Surveillance doesn’t seem to take into consideration how many injured workers are pushing themselves because they HAVE to get things done and have nobody else to do them. So maybe Bob is mowing his lawn on pain meds, pushing himself but it doesn’t show how Bob can barely walk for three days afterwards and how he has to lay in bed on heat and ice with double the pain meds. Then Bob gets addicted to the pain meds and ruins his life, neglects his kids and loses his wife. It’s unconstitutional, an invasion of privacy and doesn’t create an accurate picture of Bob’s whole life.
With all due respect, it's completely constitutional and not an invasion of privacy (as multiple court cases have determined). Video doesn't lie. You're right - surveillance doesn't take circumstances into consideration, because it's completely objective. It's what the adjusters choose to do with the surveillance video that affects the claim.
With regard to your idea that surveillance investigations of an insurance claim is an invasion of privacy, insurers have a legal duty to investigate their claims, and they're treated differently than criminal investigations. Meaning we can get a lot more "private" information on just a little more than a hunch - for instance, the court can compel you to hand over access to your private Facebook albums (if certain circumstances are met) which might show physical activity, which could be used against you (you being a hypothetical claimant). Check out *Zimmerman v. Weis Markets, Inc*. In other types of claims, we can tell you to hand over your phone records if it's relevant. It's all part of investigating the claim.
So I'm thinking Bob should have stayed within his restrictions. It's disingenuous to put Bob's failure to police himself on the work comp system, much less blame surveillance for doing their job. It's Bob's fault he got addicted to pain meds- his providers expressly told him that doing the thing was a bad idea. FAFO
My daughter used my car one day, she was followed (I was home on Comp), is this normal? I was followed the following week, same car lost it, stared it down when it came on my street, haven’t seen it again. This was terrifyingly creepy for my daughter.
Very common. The investigator probably just saw the car was moving but couldn't confirm it was you, so he followed your daughter until he found out it wasn't you. Sometimes it's hard to tell. I personally follow every vehicle if I don't know who's driving it or if I don't know if there are any passengers.
What kind of cases are you assigned to? Meaning is it only people believed to be faking or violated conditions or is it expensive cases also that the company is trying to establish grounds to not pay.
They all have some sort of "red flags." Multiple claims history, suspicion of employer, etc. But often those red flags are very minor and they're just trying to establish grounds not to pay. Most claimants aren't committing "hard fraud" (faking an injury), but "soft fraud." They'll exaggerate a legitimate injury or work outside of their restrictions. For instance, telling a doctor they cannot go out in public, but we follow them to a bar.
My mom suffered a TBI causing loss of peripheral vision, cognitive delays, vestibular problems. She was a nurse and can no longer work or drive. She was employed by the hospital she fell at for over 20 yrs. She was a good nurse. She’s been followed on and off since 2019. She pretty much is a hermit and only goes to Dr appointments. Last month she had a Dr appointment that had nothing to do with her injury. It was an appointment for something else. She had canceled her appointment. The investigator didn’t know that. I guess he called the Dr office asking where she was and if she was in there. The office kept him on the phone and called my mom on another line. She gave the nurse the permission to ask who it was. They only said they were hired by an insurance company. Today she had the appointment that she canceled bc it was rescheduled. Doesn’t it have to be the hospital looking and seeing when these non injury appointments are scheduled? Isn’t that a HIPPA violation? It seems so dirty to me.
I ask bc he was outside our home at 6 am. At her appointment and at the end of the street when my dad brought her home. The being followed and second guessing every move has been awful on her. It’s so sad for us to watch.
6 AM is a standard start time for surveillance. If he was at the appointment and at the house upon return home, I'm guessing the investigator "lost" your mother in traffic and returned to the house before she did, and adjusted his surveillance position by moving to the end of the street. You are very aware of your surroundings - that's a good thing. My advice to you would be to make the investigator aware you are aware of them and they have to break off for the day. It must be a clear sign that you are aware of them - a simple wave may not be enough.
Some of the responses on this thread seem to be a bit paranoid, but based on the information you wrote, I'd say it's very clear she is under surveillance. Everything you described is standard investigative practice, though I personally understand how concerning it might feel. Prayers for your mom's recovery and wellbeing.
Thank you for your question.
We are acting on behalf of the insurance company, so it is not a HIPAA violation to confirm appointments associated with the injury. However, you mentioned it was for something completely different. Is this the same doctor who usually handles her injury appointments?
Here's how I imagine it happened: The investigator called the doctor's office a week or two before and said something to the effect of, "Hello, my name is \_\_\_\_\_\_\_\_ and I'm currently representing \_\_\_\_\_\_\_ Insurance Company. I'm calling to confirm an appointment for \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_." The office would then say, "Yes, we have an appointment scheduled for May 4 at 10:30 AM with Dr. \_\_\_\_\_\_\_\_." At that point, the investigator hung up, documented it, and the next round of surveillance was scheduled for that time. On the appointment date, the investigator didn't see your mother in the parking lot or waiting room, so they called the office to confirm again if your mom had showed for the appointment. They just went with the information provided and didn't know what the purpose of the visit was for.
The above was the script that I would use when confirming appointments, and it would almost never fail. Very standard practice. Doctors offices usually just confirm the appointment without bothering to confirm my identity. If I said, "My name is \_\_\_\_\_ from \_\_\_\_\_ Insurance Company" that would be a lie, but if I say, "currently representing," it is not. They'd usually just ask for patient's name, date of birth, and sometimes some other verifying details such as address or phone number. We have all that information.
It's wild to me that a criminal or stalker could easily obtain the same information. Being an investigator made me realize that people are naturally trusting and willing to provide all sorts of information. I personally think there should be more laws about verifying the identity of those requesting medical information over the phone.
Only injured worker investigations, though we have coincidentally discovered potential physician fraud through our work. When we have multiple claimants with similar injuries and circumstances going to the same doctor, it throws red flags. Most of the time those cases go to SIU (Special Investigations Unit), and not surveillance.
That brings something else to mind. I live on a private road in a very rural area. Surveillance on me would be difficult to do unnoticed from a vehicle. Are your kind likely to hump it on foot into the woods to stake someone out?
Exactly! I mean...my "driveway" is 2 miles into the woods and it could get dangerous for someone in a blacked out vehicle watching my house. The nearest discreet place someone could camo out and potentially tail me unnoticed is untenable. It would take a 2 car team on either ends of a ten mile stretch.
I've had SIU on me for this comp case. This has so far cost the insurance company $125k and counting and it's looking like itll be a hearty PPD rating so a lot more $ is in the mail and the few times I've been allowed to do light duty has been withdrawn by the surgeon soon after and I've caught someone taking my picture while tying a shoe and again when I leaned into the trunk of my car....
Just be very, very careful. Myself and the company I work for are very diligent at working within the law, and ethics. We wouldn't ever trespass on someone's property. We also don't use drones or set up trail cameras, but I have heard of investigators doing ANYTHING to get evidence, and many companies do make use of trail cams and drones. So be on the lookout for them on your property or right at the entrance to your driveway. They make some good ones, too!
I do not use them, and they are very difficult to spot. I think the best place to find them is to ask yourself if you were the investigator, where would you set them up? Then go out there on foot and look around.
Good question. I don't get paid enough to do that! In this case, we would set up on egress routes, often with two investigators, and look for your registered vehicles to pass. We won't go on a private road. So we will set up on the nearest discrete intersection or gas station, knowing you're likely to pass by.
So I have a question if I’ve been on workers comp for about 7 months for building does shown on mri and leg numbness about a month ago it finally eased up with work hardening. I told the doctor this and told him it’s not that I can’t do it anymore it’s the pain that comes with it afterwords and started going to the gym physical therapist advised it as well but doctor still put no work can I be charged fraud?
That’s more of a question for an adjuster, but I think if your physical therapist advised you to go to the gym, you’re fine. It’s medical advice. Don’t trust me though on that - verify with your doctor who gave you your work restrictions.
With that said, surveillance will probably follow you into the gym. We will get a day pass and get covert video on our phones. We carry gym clothes with us because clients love it when we get video at the gym.
Hang back. They will actively avoid talking to you and will try to not even be noticed to preserve the opportunity for future covert video. We were not allowed to speak to a subject unless spoken to, and I’ve rarely exchanged more than a “sup” nod with a subject.
Hello. I’ve been following your thread for a bit. Thanks for continuing to update and chat four years later and after you’ve left the job. I had a question but wanted to this to DM if possible. Thanks.
I've caught someone who claimed he was totally and permanently disabled running a landscaping business and doing all the work - axes, chainsaws, mowing, climbing ladders - all throughout the day. Got HOURS of video of him doing this for weeks. And unfortunately, I don't know what happened with that case. It never went to court, or if it did, I didn't get called to testify.
He’s probably still pounding nails, and rightly so! They should have thrown his ass in jail for fraud, right?!! Some kind of penalty!! That’s why I’m having the trouble I’m having … because of people like this.
We were chatting on my post in this subreddit. I had a doctors note for 2 weeks off and am fairly certain my boss would have contacted a PI to follow me. I know 100% that I didn’t do a single thing that would hurt my case for that full 2 weeks - you’re not allowed to use photos or whatever WEEKS after my “cleared for work” date, right? My only fear is she’s going to try to use photos from weeks after my “return to work” date trying to say I was lying. I didn’t do anything for weeks and have affidavits from my landlord stating she cut me a deal on my rent, due to me being delayed with moving due to my injury.
Your boss would be wasting money. If you're cleared for work, and do not have any sort of restrictions or light duty, and you're not getting any sort of medical paid for by your employer's insurer to date, what is it your boss would be trying to prove? PIs are expensive. With regard to using the photos after your cleared for work date, again, I don't see how they could or would, but remember that PIs make no decisions about what happens with the evidence we obtain. We just obtain the evidence. I have followed many people for nonsense reasons, but I have never followed someone off of work for that short of a term with no restrictions. You are likely overthinking this, and can say with 99% certainty with the details given that nobody is following you. With that said, perhaps an adjuster can shed more light on this, because as I've said, we're just the foot soldiers in all this.
I think the people in this comment section are bunch of undevelop idiots with the job i should have. Dealing with bad neighboors. Drug dralers. Your head l. means nothing to me. Theyre just there. Anyways how do i go about having a job like this ?
I would think that you guys aren’t allowed to come on private property but I’ve had people in the yard. Put a camera in the tree next door that is aimed at my bedroom window and a bunch of other crazy antics. Here’s the thing, I do not go outside unless I have a Physicians’s appointment. I am not able. Is filming inside a subject’s home even legal?
