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WORKERS' COMPENSATION / DISABILITY INSURANCE CLAIMS

The majority of companies operating in Alberta ensure that employee safety is a top priority, as a safe work environment allows for a healthy and more productive workforce. Unfortunately, despite a company’s best efforts, injuries and illness are inevitable in the workplace. The majority of claims are legitimate and workers’ compensation benefits (“WCB”) or disability insurance coverage are in place to take care of the needs of the employee.

Regrettably, fraudulent exploitation of the “WCB” claim system and corporate Long Term Disability (LTD) coverage continue to escalate within the Province of Alberta and across the country. The ripple effect of these fraudulent work-related injury claims includes the loss of profits and workplace productivity and can often result in a higher cost of delivering goods and services to their consumers.  The immediate and direct results of fraudulent claims are the realization of higher “WCB” and insurance rates for an employer and the added cost of training new employees.  All these factors affect a company’s financial stability and profitability. 

Should a company find itself presented with a fraudulent workplace-injury claim or a Long-Term Disability claim and if such a claim goes unchecked, the morale of the existing employee base can suffer, the productivity of their workforce may decline or even worst yet, it could lead to others making the same type of claims. You must take the steps to protect your business.    

As an employer, there are a number of indicators, separately or in combination, that can signify the difference between a legitimate claim and a fraudulent claim. These may include:

  • Inconsistent story by the claimant – the claimant does not have a firm grasp of the details surrounding the injury or the claimant frequently alters the information pertaining to the incident.

  • A disgruntled or underperforming employee is more likely to put forth a fraudulent claim.

  • Financial difficulties. A claimant will utilize the paid benefits of the claim and seek additional employment to relieve their financial hardship – ie. “double dipping”.

  • When you attempt to contact the claimant at home while they are off work, they rarely answer the telephone or return your call using a cell phone rather than their home phone.

  • The claimant consistently misses physiotherapy sessions or doctor’s appointments. A legitimately injured worker will want to get back to work and make the therapy a priority in their life.

  • The claimant is performing activities in their personal life that are in direct contrast to their injuries. You often hear about these activities through other employees.

Our company has conducted “WCB” related investigations for over 15 years and we are familiar with “WCB” protocol as it relates to the submission of evidence on a claim. Our video photographic evidence and detailed reports are prepared in anticipation of litigation and are presented in a court acceptable manner.  Our results can be utilized by the client to resolve the claim internally or we can facilitate the transition of evidence to “WCB” for their investigative involvement.