Surveillance in Workers’ Compensation Cases
Although the majority of workers’ compensation claims arise as a result of a serious workplace injury, there are some instances in which fraudulent claims are made in order to unjustly receive benefits. Workers’ compensation carriers argue that it is their duty to ensure all claims are valid and that any fraudulent activity is shut down. This due diligence detects fraud committed by not only employees but also employers, vendors, doctors and more. In order to keep the workers’ compensation system effective and legitimate, these carriers believe it is important to guarantee that everyone receiving benefits from the system rightfully deserves them. One way workers’ compensation insurers detect fraud is through surveillance of injured workers. Through surveillance, insurers can uncover that an injured worker’s “injury” is not inhibiting other activities of their life, thus making their claim for workers’ compensation suspicious. This monitoring of injured workers maintains the integrity of the workers’ compensation system and can deter fraudulent behavior from happening in the first place.
On the other hand, attorneys who represent these injured workers see detrimental effects from this surveillance. They feel as though the imposition of surveillance paired with the restrictions limiting the doctors an injured worker can see for treatment are used to intimidate injured workers into dropping their claims. Although insurers claim they are using surveillance to keep the workers’ compensation system in check, attorneys disagree, claiming that they are using surveillance to try to escape the responsibility of paying out workers’ compensation benefits to a deserving injured worker.
Fraud in the System
The source of this disagreement stems from another equally controversial debate, the prevalence of fraudulent claims in the system. Some claim that nearly 10% of workers’ compensation claims are fraudulent. If this is the case, the need to enforce more stringent measures to monitor claims seems extremely pertinent. In contrast, others say that an estimate of 10% is unrealistic. Les Boden, a professor of environmental health at Boston University’s School of Public Health, commented that “anybody who’s tried to look at worker fraud in a serious and even-handed way would say at most 1 to 2 percent and probably way less than that.”
No scientific research has been conducted about the frequency of fraudulent claims in the workers’ compensation system. Government studies have determined that the fraud rate in unemployment insurance is around 2%, and many researchers suspect that the rate in workers’ compensation is similar. There are studies, however, that measure fraud in the workers compensation system conducted by employers, not employees. Many people assume that injured employees are most likely to commit fraudulent activity, but in fact, employer fraud also presents a serious risk to the system.
Negative Impact of Surveillance
Regardless of the fraud rates in the system, surveillance can worsen the suffering of an injured worker. By violating a worker’s privacy, workers’ compensation carriers threaten to hinder the worker’s recovery process while also potentially creating lasting damage. Surveillance is an invasion of privacy and can lead to diminished mental health and a damaged reputation. Fraud should not be taken lightly as it impacts the overall validity of the workers’ compensation system, however, the negative implications of the use of surveillance to detect fraud should not be overlooked either.
If you have been injured on-the-job and are dealing with a violation of your privacy or would simply like more information about your rights, call Poirier Law Firm today. Our main priority is always the health, safety and well-being of our clients!