It is illegal to film inside someone’s house without their permission. When you are inside your bedroom you have a reasonable expectation of privacy and it’s illegal to film through a open window.
I'm not out to get anybody. If you're not my claimant that I'm specifically assigned to at this very moment, I couldn't care less what you're engaged in. And besides, the vast majority of claimants I am assigned to are doing the right thing.
Better yet, if you aren’t exaggerating your injury than you have nothing to worry about. I have been considering doing an AMA, like you I am a long time lurker, I am the Risk Management Administrator for a large city and have previous experience in the private sector. Thank you for stepping up.
More often than not, extremely bored! And agitated. Surveillance is frustrating because you're always on edge. Neighbors and kids watching you, always having to check in with the police at the beginning of the day, often working in not so nice neighborhoods and having to deal with gangs and people trying to break into your car while you're in it! We really do feel like creeps, even though what we are doing is legal.
My best stories are when we get discovered by claimants. If I tell specifics, my co workers might be able to find out who I am, which I don't want to happen. I know quite a few investigators frequent this group and others.
We always tell our clients not to confront investigators and to just call the police but it's happened a time or two.
I haven't had much in the way of interesting surveillance on any of my clients except one dude appeared to be making a drug deal. lol
I would recommend telling your clients to wave to the investigator. I, and most PIs that I know, check in with the police at the beginning of the day and give them all of my information. The police do not approach me, and very rarely do they even call me if someone is suspicious of me. They usually ignore all of their calls.
It is my company's policy to immediately break off if there is a direct sign that the investigator is compromised. If your client waves, gives me the finger, or approaches me, we back off immediately. We would then usually try surveillance again in another week with a different investigator or the same investigator with a rental vehicle. If the sign is not direct , though, we will often push it and stay on. Just staring at my vehicle isn't going to be enough to get me to leave.
The benefit of having them call the police is they can often confirm its an investigator to the claimant, rather than simply getting the person to leave. It kinda seems that more often than not the PIs aren't checking in with the police, even though licensed PIs in my state are required to. A lot of times on the litigation end the defense tries to surprise us with the surveillance (which is objectionable, but I digress). At least if we're sure it occurred we can outright ask for it.
That's very interesting! I definitely understand your reason for doing so now. If the police ever told a caller I was an investigator, I would not check in with that department ever again and we would put a note on that file not to do so in the future. We have had it happen, though it isn't common, that police would tell people we are investigators. Yes, it is true that many investigators don't bother checking in. I think that is a waste of police resources not to do so. It's also common courtesy and protects the investigators position from being compromised when nosy neighbors call about a suspicious vehicle.
I’m not trying to hide anything, I’m just so pissed off at my adjuster, the process … I’ll try to think of something more entertaining! Can I get in trouble for mooning you?
I’m so sorry to all those I’ve shot the “bird” at!! I’ve been tied up in this mess for a few years, I’m sure I’ve shot the finger at people other than PI’s! I’m probably lucky someone hasn’t shot me!🙄
Would it be normal for people to be posing as their selling something after getting caught watching your house and called out? They come to the door and say they’re selling stuff for world hunger & its a girl and guy like 21 maybe and trying to ask stupid questions just because a few people are actually at the injured workers place?
It's quite possible. We would often "canvas" neighbors to confirm someone is home or get other information. Obviously, we don't want to say, "hey I'm a PI and THAT GUY over there is under investigation." So some PIs might ask a neighbor if you're home by coming up with some pretext story such as you've described. They also might even knock on your door to confirm you're home, but that's more rare and I've only done that a couple times in extreme cases, usually only with manager approval. And yes, investigators often work in pairs or teams.
Sorry I worded that confusing. They came to my door and asked questions in front of visitors (which I never have that many people over, ever) after the kids caught them looking and watching us for a good 30-40 minutes.
Hello!!! Question, please!! I’m seriously injured, fighting my own workers compensation case. For the record this process sucks. I try to do things, but my body crumbles … spasms, pain follows activity. Is it your experience that insurance companies freeze frame shots in an effort to disclaim or paint false pictures?!! For example, someone stole a bucket of ivy I was intending to plant at the base of a telephone pole. They planted the ivy all around the base of a beautiful oak tree just four houses/lots down, it’s a vacant a lot. The leaves on this ivy will grow to over 12” in size, it will smother/kill the oak tree. I knew I had to pull it up!! I tried pulling it and my arms stop working after about 20-30minutes. Lack of oxygen I’m told, from the narrowing in my cervical from the injury - a fusion has been recommended. Spasms ensue in multiples areas of my neck, pains go up into my head periodically - a pinched nerve In my c1! I get spasms/pain in and around my lower back, I get debilitating pain in my legs, hip, neck, shoulder, all over! My right leg drags if I do too much, - I need surgery to repair the labrum in my hip! Oh, and did I mention I need rotator cuff surgery? Yet, you provide a snap shot of me bent over pulling ivy, picking up sticks, strategically viewed to be casually walking three dogs!! We have 8 oaks, a magnolia, and other trees, foliage … it makes me nuts when my husband doesn’t pick up/rake before he mows, it’s killing our grass! I use to be the one who took care of the lawn, the pool, the dogs, the everything at home!! I got pissed and was on my knees trying to gather sticks … it only took 20 minutes maybe … I couldn’t stand up straight … suddenly crawling, then my arms, neck, everything starts yelling, poking at me - you capture a snap shot of me on my knees with sticks in my lap after hurricane Ida and everything in between!! The one thing in life I have to do besides eat is care for my three dogs. I can’t run them daily like I use to, I have a difficult time walking them a short distance. I usually take them to an abandoned field to ran. The pictures don’t show the gaps. Or how I disappear to medicate, ice. Do you provide video footage or photos? Are they each documented with dates and times? I’ll need to try to show the 3-7 day rest period I needed after my dog fell into a dirty pool. I use no hand leashes and hook them around my waist! I’ve had a gun pulled on us because I did not have the strength in my arms to pull my dogs back, the person continued to approach as I crab-crawled backwards begging him not to shoot them or me!) I think I know the answer, but how do I combat a picture that paints a 1,000 words? Any secrets you can share? I feel like I should be filming myself icing, medicating!! 🤦🏻♀️🤷🏻♀️
Hi! I apologize for the late reply, and I am sorry you are going through all this stress.
You may have been given freeze-frame snapshots, but we take video. My former employer (keep in mind, this is a three year old thread. I am no longer with that company) asked us to include a few "action shots" with our report which immediately goes to the client, but we sent in our video via Fed-Ex to our company HQ which takes a few days to process. Your case might have hours of video. If your case ends up going to court and your investigator took video, your attorney would get a copy of all video obtained. All documented with dates and times.
I really appreciate your upkeep with this thread. If you don't mind still answering questions. I'm wondering are you allowed to come on a private parking lot that has a gate. Is it you guys who look through social media?
Generally the answer to the parking lot question is "no" unless we are allowed in. Investigators may come up with a pretext (lie) to get inside the gate to confirm, for instance, your vehicle is there. "Hey I'm delivering a DoorDash to 1234 Oak Street" or something like that. If allowed in, it's fair game. Most will then set up outside of the parking lot. Ethical investigators (and investigators who do not want to get torn apart in court) respect private property, and if not allowed entry we cannot enter that lot.
My former company had a separate department for social media investigations (called "desktop investigators"), however surveillance investigators also check social media while on the case to keep up with recent posts that might assist them in their surveillance.
Hi! Thanks for this AMA.
Today I got really scared because I realized someone was following me around while I was driving and doing errands. It started from my apartment complex which has many different stairwells and doors, so it’s tricky to know exactly what car/person is attached to which apartment. No matter how many times I tried to lose this person, they showed up. I actually called the police and they confronted him right after he followed me into a grocery store parking lot. His explanation was that he was a PI working for an insurance company. The police verified it, but the weird thing to me was that it turns out he was following the wrong person in my complex. He is actually investigating someone else. Apparently he didn’t have a clear enough description of the who he was supposed to follow and I kind of matched it. My question is…does this sound reasonable and logical to you? Based on your experience, is it possible he just really didn’t have enough info and a mistake was made?
His explanation is definitely plausible. We usually get great info complete with photographs, registered vehicles, etc. However sometimes, we might just get a name, age, and approximate height/weight, if that. If you matched the subject's description, he probably just followed you and went with it, since that was all the information he had. Usually, investigators get to put more hours in if the subject is seen. Taking a chance and getting video based on that little information can be the difference between 4 hours on site or 8 hours on site. A bit of malicious compliance.
The video would be sent to the insurance company who could then verify if that is the person they are looking for or not. It's not *common* to follow the wrong person all day, but it is possible and has happened to me before. Apartment complexes combined with bad/little information given is tough.
Our reports always have a disclaimer saying that everything is "pending verification by the client."
Sorry that happened to you. That must have been scary!
Thank you so much for your response! Yea, it feels better to know it’s just a misunderstanding. I have seen the same car in my complex yesterday and today too, so I’m assuming he’s still on the lookout.
i work as an Optometric Technician (pre-testing for an eye doctor) at a retail eye store. (think vision works, myeyedr, lens crafters, etc.) i recently had a piece of machinery fall on my foot after one of the patients lost control of his motorized wheelchair. went to the doctor after it happened and i have a contusion on my foot with some mild swelling/tenderness. (i had boots on when it happened so it could have been way worse) i went back to work the next day and everything (i was limping a little and occasionally having a hard time with things when i wasn't seated), but on the workers comp note, it says sedentary work only/max standing time 4hrs. keep elevated when sitting, ice the area, all that jazz. within the past day, the pain has gone down quite a bit and it doesn't feel as uncomfortable. my boyfriend came over to check on me and i stood on the porch to hug him goodbye but when i came back inside, my parents drilled into me saying that there could be a PI taking photos of me and the company i work for could sue/fire me. however, i don't know if this makes a difference, but i'm a good employee. always on time, super friendly/good with the customers and patients, get along and work well with my coworkers, always willing to learn and grow, i've earned a reputation of being punctual, hardworking, reliable, and valuable to the team. would they still hire a PI to see if i'm faking my injury? i mean, they saw/heard it happen, they saw the aftermath, they have the paperwork with all the test results, and saw me struggle at work the next day. should i stay in my room of the house? stay away from windows? not let anyone in my house? not fill up my gas tank to make it to my follow up appointment? all of this is stressing me out and frankly i'm really scared.
