Unfortunately injured workers are often presumed guilty (of workcover fraud) until proven innocent, even though the actual fraudulent workcover claims are negligible (1% or less!). Workers comp insurers falsely claim that surveillance is a necessary tool to combat workcover fraud, but the harsh reality is that surveillance of injured workers is conducted to find any way to minimise the injured worker’s benefits.
Surveillance of injured workers is rife, and chief among the many benefits of assigning a private investigator and surveillance is the certain knowledge of where the injured worker will be on the day the surveillance is to be undertaken.
Workcover Surveillance often occurs on the day of your IME Examination
It is therefore well known that workcover insurers will commence surveillance of an injured worker on a known day, such as a known doctor’s appointment and a scheduled independent medical examination.
An extract of a real surveillance report reads the following:
“…The [subject] was claiming a serious knee injury. He had an independent medical examination scheduled for [date] so we (the private investigators) knew he would be active. The private investigator arrived early and was alerted to a slight movement at the door of the entrance to the [subject] home. Quite suddenly, the [subject] exited his home and dropped a file of papers down the steps. The private investigator obtained excellent film as [the subject] moved quickly and without apparent difficulty to retrieve the documents on the steps. His walking and bending skills, demonstrated on the steps, appeared less impaired. The subject then boarded a taxi and the investigator was easily able to beat the taxi to IME doctor’s office and was able to get footage of the [subject] adjusting his knee brace prior to his appointment. The private investigator then awaited the arrival of the [subject] to keep his appointment for the independent medical exam. Knowing the nature of the claim, it came as a small surprise to see him approach, hobbled and limping severely, requiring much time to cover a short distance….”
Surveillance footage is often obtained when the surveillance team or the private investigator knows where the injured worker will be present, such as an appointment with an independent medical assessor.
The surveillance footage before and after the independent medical examination combined with positive, unassailable identification of the injured worker, has led to “many successful claim resolutions”.
The strategy of putting injured workers under surveillance the day of their independent medical examination(s) is a common routine, so beware folks.