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Workers Compensation Investigations and What They Look For

When you file a workers’ compensation claim, your employer will likely order an investigation into it. The main purpose of conducting this surveillance is to determine whether your injuries may have been incurred away from work. Arizona Workers’ Compensation Attorneys can help you determine whether your employer’s investigation is an attempt to deny a valid claim.

If you are not careful, your employer might use evidence gathered during investigation to undermine your case. A photo or video of you away from work could be used to argue that you are employed elsewhere despite your reported injuries.

Below, we look at what workers’ compensation investigators look for:

Purpose of Conducting Compensation Investigation

Sometimes, employees exaggerate their injuries or self-inflict harm to obtain benefits. This explains why most employers employ private investigators once you file a claim. Workers’ compensation investigators collect evidence and information surrounding your injury so they can either validate or deny your claim.

We advise our clients to allow us to handle all correspondence with private investigators to avoid saying or doing something that may hurt their case. Typical information that an investigator will search for include:

Detailed Description of the Accident

An investigator will likely begin by asking about the accident through which you suffered your injury. Although this may sound like an innocent question, they are usually looking for any hesitation, omission, or variance in your story.

As workers’ compensation attorneys, we understand that the period following an injury can be uncomfortable. You may be in pain or traumatized, and it is normal to make mistakes. This fact should not be as a basis to deny your case.

Presence of Witnesses

Witness statements can drastically change the outcome of a workers’ compensation claim. Your employer’s investigator will be looking to determine a personal connection between you and a witness that may cause bias. They may also look for inconsistencies in witnesses’ recounts of the accident and conditions surrounding it.

Your Job Duties

What were you doing when you got injured? Is it part of your job description? Are you qualified to do it? These are some of the questions you may be asked to determine the validity of your claim. An employer will argue that your case should be thrown out if you were injured while doing a job outside your scope of employment.

Description of the Location of the Accident

Investigators will want to know the physical condition of where you got your accident. If you slipped, they might ask whether the site was wet, muddy, or cluttered. The aim is to dispute whether your accident took place at work and whether it was due to negligence. 

Proof of Your negligence 

Companies have a set of procedures put in place to prevent accidents. If you work with harmful gases, for example, you may be required to wear protective masks at all times. An investigator will check whether you were following such safety procedures at the time of your accident.

Nature of Your Injury

The investigator will likely contact your health care provider to ask about the scope and nature of your injury. This is why we recommend that all our clients keep detailed medical records of their prognosis, diagnosis, and treatment plan.

Final Thoughts

Although investigations and surveillance can be scary, you should not actively shirk them as you may seem guilty. Limit your meetings with your employer’s investigator and bring your lawyer to every session you attend. Answer questions with facts, not opinions, and consult with your attorney if you don’t understand a question.

Contact Snow, Carpio, and Weekley today with your workers’ compensation claim and let us guide you through the process of getting remuneration for your misery.