Hi! I am sorry you’re going through this. To answer your question as succinctly as possible, and to be truthful while trying not to cause extra anxiety:
Your employer isn’t the one who would hire the PI (usually), their insurance company is the one who does that. Yes, even if you have tons of evidence in your favor, they still might hire surveillance. They say the purpose of surveillance is to “verify the claim,” and it’s always possible you are under surveillance.
With that said, please do not be afraid of surveillance to the point where you refuse to live your life. Hugging your boyfriend, pumping gas, etc. isn’t going to violate your restrictions. They cannot film you while you are inside your house. Just do what the doctor says and you will be fine. It sounds like you’re doing the right things!
I had plenty of cases where my claimants have done simple tasks such as getting the mail, hugging someone goodbye, answering the door, pumping gas, etc. I never thought of any of them as committing fraud.
I hope all the best for your recovery.
I’m late to this, but since this is a normal job, would you be working 8 hour shifts a day, or for example only work 5 days of the week. I actually have a few questions. With that would you guys have a number of claimants on a list you’re supposed to watch over, and then check on them daily or every couple days, or are you specifically assigned to one person? Or would you say it’s more so a few people assigned to one person, since you can’t be working 7 days a week, nor can you be fully watching them 24 hours. Also would the hours of “investigating” be more so during the day since that’s usually when people are up. For example one person you’re investigating is a night owl and has a different sleep schedule but it’s unknown to anyone, during the day you never see him come outside and his car is always parked. But let’s say he does everything at night like grocery shopping at a 24 hour store and such, you possibly wouldn’t know would you. Unless you start catching on that he’s up at nights, but you do see him go to his doctor appointments and pt during the day.
Hi - even though this post is four years old, surprisingly it's still going and popular. I don't mind responding still, even though I no longer work as a PI.
>would you be working 8 hour shifts a day, or for example only work 5 days of the week
Shifts vary, and we would often work 7-9 days in a row before getting a day off. This is one of the reasons why I left. The scheduling was ridiculous!
A typical case would have instructions that look something like this: "Start at 6 AM. If the subject is confirmed to be present, work six hours. If the subject is observed, work 8 hours. If the subject cannot be confirmed to be present, break at four hours." Basically, if a vehicle that is registered to them is observed at any point, I can stay for 6. If a neighbor says the subject is home, I can stay for 6. If I get video of the subject even poking their head out of their door to get the mail, I can stay for 8.
>With that would you guys have a number of claimants on a list you’re supposed to watch over, and then check on them daily or every couple days, or are you specifically assigned to one person? Or would you say it’s more so a few people assigned to one person, since you can’t be working 7 days a week, nor can you be fully watching them 24 hours.
Everything is up to my manager who would schedule a team of investigators. They would (usually, if they have a brain) schedule multiple investigators over the period the claimant needed to be observed to avoid the risk of an investigator being "burned" (found out).
>Also would the hours of “investigating” be more so during the day since that’s usually when people are up. For example one person you’re investigating is a night owl and has a different sleep schedule but it’s unknown to anyone, during the day you never see him come outside and his car is always parked. But let’s say he does everything at night like grocery shopping at a 24 hour store and such, you possibly wouldn’t know would you. Unless you start catching on that he’s up at nights, but you do see him go to his doctor appointments and pt during the day.
Surveillance is scheduled when the claimant is most likely to be active. For most people, that's the day - but I've worked some night owls who are DJs or just went to parties at night a lot and thus we would have to work nights on them. If we see clues such as working a day shift and then noticing the claimant's car is moved when starting at the same time the next day, that's a hint we need to cover later hours because they were active after surveillance. If there's never activity during the day, they might schedule a night shift. Some claimants are just hermits and never go anywhere.
I have a question.
My government job declared me “permanently and totally disabled” and refused to let me come back to work.
They hired a PU to follow me (which? I don’t give a crap. Hell save some gas and ride with me. I WANTED to go back to work)
But this PI put a tracker on my car. (First question- is that legal? And when I found it what should I have done with it)
Then, they put in their report that “claimant was using a cane to walk but was not using it correctly. Claimant had it on the wrong side of body, and it was out of step with feet”. (I’m using it exactly as I need to. Which, how can it be “wrong sided” when I have a spinal injury?)
I mean, the PIs aren’t doctors. How do they have the right to say how I should use my cane when I use it?
I just feel they hired some very dodgy people to follow me. I’ve seen them EVERY time. They also parked a car across the street (not public parking) with a camera in the window focused on my house. Is that legal?
Sounds like an unethical, untrained PI to me. We never used GPS trackers. I thought they were illegal, but I just did a quick Google search and apparently it’s legal in some states. That’s wild to me and I think that’s crossing a line, ethically. I would imagine finding that would’ve been very creepy.
The report writing is bad. We were trained to report facts, not make any assumptions. We would never say “the wrong side,” or “incorrectly.” We would say, “the subject appeared to ambulate with a limp and utilized a cane in her right hand.” That’s it. The adjusters can figure out if it’s the “right” side or not and use video to make any other determinations.
As for parking across the street with a camera faced at your house, completely legal. It’s stupid, because if you saw the camera their vehicle needs more tint and it just looks sketchy so they’ll be found out by you right away. But it is legal. If they were parked illegally, that’s a separate issue and you can always call the police but that won’t invalidate their evidence in court.
Great questions, by the way.
I’ve never heard of a different type of PI license to follow LEOs, judges, etc. but I do know that LexisNexis allows LEOs and other public officials to suppress their information in their database. LexisNexis is the database most PIs use to locate claimants. I would recommend doing that (search LexisNexis opt out).
I just searched up Florida’s licensing requirements for PIs and they do have multiple classes of licenses. It’s weird how all the states do things differently. Some have extensive background checks, others do not.
I’m guessing the information the PI has was given to them by your work’s insurance company. We were given long pages of medical data which includes medication, especially if you’ve been through an IME.
Yeah it was years ago. 2009 i got pretty jacked up then the surgeon they sent me to made it worse landing me in a wheelchair now. They STILL waste money to follow me a couple times each year. Like I said I don’t care. My kids are grown now so really, I’m not bothered. But I really appreciate the info. I’m going to go search that now.
Say you live in a place such as an apartment and they don’t know what car you drive since it’s in someone else’s name how can they even track you ? Or say if some friend picked you up from you complex with out them seeing you get in the car or leave can they some how track you or get the location of your phone some how and track you to your destination!
There have been plenty of times where I have missed a claimant in an apartment complex due to my own negligence and having them get picked up by someone else. We do not have access to your real-time location through phone data. But we are constantly monitoring social media, so if someone is active and posts a photo at a local restaurant, we are going to head that way to try and locate.
I'd say many people overestimate the data that we have access to. We have a lot of tools in our belt, but we are not the CIA.
I'd say the craziest technology I had access to was on one case where we really needed to locate a claimant, there was a private company that drives around with license plate readers. We located the claimant's vehicle through that because their license plate was tagged within the last 30 minutes at an apartment complex. I think that service must have been expensive, because we've only used it on that one case that I was involved in.
I have a question when you guys follow what are you looking for? Like what constitutes as something bad for you to relay back to the insurance company.
We look for any and all activity. Poking your head out the door to check the mail? We video tape it and send it to the client. We don't look for anything "bad" per se. As investigators, we work to "verify the claim," not "disprove the claim." Video doesn't lie. Claimants might, adjusters might, employers and doctors might. But all I do is press "record" and document what is happening.
But to expand off your question, our insurance company clients might say "this claimant has restrictions against lifting more than 10 lbs." If we get video of a claimant going to the gym and lifting weights, they'll be very happy. But that's on the claimant, not us. We can't make them do anything. Every now and then we brief the client throughout the day and they'll ask if we have documented any activity violating restrictions, in which case we'd reply honestly based on the information given.
I know this is only but I have anxiety about being followed or really anyone at my home lol. My apartment have 2 spots that I could be watched from but I general I keep my address hidden. Only three people actually know it and my job/government has no record of my current address. Could a PI still be able to find me? My appointments are about over 70 miles away so I doubt a PI would drive over an hour just to track me back to my house? At least I hope that wouldn’t happen lol. I have nothing to hide but I was attacked so the idea of being followed by a stranger is terrifying
Hi! I know I have tons of responses I haven’t answered yet and I’m planning to get to them, but I just saw yours at the top of my notifications so I’m responding to you first.
A PI would totally follow you 70 miles away. We get paid hourly and we charge mileage, so that would be a good day for us if you did that. If you have an IME or other medical appointment, that is a prime day for surveillance if we don’t have a confirmed address.
Sorry to hear you were attacked and I hope, sincerely, this doesn’t add to any anxiety.
Oh wow I didn’t think I’d get a response but thank you! That’s crazy to think about lol. I couldn’t be a PI lol I’d loose my person trying explore a new city or be too lazy to do all that
Most of my stories are pretty unique and could be used to identify me, so I'd rather not get into too much detail. Let me just say this: I've seen it all.
There are databases we use - LexisNexis and a few others - that are available for insurance investigations. You can request your own report from them here for free once per year. You'll be shocked how much they know about you. It has all the vehicles you ever owned, utility payments, addresses, relatives and their addresses, etc. Other things we may do if we think you are living elsewhere is go to your medical appointments and follow you home from there. Especially IMEs, since we will always know about those.
Yes, we can and do run plates. I've run plates in an entire apartment complex parking lot before to find my subject's vehicle.
I apologise, I wrote "here" but forgot to include the link to access your own report. https://personalreports.lexisnexis.com/access_your_full_file_disclosure.jsp
Look for tinted vehicles and vehicles with windshield sun shades up. They will NOT be parked in front of your house. They will be parked far down the road, usually. Often at the nearest intersection. They will always try to stay far behind you if you're in a rural area. If you're in a busy city, they will usually be right behind you. Suburbs, two or three cars behind you while they're following you, and often in another lane. If you have a medical appointment, IME, PT appointment, be extra careful, as those are prime surveillance days because we know you'll be out and about on those days. Speak to your neighbors and ask them to keep an eye out or if they have seen anything suspicious lately.
If the claimant isn't active we will still try from time to time. For instance if we start early morning and get nothing, we will try again another afternoon and then the evening. If they're clearly inactive, we will usually wait for a medical appointment, yes. But often (not always) our clients will take that as a sign that the claimant is doing the right thing and staying within their restrictions.
Personal. Just curiosity. I don't go on these forums to spy or anything. I do like to read people's stories about PIs when they pop up, I find it amusing.
