Suppose you have seriously injured your hand in a workplace accident. Unable to lift more than five pounds with your injured hand, you file for workers' compensation benefits. After several weeks of collecting benefits while you are out-of-work, you keep yourself busy with chores at your home. A few days later, you receive notice that your benefits are ceasing - and that you could even face claims of fraud.
The notice includes a photograph of you carrying heavy tools in your healthy hand and a mixing bucket in your injured hand. You feel angry because the photo presents a misleading depiction of your activity - the lightweight bucket you were carrying was empty. You also feel violated because you were unknowingly under surveillance.
Surveillance Rights in New York
While you still have every right to challenge the withdrawal of your benefits, this hypothetical example could have been easily avoided. Even when workers' comp claimants have done no wrong, they should be mindful that their actions may be taken out of context to give the appearance of workers' compensation fraud.
When a workers' comp claim is filed an employer, claims adjuster or third-party adjuster may decide keep surveillance on the claimant. Surveillance is both legal and common in benefit claims.
To help prevent a claims dispute resulting from surveillance, keep in mind the following common-sense precautions:
- Always act consistent with your claim - never perform any functions that are inconsistent with your claim. Some people deal with pain quite well and may pick up their grandchild or a bag of groceries, even if they could not do so on a regular basis. Don't ever perform any physical task that is inconsistent with your application.
- Never exaggerate your condition - when filing for benefits, be honest. Don't exaggerate your injury, as it could result in a complete denial of benefits and fraudulent charges against you - even if you are legitimately injured.
- Be mindful of internet use - investigators will also use the internet to monitor your physical activity. Don't post anything online that could mislead adjusters into believing you are doing physical activities that are inconsistent with your claim.
Above all else, use your common sense and assume that you are always under surveillance while receiving workers' compensation benefits. Investigators who monitor you will often do so for several days or even a week, hoping that at some moment you will act in a manner conflicting with your claim.