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Workers Comp Fraud Case Study


A Client contacted ICS saying they would like to determine what their prior employee is doing during the day and if he is working under the table at another place of business. This employee is receiving Worker’s Compensation and claims to have “extreme” pain to his right shoulder that makes it impossible to work and hasn’t returned to work for three years.


Summary:


A Client contacted ICS saying they would like to determine what their prior employee is doing during the day and if he is working under the table at another place of business. This employee is receiving worker’s compensation and claims to have “extreme” pain to his right shoulder that makes it impossible to work and hasn’t returned to work for three years.

ICS decided to do an initial background search and conduct surveillance of the Subject over a 4 day period.

Conclusion:


Throughout the surveillance, the Subject was observed several times a day getting in and out of his truck and driving around town. The Subject could also be seen opening and closing the driver side door of his lifted truck and grabbing the grip handle at the top of the door with his right hand to lift himself into the truck with no apparent pain. Each time the subject got in the truck he was observed grabbing the seatbelt with his right hand and pulling it across his lap to buckle it. While using his right arm he never showed any signs that he was in pain or hurting.

On day 3 of the surveillance, the investigator followed the subject to a grocery store. When he exited the store, Subject was carrying two bags of groceries with his left hand and a 24 pack of beer in his right hand. He was walking normal and moving his hands and arms without difficulty or any signs of pain. The investigator took pictures of the Subject holding the groceries and beer.

On day 4, the Subject was seen getting into his truck with no difficulty and the investigator followed him to another shop. He pulled up to the drop off/delivery area and met another man. The Subject was then observed lifting a washing machine with both hands with some help from the other man.  Together they lifted it onto the tailgate of the truck. The Subject then jumped up into the bed and pulled the washer with both hands off the tailgate and into the bed of the truck. The subject was observed bending, lifting, using his arms, shoulders, back and legs and never showed any signs that he was in any pain or hurting from lifting the heavy washing machine. Throughout this activity the investigator was able to get several unobstructed photos of the Subject while lifting the washer.

Throughout the 4 day surveillance, the Subject was never observed as being in pain or had any signs that he was affected by the use of his shoulders, arms, or other parts of his body while lifting or carrying heavy objects with either hand.

The report and pictures of the Subject carrying beer and lifting the washer were given to the Client. The Client was grateful that the company had positive proof that the Subject’s shoulder no longer seemed to be injured and the company could ask him to come back to work and terminate his Worker’s compensation.

What to Do Next:


Do you have an employee on worker’s comp and have suspicions that he or she is well enough to return to work? Do you also want to see if maybe this person is working elsewhere while still collecting worker’s comp from your company? If so, call ICS at (800) 828-9198 or contact us online to begin your worker’s compensation fraud investigation today.

See the following case types for more information:

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