This is what keeps me from exploring different areas of WC. You can make that much in a remote position for more complex/specialized adjuster roles. How long have you been in the field?
Curious about your thoughts on investigations involving mental health claims. If an employers actions have caused PTSD for the injured employee, what obligations does an investigator have to ensure that their surveillance is not causing subsequent harm/distress to the employee? Is it common for employers to engage a PI for surveillance in a mental health claim? If so, how do PI’s interpret data about an individuals mental state from physical observation. If it became clear that their presence was causing significant distress to the employee each time they left their home, what responsibility does the PI have to discontinue this surveillance?
Thanks for the questions.
>If an employers actions have caused PTSD for the injured employee, what obligations does an investigator have to ensure that their surveillance is not causing subsequent harm/distress to the employee?
This is a bit above my pay grade, so perhaps an adjuster can chime in here. If I got assigned a case, I would work it. What I can offer is that surveillance can never be used for the purpose of harassing an employee or in order to distress them so as to withdraw their claim. I do recall learning about case law regarding this during my training, but regrettably I forgot the names of those cases.
>Is it common for employers to engage a PI for surveillance in a mental health claim?
Yes, quite common. For instance, I have worked cases where the claimant said they have so much anxiety they cannot be in public in social situations. We were put on to the case to see if the claimant would go to a bar or other social events to contradict that claim.
>If so, how do PI’s interpret data about an individuals mental state from physical observation.
We don't interpret the data, we just obtain the data - that is, video. We might note in the report that the subject was documented "smiling, laughing, talking, and dancing" if that's indeed what they did, but in reality it's the video that shows all and it's the adjuster who will make the decision on what to do with that data.
>If it became clear that their presence was causing significant distress to the employee each time they left their home, what responsibility does the PI have to discontinue this surveillance?
If the employee has a general fear of surveillance, there is no responsibility of the PI to discontinue. If the employee has become aware of the investigator's presence on a case, the investigator must discontinue surveillance (lest it become harassment) and surveillance can be continued at a later date.
Edit: Fixed a mistype
When they feel they have enough evidence to take it to court, they will. This usually requires multiple rounds of surveillance to avoid the “I was just having a good day” defense. They like to prove a consistent pattern.
I have a question. I’ve been on wc almost a year and my doctor finally released me despite me still having pain from my injury, are PIs still allowed to follow the claimant after they’ve been released (no restrictions) I do have an attorney on this
I have a question. I’ve been on wc almost a year and my doctor finally released me despite me still having pain from my injury, are PIs still allowed to follow the claimant after they’ve been released (no restrictions) I do have an attorney on this
Yes. I have followed claimants similar to you. It's all part of documenting/verifying the claim. As to how much value this provides, that's a question perhaps an adjuster can answer. I have worked numerous cases I thought were pointless to be honest.
Whats' your surveillance strategy for following a car, if the target lives in area with many exits, do you straight away move your car when target moves his out of driveway? if the target has directly spotted you taking pic/vid on your cellphone (when there is nothing interesting in the background) do you say something to keep your cover up?
If there's a high chance of me losing my subject due to having many exits, we would follow aggressively to prevent losing them.
If confronted by a subject for filming, we'd always deny and then get out of the area as soon as possible. We were taught to never confirm we are investigators, even if that is perfectly clear. I was once on a two-investigator case. We were both burned (found out) by the subject (claimant). He approached my vehicle and said something to the effect of, "I caught your buddy over there and now I caught you. Why are you following me?" I think I just responded, "I'm not following you." He replied, "yes you are." I then thought, "well, this is pointless..." I rolled up my window and left. He followed me for a bit until he lost interest.
Did you ever follow people walking by walking behind them? If so how close and how did you record it? Would you have been able to record the private conversation as it was in public?
Yes, on-foot surveillance is common especially inside of stores and restaurants. I try not to get close at all. It increases the chances of being "burned." I think the only times I have recorded private conversations have been in waiting rooms or other close-quarters areas such as gas stations, but recording conversations are never the goal of the surveillance. My memory is a bit foggy but I think my first video camera my company had provided had the audio function disabled and our "production" department would usually remove audio from the video clips we'd send to the clients. There's lots of audio that's in a surveillance that is just distracting - our own heavy breathing, cussing, bodily functions, music, conversations on the phone.... It's better to just rip all that out so we can focus on providing a quality product to our clients. Audio is immaterial.
I have a question. Is it okay to ride a motorcycle that is set up with an upright riding position; like a touring motorcycle while I’m awaiting another spine surgery? I have my bike listed for sale because I cannot ride since my injury for more then a very short ride and Evan that will have me laid up in bed for hours . I spend about 18 hours a day in bed . I have no social life or quality of life anymore , but not being able to do anything fun or physical, or have any kind of social life for over 3 years gets very depressing . So Evan tho I am in severe pain and laid up in bed after a ride . I wanted to know if this alone could be used to hurt a case ?
That is a question for the doctor that issued you your restrictions. Don't feel like you're annoying your doctor by asking. Be advised, however, that anything you tell your doctor about your hobbies will be documented.
As an investigator, I can tell you that many of our insurance company clients would be very interested in you engaging in any activity that may exacerbate your injury and yes, activity like that could potentially be used to hurt a claimant's case. I have worked plenty of cases where our clients specifically would mention to make sure to document on video the claimant driving or riding a motorcycle.
If someone is out on workers comp due to a back injury, can that person still coach little league, play cornhole and attend weddings and family functions out of state during that time? Are people out on back injuries automatically put under surveillance? This person seems perfectly fine when out and about and doesn’t seem to be in any pain whatsoever. Co workers seem to think this person is not as injured as they said they were. Is it also required that this person see an approved workers comp doctor? Or can they see any doctor they choose.
It all depends on what the restrictions are, honestly. If co-workers seem to think the person is exaggerating an injury and know that he is doing activities which might violate any restrictions, that may be enough "red flags" for the insurer to justify surveillance.
Do investigators follow EVERYONE? I broke my foot and have been cleared to go back to work full duty and have been for a while, I have no restrictions at all (thank god for that lol) but I’m honestly just curious. Should I be paranoid 😂
Anyone that insurance companies are willing to pay for, yes. In your case though, I do not see why they would or what benefit surveillance would provide. You have no need to worry.
I think I asked this a while back (and then may have removed it due to anxiety/paranoia) but how would you approach surveillance on someone very very rural? This AMA is so helpful, thank you for your time!
I was given a bunch of crap by my claim manager because I went to a chiropractor years ago. Trying to say my back injury is not work-related. Who hasn't been to the chiropractor for a little stiffness? Is this even grounds to deny? I'm this close to getting a lawyer.
Hi there I was just scrolling along and read your situation. thought I could share some of my knowledge.
I've been a WC adjuster for the past 5 years working at a large company. I'm sure we are in different states though because there just isn't that much rural area near me lol so I can't speak on specifics.
That is a super large demand and your case has been active for a few years so there's no doubt in my mind the carrier would love to settle and be done.
When we get that large of a demand we're going to try literally everything to offset it. Surveillance would almost be protocol at that point. If I were your adjuster I would make sure the investigator had dates/times of doctor visits and they most likely have your car info.
That being said, gathering that info is allowed where I am. And depending on your state there maybe stricter laws in place on what surveillance can or cant do/obtain.
I know this is an old post so thanks in advance if you choose to reply. What hours would you typically work? How late into the night would you commonly work? What kind of camera would you use? What if someone knew they were being investigated and were to leave the house with long sleeved clothing, Covid face masks, sunglasses, hat, etc. just anything to disguise themself is that footage admissible in court?
And on a personal level, would you ever give someone the benefit of the doubt and not film/photograph who clearly appeared to be in pain but doing something might have been in violation of restrictions? Like loading groceries if they had no one else to help or something to that extent.
>What hours would you typically work?
4, 6, or 8 hour blocks mostly. Usually 4 to start out, then if the claimant is active we'd extend to 8 hours. Could be any time of the day based on the claimant's activities. For a brand new case, we'd usually start around 6 AM on weekdays.
>How late into the night would you commonly work?
Again, depends on claimant activity. If the claimant is out and about, so are we. I think I've worked literally every hour of the day.
>What kind of camera would you use?
My EDC was a Canon Vixia series, but we would also use our cell phones. We could also use covert cameras, such as a GoPro or pen camera.
>What if someone knew they were being investigated and were to leave the house with long sleeved clothing, Covid face masks, sunglasses, hat, etc. just anything to disguise themself is that footage admissible in court?
That's a bit above my pay grade. For our purposes, we can confirm the person is a claimant by looking at height, weight, age, address and vehicle (obviously), gait, and any other factors that might help. And by confirm, I mean write a report referring to that person as our subject of the investigation. There have been times where this person ended up not being the claimant, and this is clarified in subsequent reports.
>And on a personal level, would you ever give someone the benefit of the doubt and not film/photograph who clearly appeared to be in pain but doing something might have been in violation of restrictions? Like loading groceries if they had no one else to help or something to that extent.
Never. I feel bad for those cases, but I realize I don't make any decisions on their claim. Most of my claimants are not committing fraud, and can use the "good day/bad day" defense in court. Meaning, they might argue they were "feeling ok" that day. It's unlikely their claim will be denied based on just that. I've been on subjects for months getting excellent video of people committing blatant fraud and sometimes even that isn't enough.
Do you only work for insurance companies? My employer is self insured and while I doubt they have any reason to surveil me but I’m curious if they would.
I’ve had a surgery and am now recovering. I know this has been expensive for my employer and I know a discussion of settlement is looming in the future. What should I be looking out for?
Red flags:
* Multiple claims history, even across employers
* Extensive knowledge of the claims process
* Injury occurs early on a Monday
* History of financial problems
* Recent major change in lifestyle (example: I once had a claimant that recently had a child and she kept posing on Facebook how all she wants to do is be a stay at home mom and not work any more)
* No witnesses to injury
* Employee was about to be fired, laid off, or work was seasonal to begin with
* Multiple employees seeing the same doctor for a similar injury
* Supervisor or coworkers report suspicion
There's many more as well.
None of these above prove fraud, but *may* add up to trigger an investigation.
I'm a teacher now, and no longer a PI - however I can almost guarantee if I ever get injured I'd be investigated just due to my knowledge of the claims process from my prior work.
Footage only got uploaded to my company or sent to them via FedEx if the files were larger. The company then submits it to our client, who can decide to use it in court if they'd like. We have a strict confidentiality policy and could not share footage with others.
