- January 26, 2023
A private investigator might be involved in a workers comp dispute. Believe it or not, even if your workers’ compensation claim is approved, that doesn’t mean you’re in the clear. Depending on the situation, your employer or their insurance carrier may continue to investigate your claim long after you file it.
Our Atlanta workers’ compensation lawyers have represented clients whose claim was approved only to be denied a month later. If your employer doubts that your claim is legitimate, they may approve it initially to buy them time for a thorough investigation with a private investigator. If you have a feeling this is the case with your claim, give us a call. You should talk to a worker’s comp attorney in Georgia right away.
The Insurance Company May Think You Filed a Fraudulent Claim
If the insurance adjuster has a feeling that your claim is suspicious, they may conduct an intensive investigation. Of course, they aren’t going to waste their time and money on this kind of investigation if your claim is small.
For example, if you are only expected to be out of work for three or four weeks with a broken wrist, it wouldn’t make sense for the insurance company to single your claim out. However, if your injuries were more serious and you’re demanding long-term benefits under workers comp, it may be worth a second look with a private investigator.
Some of the things the insurance adjuster may be suspicious of include the following:
- Your injuries were probably caused by something other than your workplace accident.
- There is a good chance you hurt yourself on personal time but are trying to blame it on your job.
- You have a history of filing workers’ compensation claims.
- You have only worked for the company for a few weeks or months.
- You seem to be exaggerating your injuries and coming up with countless reasons why you can’t return to work.
In some of the cases our Atlanta workers’ compensation lawyers handle, the insurance adjuster claims several of these things. They may argue that they think you were hurt in a car accident days prior to your alleged workplace accident. They believe that you are fraudulently blaming your job for your injuries and that you have done this before.
Your Employer May Believe You’re Exaggerating Your Injuries
One of the basic rules of law is that you take your victims as you find them. An example is when one child yanks their classmate’s chair out from under them. The classmate falls and hits their head. Rather than end up with a simple bump on the head, the classmate dies from a skull fracture and bleeding on the brain.
The parents of the child who yanked the chair out from the classmate insist that there is no way a simple prank like that killed the child. They argue that the kid must have had some other condition that caused their death – not a simple fall from an elementary classroom desk chair.
In this scenario, the law would say that the prankster was liable for the death of their classmate. This is because, when a person decides to play a prank or behave negligently or recklessly, they have to assume that the victim is a fragile being.
Like the kid in the above hypothetical, it doesn’t matter that the victim has some sensitivity that the average person doesn’t have. It doesn’t matter that the defendant could not have foreseen that the child would have died because of their prank.
The law holds that you take your victim as you find them – eggshell skull and all. The insurance adjuster may think that you’re behaving like the child whose chair was yanked out from under them.
They may think you’re exaggerating your injuries and milking the system for every penny. If this is the case, they may look to see if your injuries aren’t as bad as you claim they are.
What Kinds of Things Are the Private Investigator Hoping to Find?
When your employer decides to do a follow-up investigation of your claim, there are certain things they are looking for. Most insurance companies have their own in-house private investigator who can do this. They will look to see if anything is out of the ordinary in your case. Some of the things they’re looking for include the following:
- You claim your back is injured to the point where you cannot work but you are seen going to play basketball three times a week.
- You have argued that you’re suffering from anxiety and depression as a result of your workplace accident. However, in your Facebook posts, you are smiling and having a great time.
- You claimed that you were injured in a fall, but video footage shows you intentionally positioning yourself on the ground before telling your manager that you fell.
This sort of behavior is what sparks a termination of your workers’ compensation benefits.
Make Sure You’re Upfront and Honest with Your Workers Comp Attorney in Georgia
Some people assume that, just because their workers’ compensation claim was approved, the insurance company is done with their case. The truth is that, for larger claims, employers and their insurance carriers will continue to investigate well past their initial approval. If they have a feeling that the employee is exaggerating their injuries to get more money, they may have a private investigator follow the employee.
They will look to see if the person engages in activities that they claimed they are not able to do as a result of their workplace accident. In fact, by the time our workers comp attorneys in Georgia are contacted by a potential client, it is because the legitimacy of their claim is being questioned.
As discussed here, if your claim was 100% legitimate, you shouldn’t have anything to worry about. It shouldn’t matter how long the insurance company’s investigator follows you. If you’ve been honest about your injuries and the limitations they have placed on your life, you should be fine.
This is why we always tell our clients to be completely honest with us. The last thing you want to happen is for your Atlanta workers’ compensation lawyer to be blindsided halfway through your case. If you have a feeling that your employer is suspicious of your claim, contact our office right away.
It may only be a matter of time before you learn that your claim is being put on hold. You are going to want to have an experienced workers comp attorney in Georgia there to help. Our attorneys are familiar with the insurance company’s tactics. They also have decades of combined experience handling cases like yours. Since your consultation is free, there’s no reason to wait.
