not there is actual basis for a compensation claim. A range of criteria is included ranging from alcohol/substance abuse to refusal to obey workplace regulations. A thorough examination of the case file is conducted. This phase will not generally involve surveillance of the subject.

The second phase proceeds to confirm the legitimacy or fraudulence of a claim. It centers on surveillance of the claimant and includes, but is not limited to :

Claimant Interviews

Eagle Investigative Services, Inc. can obtain both written and recorded statements from claimants at their home, office or hospital. These statements can include all of the requested information on the claimant's daily activities, hobbies and ability to perform day-to-day functions. In addition, neighbors are contacted to obtain independent confirmation of the information provided by the claimant. This process can uncover inconsistencies in the claimant's statements and their actual activities.

Video Surveillance of Claimants

Experience teaches us that claimants will often exaggerate their disabilities. This type of falsification results in dishonest claimants collecting more money than they deserve. Whether you're self-insured or not, bodily injury claims can severely impact your bottom line. This can be in the form of the direct payment of exorbitant claims or experiencing skyrocketing insurance premiums. One way to verify whether or not a claimant is as disabled as alleged is through the use of video surveillance
This is a legal, cost-effective tool which can help the employer or claims handler improve the bottom line. The strategy involves covertly observing and videotaping a claimant and then comparing the claimant's activity on the resulting tape to their allegations of disability. The following is a guide to controlling video surveillance operations. It includes selecting candidates for surveillance, controlling costs, conducting surveillance legally, and using videotapes as evidence. This guide is for all levels of claims handlers as well as attorneys and risk managers.

Identifying a Malingerer

Claims handlers are often kept in the dark as to the extent of a claimant's disability. In some cases, surveillance may provide evidence that a claimant is malingering, while other times it may help confirm the disability. When considering the use of surveillance, refer to the following indicators to identify the likely candidates.

Red Flags

Claimant is never home to answer the phone or is "sleeping and cannot be disturbed."	Claimant has a history of malingering.
Leads from co-workers suggest that your subject is active in sports or other activities.	Injury coincides with layoffs or a plant closing.
No organic basis for disability. All indications are that the subject has made a full recovery.	Rehab reports indicate a healthy-looking claimant.
Claimant has a history of self-employment and/or is a tradesman (carpenter, electrician, etc.) who might readily work for cash while feigning disability.	Claimant receives mail at a post office box and will not divulge the actual address of his/her residence.
Excessive demands for compensation.	Claimant has moved out of state or country.
Disability beyond that normally associated with claimed injury.	"Dueling Doctors." One says the claimant is disabled, the other says no.

For more information about how our service can investigate your Worker's Compensation claimants, click on the Request For Information and provide us with as much information as you have about your subjects.