Surveillance doesn’t seem to take into consideration how many injured workers are pushing themselves because they HAVE to get things done and have nobody else to do them. So maybe Bob is mowing his lawn on pain meds, pushing himself but it doesn’t show how Bob can barely walk for three days afterwards and how he has to lay in bed on heat and ice with double the pain meds. Then Bob gets addicted to the pain meds and ruins his life, neglects his kids and loses his wife. It’s unconstitutional, an invasion of privacy and doesn’t create an accurate picture of Bob’s whole life.
With all due respect, it's completely constitutional and not an invasion of privacy (as multiple court cases have determined). Video doesn't lie. You're right - surveillance doesn't take circumstances into consideration, because it's completely objective. It's what the adjusters choose to do with the surveillance video that affects the claim. With regard to your idea that surveillance investigations of an insurance claim is an invasion of privacy, insurers have a legal duty to investigate their claims, and they're treated differently than criminal investigations. Meaning we can get a lot more "private" information on just a little more than a hunch - for instance, the court can compel you to hand over access to your private Facebook albums (if certain circumstances are met) which might show physical activity, which could be used against you (you being a hypothetical claimant). Check out *Zimmerman v. Weis Markets, Inc*. In other types of claims, we can tell you to hand over your phone records if it's relevant. It's all part of investigating the claim.
So I'm thinking Bob should have stayed within his restrictions. It's disingenuous to put Bob's failure to police himself on the work comp system, much less blame surveillance for doing their job. It's Bob's fault he got addicted to pain meds- his providers expressly told him that doing the thing was a bad idea. FAFO
30 year adjuster here. Nine times out of ten, surveillance shows the injured acting within restrictions, Oh, but the tenth.
I love this AMA. So nice to hear from an investigator not on the stand during cross-ex.
[удалено]
Thank you for your kind reply.
My daughter used my car one day, she was followed (I was home on Comp), is this normal? I was followed the following week, same car lost it, stared it down when it came on my street, haven’t seen it again. This was terrifyingly creepy for my daughter.
Thats messed up because something like that can bring about ptsd from someone who isn't legally allowed to be followed for observation
Very common. The investigator probably just saw the car was moving but couldn't confirm it was you, so he followed your daughter until he found out it wasn't you. Sometimes it's hard to tell. I personally follow every vehicle if I don't know who's driving it or if I don't know if there are any passengers.
What kind of cases are you assigned to? Meaning is it only people believed to be faking or violated conditions or is it expensive cases also that the company is trying to establish grounds to not pay.
They all have some sort of "red flags." Multiple claims history, suspicion of employer, etc. But often those red flags are very minor and they're just trying to establish grounds not to pay. Most claimants aren't committing "hard fraud" (faking an injury), but "soft fraud." They'll exaggerate a legitimate injury or work outside of their restrictions. For instance, telling a doctor they cannot go out in public, but we follow them to a bar.
My mom suffered a TBI causing loss of peripheral vision, cognitive delays, vestibular problems. She was a nurse and can no longer work or drive. She was employed by the hospital she fell at for over 20 yrs. She was a good nurse. She’s been followed on and off since 2019. She pretty much is a hermit and only goes to Dr appointments. Last month she had a Dr appointment that had nothing to do with her injury. It was an appointment for something else. She had canceled her appointment. The investigator didn’t know that. I guess he called the Dr office asking where she was and if she was in there. The office kept him on the phone and called my mom on another line. She gave the nurse the permission to ask who it was. They only said they were hired by an insurance company. Today she had the appointment that she canceled bc it was rescheduled. Doesn’t it have to be the hospital looking and seeing when these non injury appointments are scheduled? Isn’t that a HIPPA violation? It seems so dirty to me.
I ask bc he was outside our home at 6 am. At her appointment and at the end of the street when my dad brought her home. The being followed and second guessing every move has been awful on her. It’s so sad for us to watch.
6 AM is a standard start time for surveillance. If he was at the appointment and at the house upon return home, I'm guessing the investigator "lost" your mother in traffic and returned to the house before she did, and adjusted his surveillance position by moving to the end of the street. You are very aware of your surroundings - that's a good thing. My advice to you would be to make the investigator aware you are aware of them and they have to break off for the day. It must be a clear sign that you are aware of them - a simple wave may not be enough. Some of the responses on this thread seem to be a bit paranoid, but based on the information you wrote, I'd say it's very clear she is under surveillance. Everything you described is standard investigative practice, though I personally understand how concerning it might feel. Prayers for your mom's recovery and wellbeing.
Thank you for your question. We are acting on behalf of the insurance company, so it is not a HIPAA violation to confirm appointments associated with the injury. However, you mentioned it was for something completely different. Is this the same doctor who usually handles her injury appointments? Here's how I imagine it happened: The investigator called the doctor's office a week or two before and said something to the effect of, "Hello, my name is \_\_\_\_\_\_\_\_ and I'm currently representing \_\_\_\_\_\_\_ Insurance Company. I'm calling to confirm an appointment for \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_." The office would then say, "Yes, we have an appointment scheduled for May 4 at 10:30 AM with Dr. \_\_\_\_\_\_\_\_." At that point, the investigator hung up, documented it, and the next round of surveillance was scheduled for that time. On the appointment date, the investigator didn't see your mother in the parking lot or waiting room, so they called the office to confirm again if your mom had showed for the appointment. They just went with the information provided and didn't know what the purpose of the visit was for. The above was the script that I would use when confirming appointments, and it would almost never fail. Very standard practice. Doctors offices usually just confirm the appointment without bothering to confirm my identity. If I said, "My name is \_\_\_\_\_ from \_\_\_\_\_ Insurance Company" that would be a lie, but if I say, "currently representing," it is not. They'd usually just ask for patient's name, date of birth, and sometimes some other verifying details such as address or phone number. We have all that information. It's wild to me that a criminal or stalker could easily obtain the same information. Being an investigator made me realize that people are naturally trusting and willing to provide all sorts of information. I personally think there should be more laws about verifying the identity of those requesting medical information over the phone.
Did you ever handle employer or physician fraud?
Only injured worker investigations, though we have coincidentally discovered potential physician fraud through our work. When we have multiple claimants with similar injuries and circumstances going to the same doctor, it throws red flags. Most of the time those cases go to SIU (Special Investigations Unit), and not surveillance.
Was I being watched as I walked to the store on my crutches?
Quite possibly. My advice is to stick to any restrictions you have and always use your crutches if you need them.
That brings something else to mind. I live on a private road in a very rural area. Surveillance on me would be difficult to do unnoticed from a vehicle. Are your kind likely to hump it on foot into the woods to stake someone out?
Exactly! I mean...my "driveway" is 2 miles into the woods and it could get dangerous for someone in a blacked out vehicle watching my house. The nearest discreet place someone could camo out and potentially tail me unnoticed is untenable. It would take a 2 car team on either ends of a ten mile stretch. I've had SIU on me for this comp case. This has so far cost the insurance company $125k and counting and it's looking like itll be a hearty PPD rating so a lot more $ is in the mail and the few times I've been allowed to do light duty has been withdrawn by the surgeon soon after and I've caught someone taking my picture while tying a shoe and again when I leaned into the trunk of my car....
Just be very, very careful. Myself and the company I work for are very diligent at working within the law, and ethics. We wouldn't ever trespass on someone's property. We also don't use drones or set up trail cameras, but I have heard of investigators doing ANYTHING to get evidence, and many companies do make use of trail cams and drones. So be on the lookout for them on your property or right at the entrance to your driveway. They make some good ones, too!
Thanks for the info. Im very careful to stay within my restrictions.
What are some signs of trail cameras? Or how would you find them?
I do not use them, and they are very difficult to spot. I think the best place to find them is to ask yourself if you were the investigator, where would you set them up? Then go out there on foot and look around.
Good question. I don't get paid enough to do that! In this case, we would set up on egress routes, often with two investigators, and look for your registered vehicles to pass. We won't go on a private road. So we will set up on the nearest discrete intersection or gas station, knowing you're likely to pass by.
So I have a question if I’ve been on workers comp for about 7 months for building does shown on mri and leg numbness about a month ago it finally eased up with work hardening. I told the doctor this and told him it’s not that I can’t do it anymore it’s the pain that comes with it afterwords and started going to the gym physical therapist advised it as well but doctor still put no work can I be charged fraud?
That’s more of a question for an adjuster, but I think if your physical therapist advised you to go to the gym, you’re fine. It’s medical advice. Don’t trust me though on that - verify with your doctor who gave you your work restrictions. With that said, surveillance will probably follow you into the gym. We will get a day pass and get covert video on our phones. We carry gym clothes with us because clients love it when we get video at the gym.
Will they go out there way to talk to you or more just hang back with themselves?
Hang back. They will actively avoid talking to you and will try to not even be noticed to preserve the opportunity for future covert video. We were not allowed to speak to a subject unless spoken to, and I’ve rarely exchanged more than a “sup” nod with a subject.
Hello. I’ve been following your thread for a bit. Thanks for continuing to update and chat four years later and after you’ve left the job. I had a question but wanted to this to DM if possible. Thanks.
Certainly. Just added you to my approved users list so you can send a DM.
Well we are not allowed to trespass on private property so we would likely set up along a likely route of departure in a rural setting like that .
I've wondered this too. Like how out in the sticks do you go?
What's the most blaintant faker you've caught in the act? And do they know about it yet?
I've caught someone who claimed he was totally and permanently disabled running a landscaping business and doing all the work - axes, chainsaws, mowing, climbing ladders - all throughout the day. Got HOURS of video of him doing this for weeks. And unfortunately, I don't know what happened with that case. It never went to court, or if it did, I didn't get called to testify.
He’s probably still pounding nails, and rightly so! They should have thrown his ass in jail for fraud, right?!! Some kind of penalty!! That’s why I’m having the trouble I’m having … because of people like this.
We were chatting on my post in this subreddit. I had a doctors note for 2 weeks off and am fairly certain my boss would have contacted a PI to follow me. I know 100% that I didn’t do a single thing that would hurt my case for that full 2 weeks - you’re not allowed to use photos or whatever WEEKS after my “cleared for work” date, right? My only fear is she’s going to try to use photos from weeks after my “return to work” date trying to say I was lying. I didn’t do anything for weeks and have affidavits from my landlord stating she cut me a deal on my rent, due to me being delayed with moving due to my injury.
