How private investigators handle Workers Compensation fraud

How private investigators handle Workers Compensation fraud

How private investigators handle Workers Compensation fraud

What is workers compensation?

It isn’t uncommon in the workplace for employees to suffer an injury or illness that may affect their performance even to the point where the employee may need to leave work for a time. When an accident occurs or an employee develops an illness in the workplace, workers compensation insurance is a provided option that protects companies and their employees during this time of hardship. This protection helps the employee with lost wages and medical costs during their time out of work.

However, in some cases, an employee may be knowingly lying or exaggerating the story in their claim, in an effort to receive unearned money. These false claims have cost business owners billions of dollars each year. Lying in these claims is considered fraud, which is a criminal offense and if proven guilty, can result in some jail time.

Hiring A Private Investigator for your workers compensation fraud case

It is the company’s job to look into the claimant and see if there’s an occurrence of workers compensation fraud. This can be a very tough job, as they would need to collect the proper evidence, within the law, in order to determine if the claims are true. There also may be a ton of legal implications, so they leave it up to a professional to do their investigation. That is why corporate companies usually hire a private investigator when they believe one of their employees is committing fraud by gaming the system and lying in order to obtain workers compensation or receive a larger payout.

Typically, a private investigator will start their investigation by questioning the claims representative, lawyers and the employer about the subject. They will then proceed their investigation by conducting surveillance and running background checks on the employee in question. During a workers compensation fraud investigation case, private investigators use a wide range of resources, tactics and skills to obtain the information needed to complete their investigation. 


It is not illegal or uncommon for a company to hire a private investigator to determine whether the targets claims of being injured are true. They are permitted by law to conduct surveillance on the claimant, as long as their surveillance is within what is admissible. Any evidence obtained illegally by the PI cannot be used against the claimant in court and will be overthrown if used in the case.

A private investigator has limitations to what they can do, such as entering the targets home or property without consent or warrant, hack their computer and email, put a tracking device on their car or a hidden camera in their home, etc. However, they may follow the target anywhere they go, take photographs and video of them from outside while in their home, (which is allowed only in some states) and even question their neighbors or anyone who may have a connection to the target.

Background check

When conducting their investigation, a PI may look to see if the employee has a criminal background that was never addressed with the employer or if the target was truly injured. One of the main things they will look for is if the target has been incarcerated and been in any trouble for committing fraud. This is important, because it attests to the character of the claimant.

They will also look for a history of claiming workers compensation with other employers. This may be sufficient evidence to the PI that the target has been abusing the system and trying to gain money illegally.

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