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Another Successful Workers’ Compensation Fraud Story

Workers’ Compensation Fraud

Workers’ Compensation is a slippery slope. There are those claimants that were injured, those that are not injured, and those that are retaliatory. Hiring a licensed private investigator can assist in figuring out if your new claim is real or false. With California being a no-fault state and workers’ compensation claims at an all time high, it’s vital to your company to investigate these claims.

One morning, one of our usual clients called us and informed us of a new case assignment. Our client was representing an employer who had a workers’ compensation claim against them. Prior to the claim being filed, they were having issues with an employee, Kevin. After these issues started, Kevin claimed to have had an incident while on the clock which caused major injury. He claimed he could no longer work, he couldn’t stand for extended periods of time, he couldn’t lift more than a few pounds, and he couldn’t perform ANY physical activity. On top of that, he began to claim his employer of racial discrimination, but only after the employer’s pushback to the claim.

We got started as soon as possible and rushed to Kevin’s work place. It was vital to the investigation to obtain statements from any coworkers that were there at the time of the incident. We held interviews with all those that were there at the time of the incident and we determined there were no witnesses. After our interviews, we knew the next step was surveillance.

Surveillance

We had limited information on Kevin. The employer knew basic information but we had to locate him through our own investigative methods. Once we located him and his vehicle we began our surveillance. On the first day of surveillance, we picked Kevin up at a medical appointment. After the appointment, as we suspected, it was clear Kevin was not injured. He ran

Kevin redoing the landscape

across traffic, dodging cars as he returned to his vehicle. He spent the rest of the day running errands and hanging out in the streets with his friends. We knew we needed to continue surveillance to gather more evidence.

One early morning, with the dew still on the leaves, we continued our surveillance. We got lucky that morning as we spotted Kevin getting into an unknown vehicle. After stopping at a home improvement store, Kevin and a family member arrived at a residence in Long Beach. Kevin removed gardening equipment from the vehicle and carried them to a residence that looked to be going through renovations. We were tingling with excitement as we knew we were about to get the money shot. We squeezed in as tight as we could, surreptitiously sitting across the street. We turned on our video camera and let it do the work.

A few minutes later, we obtained video footage of Kevin jumping on a shovel in an attempt the break the soil. The video evidence showed him using his body weight to break through the soil and bending over countless times to remove unwanted weeds. He carried large trash bags filled with weeds, grass, plants, and dirt. At one point, the green trash bin was so full, Kevin jumped into it and began to use his body weight to compress the trash. After four hours of yard work, Kevin finished his day and returned home.

Kevin on his knees plucking weeds

With the statements from Kevin’s coworkers and the video evidence we obtained, there was no doubt in our minds that this was a fraudulent claim. We turned over all the evidence to our client and we were confident they were armed with the evidence they needed.

As a result of our investigation, the employer was able to bring the workers compensation claim to a screeching halt. Kevin was required to return to work and shortly after his return, he resigned. All connections between the employer and employee were squashed and the employer was able to save tens of thousands of dollars.

Hire an experienced licensed private investigator for your workers’ compensation claims today. Check out our five step guidelines on “how to defend and investigate your work comp claim.” If you’re still not sure if a private investigator is what you need, look into our “ultimate guide to hiring a private investigator.”

More Workers’ Compensation Fraud Stories

Workers’ Compensation fraud can extend past the employee. For other stories, look into a large workers’ compensation fraud story from the FBI and a husband and wife duo who committed workers’ compensation fraud.

 

Author Ken Childs Paramount Investigative Services Inc

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