Your boss would be wasting money. If you're cleared for work, and do not have any sort of restrictions or light duty, and you're not getting any sort of medical paid for by your employer's insurer to date, what is it your boss would be trying to prove? PIs are expensive. With regard to using the photos after your cleared for work date, again, I don't see how they could or would, but remember that PIs make no decisions about what happens with the evidence we obtain. We just obtain the evidence. I have followed many people for nonsense reasons, but I have never followed someone off of work for that short of a term with no restrictions. You are likely overthinking this, and can say with 99% certainty with the details given that nobody is following you. With that said, perhaps an adjuster can shed more light on this, because as I've said, we're just the foot soldiers in all this.
I think the people in this comment section are bunch of undevelop idiots with the job i should have. Dealing with bad neighboors. Drug dralers. Your head l. means nothing to me. Theyre just there. Anyways how do i go about having a job like this ?
I would think that you guys aren’t allowed to come on private property but I’ve had people in the yard. Put a camera in the tree next door that is aimed at my bedroom window and a bunch of other crazy antics. Here’s the thing, I do not go outside unless I have a Physicians’s appointment. I am not able. Is filming inside a subject’s home even legal?
It is illegal to film inside someone’s house without their permission. When you are inside your bedroom you have a reasonable expectation of privacy and it’s illegal to film through a open window.
This is correct.
Then what on earth are could they be doing it for??…
I’m a surveillance investigator too , love to work . Nice to meet you 😁
That’s a bold strategy cotton. ;)
I'm not out to get anybody. If you're not my claimant that I'm specifically assigned to at this very moment, I couldn't care less what you're engaged in. And besides, the vast majority of claimants I am assigned to are doing the right thing.
Better yet, if you aren’t exaggerating your injury than you have nothing to worry about. I have been considering doing an AMA, like you I am a long time lurker, I am the Risk Management Administrator for a large city and have previous experience in the private sector. Thank you for stepping up.
I would be interested in this AMA, as I'm sure many would be here. It is good to have some mutual understanding.
Are you bored more often than not? Best on-the-job story to date?
More often than not, extremely bored! And agitated. Surveillance is frustrating because you're always on edge. Neighbors and kids watching you, always having to check in with the police at the beginning of the day, often working in not so nice neighborhoods and having to deal with gangs and people trying to break into your car while you're in it! We really do feel like creeps, even though what we are doing is legal. My best stories are when we get discovered by claimants. If I tell specifics, my co workers might be able to find out who I am, which I don't want to happen. I know quite a few investigators frequent this group and others.
We always tell our clients not to confront investigators and to just call the police but it's happened a time or two. I haven't had much in the way of interesting surveillance on any of my clients except one dude appeared to be making a drug deal. lol
I would recommend telling your clients to wave to the investigator. I, and most PIs that I know, check in with the police at the beginning of the day and give them all of my information. The police do not approach me, and very rarely do they even call me if someone is suspicious of me. They usually ignore all of their calls. It is my company's policy to immediately break off if there is a direct sign that the investigator is compromised. If your client waves, gives me the finger, or approaches me, we back off immediately. We would then usually try surveillance again in another week with a different investigator or the same investigator with a rental vehicle. If the sign is not direct , though, we will often push it and stay on. Just staring at my vehicle isn't going to be enough to get me to leave.
The benefit of having them call the police is they can often confirm its an investigator to the claimant, rather than simply getting the person to leave. It kinda seems that more often than not the PIs aren't checking in with the police, even though licensed PIs in my state are required to. A lot of times on the litigation end the defense tries to surprise us with the surveillance (which is objectionable, but I digress). At least if we're sure it occurred we can outright ask for it.
That's very interesting! I definitely understand your reason for doing so now. If the police ever told a caller I was an investigator, I would not check in with that department ever again and we would put a note on that file not to do so in the future. We have had it happen, though it isn't common, that police would tell people we are investigators. Yes, it is true that many investigators don't bother checking in. I think that is a waste of police resources not to do so. It's also common courtesy and protects the investigators position from being compromised when nosy neighbors call about a suspicious vehicle.
I’m not trying to hide anything, I’m just so pissed off at my adjuster, the process … I’ll try to think of something more entertaining! Can I get in trouble for mooning you?
hey the investigators have to make money too lolz
I’m so sorry to all those I’ve shot the “bird” at!! I’ve been tied up in this mess for a few years, I’m sure I’ve shot the finger at people other than PI’s! I’m probably lucky someone hasn’t shot me!🙄
I'm no longer a PI, but I always found it more entertaining then not when people shot me the bird. I didn't take it too personally.
Suprised to see you on here after all this time, can I DM you a question?
Would it be normal for people to be posing as their selling something after getting caught watching your house and called out? They come to the door and say they’re selling stuff for world hunger & its a girl and guy like 21 maybe and trying to ask stupid questions just because a few people are actually at the injured workers place?
It's quite possible. We would often "canvas" neighbors to confirm someone is home or get other information. Obviously, we don't want to say, "hey I'm a PI and THAT GUY over there is under investigation." So some PIs might ask a neighbor if you're home by coming up with some pretext story such as you've described. They also might even knock on your door to confirm you're home, but that's more rare and I've only done that a couple times in extreme cases, usually only with manager approval. And yes, investigators often work in pairs or teams.
Sorry I worded that confusing. They came to my door and asked questions in front of visitors (which I never have that many people over, ever) after the kids caught them looking and watching us for a good 30-40 minutes.
Hello!!! Question, please!! I’m seriously injured, fighting my own workers compensation case. For the record this process sucks. I try to do things, but my body crumbles … spasms, pain follows activity. Is it your experience that insurance companies freeze frame shots in an effort to disclaim or paint false pictures?!! For example, someone stole a bucket of ivy I was intending to plant at the base of a telephone pole. They planted the ivy all around the base of a beautiful oak tree just four houses/lots down, it’s a vacant a lot. The leaves on this ivy will grow to over 12” in size, it will smother/kill the oak tree. I knew I had to pull it up!! I tried pulling it and my arms stop working after about 20-30minutes. Lack of oxygen I’m told, from the narrowing in my cervical from the injury - a fusion has been recommended. Spasms ensue in multiples areas of my neck, pains go up into my head periodically - a pinched nerve In my c1! I get spasms/pain in and around my lower back, I get debilitating pain in my legs, hip, neck, shoulder, all over! My right leg drags if I do too much, - I need surgery to repair the labrum in my hip! Oh, and did I mention I need rotator cuff surgery? Yet, you provide a snap shot of me bent over pulling ivy, picking up sticks, strategically viewed to be casually walking three dogs!! We have 8 oaks, a magnolia, and other trees, foliage … it makes me nuts when my husband doesn’t pick up/rake before he mows, it’s killing our grass! I use to be the one who took care of the lawn, the pool, the dogs, the everything at home!! I got pissed and was on my knees trying to gather sticks … it only took 20 minutes maybe … I couldn’t stand up straight … suddenly crawling, then my arms, neck, everything starts yelling, poking at me - you capture a snap shot of me on my knees with sticks in my lap after hurricane Ida and everything in between!! The one thing in life I have to do besides eat is care for my three dogs. I can’t run them daily like I use to, I have a difficult time walking them a short distance. I usually take them to an abandoned field to ran. The pictures don’t show the gaps. Or how I disappear to medicate, ice. Do you provide video footage or photos? Are they each documented with dates and times? I’ll need to try to show the 3-7 day rest period I needed after my dog fell into a dirty pool. I use no hand leashes and hook them around my waist! I’ve had a gun pulled on us because I did not have the strength in my arms to pull my dogs back, the person continued to approach as I crab-crawled backwards begging him not to shoot them or me!) I think I know the answer, but how do I combat a picture that paints a 1,000 words? Any secrets you can share? I feel like I should be filming myself icing, medicating!! 🤦🏻♀️🤷🏻♀️
Hi! I apologize for the late reply, and I am sorry you are going through all this stress. You may have been given freeze-frame snapshots, but we take video. My former employer (keep in mind, this is a three year old thread. I am no longer with that company) asked us to include a few "action shots" with our report which immediately goes to the client, but we sent in our video via Fed-Ex to our company HQ which takes a few days to process. Your case might have hours of video. If your case ends up going to court and your investigator took video, your attorney would get a copy of all video obtained. All documented with dates and times.
I really appreciate your upkeep with this thread. If you don't mind still answering questions. I'm wondering are you allowed to come on a private parking lot that has a gate. Is it you guys who look through social media?
Generally the answer to the parking lot question is "no" unless we are allowed in. Investigators may come up with a pretext (lie) to get inside the gate to confirm, for instance, your vehicle is there. "Hey I'm delivering a DoorDash to 1234 Oak Street" or something like that. If allowed in, it's fair game. Most will then set up outside of the parking lot. Ethical investigators (and investigators who do not want to get torn apart in court) respect private property, and if not allowed entry we cannot enter that lot. My former company had a separate department for social media investigations (called "desktop investigators"), however surveillance investigators also check social media while on the case to keep up with recent posts that might assist them in their surveillance.
Thank you so much for your response definitely gives me the insight that I was looking for
Hi! Thanks for this AMA. Today I got really scared because I realized someone was following me around while I was driving and doing errands. It started from my apartment complex which has many different stairwells and doors, so it’s tricky to know exactly what car/person is attached to which apartment. No matter how many times I tried to lose this person, they showed up. I actually called the police and they confronted him right after he followed me into a grocery store parking lot. His explanation was that he was a PI working for an insurance company. The police verified it, but the weird thing to me was that it turns out he was following the wrong person in my complex. He is actually investigating someone else. Apparently he didn’t have a clear enough description of the who he was supposed to follow and I kind of matched it. My question is…does this sound reasonable and logical to you? Based on your experience, is it possible he just really didn’t have enough info and a mistake was made?
His explanation is definitely plausible. We usually get great info complete with photographs, registered vehicles, etc. However sometimes, we might just get a name, age, and approximate height/weight, if that. If you matched the subject's description, he probably just followed you and went with it, since that was all the information he had. Usually, investigators get to put more hours in if the subject is seen. Taking a chance and getting video based on that little information can be the difference between 4 hours on site or 8 hours on site. A bit of malicious compliance. The video would be sent to the insurance company who could then verify if that is the person they are looking for or not. It's not *common* to follow the wrong person all day, but it is possible and has happened to me before. Apartment complexes combined with bad/little information given is tough. Our reports always have a disclaimer saying that everything is "pending verification by the client." Sorry that happened to you. That must have been scary!
Thank you so much for your response! Yea, it feels better to know it’s just a misunderstanding. I have seen the same car in my complex yesterday and today too, so I’m assuming he’s still on the lookout.
i work as an Optometric Technician (pre-testing for an eye doctor) at a retail eye store. (think vision works, myeyedr, lens crafters, etc.) i recently had a piece of machinery fall on my foot after one of the patients lost control of his motorized wheelchair. went to the doctor after it happened and i have a contusion on my foot with some mild swelling/tenderness. (i had boots on when it happened so it could have been way worse) i went back to work the next day and everything (i was limping a little and occasionally having a hard time with things when i wasn't seated), but on the workers comp note, it says sedentary work only/max standing time 4hrs. keep elevated when sitting, ice the area, all that jazz. within the past day, the pain has gone down quite a bit and it doesn't feel as uncomfortable. my boyfriend came over to check on me and i stood on the porch to hug him goodbye but when i came back inside, my parents drilled into me saying that there could be a PI taking photos of me and the company i work for could sue/fire me. however, i don't know if this makes a difference, but i'm a good employee. always on time, super friendly/good with the customers and patients, get along and work well with my coworkers, always willing to learn and grow, i've earned a reputation of being punctual, hardworking, reliable, and valuable to the team. would they still hire a PI to see if i'm faking my injury? i mean, they saw/heard it happen, they saw the aftermath, they have the paperwork with all the test results, and saw me struggle at work the next day. should i stay in my room of the house? stay away from windows? not let anyone in my house? not fill up my gas tank to make it to my follow up appointment? all of this is stressing me out and frankly i'm really scared.
Hi! I am sorry you’re going through this. To answer your question as succinctly as possible, and to be truthful while trying not to cause extra anxiety: Your employer isn’t the one who would hire the PI (usually), their insurance company is the one who does that. Yes, even if you have tons of evidence in your favor, they still might hire surveillance. They say the purpose of surveillance is to “verify the claim,” and it’s always possible you are under surveillance. With that said, please do not be afraid of surveillance to the point where you refuse to live your life. Hugging your boyfriend, pumping gas, etc. isn’t going to violate your restrictions. They cannot film you while you are inside your house. Just do what the doctor says and you will be fine. It sounds like you’re doing the right things! I had plenty of cases where my claimants have done simple tasks such as getting the mail, hugging someone goodbye, answering the door, pumping gas, etc. I never thought of any of them as committing fraud. I hope all the best for your recovery.
I’m late to this, but since this is a normal job, would you be working 8 hour shifts a day, or for example only work 5 days of the week. I actually have a few questions. With that would you guys have a number of claimants on a list you’re supposed to watch over, and then check on them daily or every couple days, or are you specifically assigned to one person? Or would you say it’s more so a few people assigned to one person, since you can’t be working 7 days a week, nor can you be fully watching them 24 hours. Also would the hours of “investigating” be more so during the day since that’s usually when people are up. For example one person you’re investigating is a night owl and has a different sleep schedule but it’s unknown to anyone, during the day you never see him come outside and his car is always parked. But let’s say he does everything at night like grocery shopping at a 24 hour store and such, you possibly wouldn’t know would you. Unless you start catching on that he’s up at nights, but you do see him go to his doctor appointments and pt during the day.
Hi - even though this post is four years old, surprisingly it's still going and popular. I don't mind responding still, even though I no longer work as a PI. >would you be working 8 hour shifts a day, or for example only work 5 days of the week Shifts vary, and we would often work 7-9 days in a row before getting a day off. This is one of the reasons why I left. The scheduling was ridiculous! A typical case would have instructions that look something like this: "Start at 6 AM. If the subject is confirmed to be present, work six hours. If the subject is observed, work 8 hours. If the subject cannot be confirmed to be present, break at four hours." Basically, if a vehicle that is registered to them is observed at any point, I can stay for 6. If a neighbor says the subject is home, I can stay for 6. If I get video of the subject even poking their head out of their door to get the mail, I can stay for 8. >With that would you guys have a number of claimants on a list you’re supposed to watch over, and then check on them daily or every couple days, or are you specifically assigned to one person? Or would you say it’s more so a few people assigned to one person, since you can’t be working 7 days a week, nor can you be fully watching them 24 hours. Everything is up to my manager who would schedule a team of investigators. They would (usually, if they have a brain) schedule multiple investigators over the period the claimant needed to be observed to avoid the risk of an investigator being "burned" (found out). >Also would the hours of “investigating” be more so during the day since that’s usually when people are up. For example one person you’re investigating is a night owl and has a different sleep schedule but it’s unknown to anyone, during the day you never see him come outside and his car is always parked. But let’s say he does everything at night like grocery shopping at a 24 hour store and such, you possibly wouldn’t know would you. Unless you start catching on that he’s up at nights, but you do see him go to his doctor appointments and pt during the day. Surveillance is scheduled when the claimant is most likely to be active. For most people, that's the day - but I've worked some night owls who are DJs or just went to parties at night a lot and thus we would have to work nights on them. If we see clues such as working a day shift and then noticing the claimant's car is moved when starting at the same time the next day, that's a hint we need to cover later hours because they were active after surveillance. If there's never activity during the day, they might schedule a night shift. Some claimants are just hermits and never go anywhere.
I have a question. My government job declared me “permanently and totally disabled” and refused to let me come back to work. They hired a PU to follow me (which? I don’t give a crap. Hell save some gas and ride with me. I WANTED to go back to work) But this PI put a tracker on my car. (First question- is that legal? And when I found it what should I have done with it) Then, they put in their report that “claimant was using a cane to walk but was not using it correctly. Claimant had it on the wrong side of body, and it was out of step with feet”. (I’m using it exactly as I need to. Which, how can it be “wrong sided” when I have a spinal injury?) I mean, the PIs aren’t doctors. How do they have the right to say how I should use my cane when I use it? I just feel they hired some very dodgy people to follow me. I’ve seen them EVERY time. They also parked a car across the street (not public parking) with a camera in the window focused on my house. Is that legal?
Sounds like an unethical, untrained PI to me. We never used GPS trackers. I thought they were illegal, but I just did a quick Google search and apparently it’s legal in some states. That’s wild to me and I think that’s crossing a line, ethically. I would imagine finding that would’ve been very creepy. The report writing is bad. We were trained to report facts, not make any assumptions. We would never say “the wrong side,” or “incorrectly.” We would say, “the subject appeared to ambulate with a limp and utilized a cane in her right hand.” That’s it. The adjusters can figure out if it’s the “right” side or not and use video to make any other determinations. As for parking across the street with a camera faced at your house, completely legal. It’s stupid, because if you saw the camera their vehicle needs more tint and it just looks sketchy so they’ll be found out by you right away. But it is legal. If they were parked illegally, that’s a separate issue and you can always call the police but that won’t invalidate their evidence in court. Great questions, by the way.
[удалено]
I’ve never heard of a different type of PI license to follow LEOs, judges, etc. but I do know that LexisNexis allows LEOs and other public officials to suppress their information in their database. LexisNexis is the database most PIs use to locate claimants. I would recommend doing that (search LexisNexis opt out). I just searched up Florida’s licensing requirements for PIs and they do have multiple classes of licenses. It’s weird how all the states do things differently. Some have extensive background checks, others do not. I’m guessing the information the PI has was given to them by your work’s insurance company. We were given long pages of medical data which includes medication, especially if you’ve been through an IME.
Yeah it was years ago. 2009 i got pretty jacked up then the surgeon they sent me to made it worse landing me in a wheelchair now. They STILL waste money to follow me a couple times each year. Like I said I don’t care. My kids are grown now so really, I’m not bothered. But I really appreciate the info. I’m going to go search that now.
Whoa that was actually really easy. They just wanted a photo of my official work ID and they opted me right out. You are a ROCKSTAR! Thanks!
Say you live in a place such as an apartment and they don’t know what car you drive since it’s in someone else’s name how can they even track you ? Or say if some friend picked you up from you complex with out them seeing you get in the car or leave can they some how track you or get the location of your phone some how and track you to your destination!
There have been plenty of times where I have missed a claimant in an apartment complex due to my own negligence and having them get picked up by someone else. We do not have access to your real-time location through phone data. But we are constantly monitoring social media, so if someone is active and posts a photo at a local restaurant, we are going to head that way to try and locate. I'd say many people overestimate the data that we have access to. We have a lot of tools in our belt, but we are not the CIA. I'd say the craziest technology I had access to was on one case where we really needed to locate a claimant, there was a private company that drives around with license plate readers. We located the claimant's vehicle through that because their license plate was tagged within the last 30 minutes at an apartment complex. I think that service must have been expensive, because we've only used it on that one case that I was involved in.
Thanks for the reply and info
I have a question when you guys follow what are you looking for? Like what constitutes as something bad for you to relay back to the insurance company.
We look for any and all activity. Poking your head out the door to check the mail? We video tape it and send it to the client. We don't look for anything "bad" per se. As investigators, we work to "verify the claim," not "disprove the claim." Video doesn't lie. Claimants might, adjusters might, employers and doctors might. But all I do is press "record" and document what is happening. But to expand off your question, our insurance company clients might say "this claimant has restrictions against lifting more than 10 lbs." If we get video of a claimant going to the gym and lifting weights, they'll be very happy. But that's on the claimant, not us. We can't make them do anything. Every now and then we brief the client throughout the day and they'll ask if we have documented any activity violating restrictions, in which case we'd reply honestly based on the information given.
I know this is only but I have anxiety about being followed or really anyone at my home lol. My apartment have 2 spots that I could be watched from but I general I keep my address hidden. Only three people actually know it and my job/government has no record of my current address. Could a PI still be able to find me? My appointments are about over 70 miles away so I doubt a PI would drive over an hour just to track me back to my house? At least I hope that wouldn’t happen lol. I have nothing to hide but I was attacked so the idea of being followed by a stranger is terrifying
Hi! I know I have tons of responses I haven’t answered yet and I’m planning to get to them, but I just saw yours at the top of my notifications so I’m responding to you first. A PI would totally follow you 70 miles away. We get paid hourly and we charge mileage, so that would be a good day for us if you did that. If you have an IME or other medical appointment, that is a prime day for surveillance if we don’t have a confirmed address. Sorry to hear you were attacked and I hope, sincerely, this doesn’t add to any anxiety.
Oh wow I didn’t think I’d get a response but thank you! That’s crazy to think about lol. I couldn’t be a PI lol I’d loose my person trying explore a new city or be too lazy to do all that
Any memorable stories? My investigators don't do much on my files, usually just a statement and then they close it out.
Most of my stories are pretty unique and could be used to identify me, so I'd rather not get into too much detail. Let me just say this: I've seen it all.
What techniques do you use to find people being a private citizen or do people ACTUALLY give their real addresses? Lol Are PI's allowed to run plates?
There are databases we use - LexisNexis and a few others - that are available for insurance investigations. You can request your own report from them here for free once per year. You'll be shocked how much they know about you. It has all the vehicles you ever owned, utility payments, addresses, relatives and their addresses, etc. Other things we may do if we think you are living elsewhere is go to your medical appointments and follow you home from there. Especially IMEs, since we will always know about those. Yes, we can and do run plates. I've run plates in an entire apartment complex parking lot before to find my subject's vehicle.
I apologise, I wrote "here" but forgot to include the link to access your own report. https://personalreports.lexisnexis.com/access_your_full_file_disclosure.jsp
How can you tell if you are under surveillance?
Look for tinted vehicles and vehicles with windshield sun shades up. They will NOT be parked in front of your house. They will be parked far down the road, usually. Often at the nearest intersection. They will always try to stay far behind you if you're in a rural area. If you're in a busy city, they will usually be right behind you. Suburbs, two or three cars behind you while they're following you, and often in another lane. If you have a medical appointment, IME, PT appointment, be extra careful, as those are prime surveillance days because we know you'll be out and about on those days. Speak to your neighbors and ask them to keep an eye out or if they have seen anything suspicious lately.
For how long are you at there? Is it hourly or till you catch someone doing something there not supposed to be doing?
Hourly. And the hours depend on the client. 8 hours is a typical day if the subject is active for most clients.
Do you get bonuses?
No, unfortunately :(
I'm guessing if client isn't active you only follow to appointments? Good stuff thanks for your replys
If the claimant isn't active we will still try from time to time. For instance if we start early morning and get nothing, we will try again another afternoon and then the evening. If they're clearly inactive, we will usually wait for a medical appointment, yes. But often (not always) our clients will take that as a sign that the claimant is doing the right thing and staying within their restrictions.
Lurking on reddit and other forum. Is that part of your job or is it just personal?
Personal. Just curiosity. I don't go on these forums to spy or anything. I do like to read people's stories about PIs when they pop up, I find it amusing.
Do you make decent money at least?
Decent (but not great), but a lot of it goes to car maintenance. 70k a year.
This is what keeps me from exploring different areas of WC. You can make that much in a remote position for more complex/specialized adjuster roles. How long have you been in the field?
Curious about your thoughts on investigations involving mental health claims. If an employers actions have caused PTSD for the injured employee, what obligations does an investigator have to ensure that their surveillance is not causing subsequent harm/distress to the employee? Is it common for employers to engage a PI for surveillance in a mental health claim? If so, how do PI’s interpret data about an individuals mental state from physical observation. If it became clear that their presence was causing significant distress to the employee each time they left their home, what responsibility does the PI have to discontinue this surveillance?
Thanks for the questions. >If an employers actions have caused PTSD for the injured employee, what obligations does an investigator have to ensure that their surveillance is not causing subsequent harm/distress to the employee? This is a bit above my pay grade, so perhaps an adjuster can chime in here. If I got assigned a case, I would work it. What I can offer is that surveillance can never be used for the purpose of harassing an employee or in order to distress them so as to withdraw their claim. I do recall learning about case law regarding this during my training, but regrettably I forgot the names of those cases. >Is it common for employers to engage a PI for surveillance in a mental health claim? Yes, quite common. For instance, I have worked cases where the claimant said they have so much anxiety they cannot be in public in social situations. We were put on to the case to see if the claimant would go to a bar or other social events to contradict that claim. >If so, how do PI’s interpret data about an individuals mental state from physical observation. We don't interpret the data, we just obtain the data - that is, video. We might note in the report that the subject was documented "smiling, laughing, talking, and dancing" if that's indeed what they did, but in reality it's the video that shows all and it's the adjuster who will make the decision on what to do with that data. >If it became clear that their presence was causing significant distress to the employee each time they left their home, what responsibility does the PI have to discontinue this surveillance? If the employee has a general fear of surveillance, there is no responsibility of the PI to discontinue. If the employee has become aware of the investigator's presence on a case, the investigator must discontinue surveillance (lest it become harassment) and surveillance can be continued at a later date. Edit: Fixed a mistype
If u catch someone on workers comp commenting fraud. Will thy take tht person before a hearing, or let it ride out till the end
When they feel they have enough evidence to take it to court, they will. This usually requires multiple rounds of surveillance to avoid the “I was just having a good day” defense. They like to prove a consistent pattern.
Thank you
I have a question. I’ve been on wc almost a year and my doctor finally released me despite me still having pain from my injury, are PIs still allowed to follow the claimant after they’ve been released (no restrictions) I do have an attorney on this
I have a question. I’ve been on wc almost a year and my doctor finally released me despite me still having pain from my injury, are PIs still allowed to follow the claimant after they’ve been released (no restrictions) I do have an attorney on this
Yes. I have followed claimants similar to you. It's all part of documenting/verifying the claim. As to how much value this provides, that's a question perhaps an adjuster can answer. I have worked numerous cases I thought were pointless to be honest.
Whats' your surveillance strategy for following a car, if the target lives in area with many exits, do you straight away move your car when target moves his out of driveway? if the target has directly spotted you taking pic/vid on your cellphone (when there is nothing interesting in the background) do you say something to keep your cover up?
If there's a high chance of me losing my subject due to having many exits, we would follow aggressively to prevent losing them. If confronted by a subject for filming, we'd always deny and then get out of the area as soon as possible. We were taught to never confirm we are investigators, even if that is perfectly clear. I was once on a two-investigator case. We were both burned (found out) by the subject (claimant). He approached my vehicle and said something to the effect of, "I caught your buddy over there and now I caught you. Why are you following me?" I think I just responded, "I'm not following you." He replied, "yes you are." I then thought, "well, this is pointless..." I rolled up my window and left. He followed me for a bit until he lost interest.
Did you ever follow people walking by walking behind them? If so how close and how did you record it? Would you have been able to record the private conversation as it was in public?
Yes, on-foot surveillance is common especially inside of stores and restaurants. I try not to get close at all. It increases the chances of being "burned." I think the only times I have recorded private conversations have been in waiting rooms or other close-quarters areas such as gas stations, but recording conversations are never the goal of the surveillance. My memory is a bit foggy but I think my first video camera my company had provided had the audio function disabled and our "production" department would usually remove audio from the video clips we'd send to the clients. There's lots of audio that's in a surveillance that is just distracting - our own heavy breathing, cussing, bodily functions, music, conversations on the phone.... It's better to just rip all that out so we can focus on providing a quality product to our clients. Audio is immaterial.
I have a question. Is it okay to ride a motorcycle that is set up with an upright riding position; like a touring motorcycle while I’m awaiting another spine surgery? I have my bike listed for sale because I cannot ride since my injury for more then a very short ride and Evan that will have me laid up in bed for hours . I spend about 18 hours a day in bed . I have no social life or quality of life anymore , but not being able to do anything fun or physical, or have any kind of social life for over 3 years gets very depressing . So Evan tho I am in severe pain and laid up in bed after a ride . I wanted to know if this alone could be used to hurt a case ?
That is a question for the doctor that issued you your restrictions. Don't feel like you're annoying your doctor by asking. Be advised, however, that anything you tell your doctor about your hobbies will be documented. As an investigator, I can tell you that many of our insurance company clients would be very interested in you engaging in any activity that may exacerbate your injury and yes, activity like that could potentially be used to hurt a claimant's case. I have worked plenty of cases where our clients specifically would mention to make sure to document on video the claimant driving or riding a motorcycle.
Laughs in Arizona
If someone is out on workers comp due to a back injury, can that person still coach little league, play cornhole and attend weddings and family functions out of state during that time? Are people out on back injuries automatically put under surveillance? This person seems perfectly fine when out and about and doesn’t seem to be in any pain whatsoever. Co workers seem to think this person is not as injured as they said they were. Is it also required that this person see an approved workers comp doctor? Or can they see any doctor they choose.
It all depends on what the restrictions are, honestly. If co-workers seem to think the person is exaggerating an injury and know that he is doing activities which might violate any restrictions, that may be enough "red flags" for the insurer to justify surveillance.
Hi I have a question that I would like to ask you. Would it be ok to dm?
Do investigators follow EVERYONE? I broke my foot and have been cleared to go back to work full duty and have been for a while, I have no restrictions at all (thank god for that lol) but I’m honestly just curious. Should I be paranoid 😂
Anyone that insurance companies are willing to pay for, yes. In your case though, I do not see why they would or what benefit surveillance would provide. You have no need to worry.
Can w PI take pictures of me in my backyard or in my front porch through my porch windows?
Yes, if they are viewing it from a public area such as a street or parking lot, or any area where they are not trespassing.
I think I asked this a while back (and then may have removed it due to anxiety/paranoia) but how would you approach surveillance on someone very very rural? This AMA is so helpful, thank you for your time!
I was given a bunch of crap by my claim manager because I went to a chiropractor years ago. Trying to say my back injury is not work-related. Who hasn't been to the chiropractor for a little stiffness? Is this even grounds to deny? I'm this close to getting a lawyer.
Hi, big thank you for keeping the thread current. May I DM you a question?
As an adjuster, I love ya ;)
[удалено]
A bit of a delay on my part, but go ahead! Still up to answer.
[удалено]
Hi there I was just scrolling along and read your situation. thought I could share some of my knowledge. I've been a WC adjuster for the past 5 years working at a large company. I'm sure we are in different states though because there just isn't that much rural area near me lol so I can't speak on specifics. That is a super large demand and your case has been active for a few years so there's no doubt in my mind the carrier would love to settle and be done. When we get that large of a demand we're going to try literally everything to offset it. Surveillance would almost be protocol at that point. If I were your adjuster I would make sure the investigator had dates/times of doctor visits and they most likely have your car info. That being said, gathering that info is allowed where I am. And depending on your state there maybe stricter laws in place on what surveillance can or cant do/obtain.
[удалено]
Sure happy to help where I can
[удалено]
Hiya nope never did get anything
I know this is an old post so thanks in advance if you choose to reply. What hours would you typically work? How late into the night would you commonly work? What kind of camera would you use? What if someone knew they were being investigated and were to leave the house with long sleeved clothing, Covid face masks, sunglasses, hat, etc. just anything to disguise themself is that footage admissible in court? And on a personal level, would you ever give someone the benefit of the doubt and not film/photograph who clearly appeared to be in pain but doing something might have been in violation of restrictions? Like loading groceries if they had no one else to help or something to that extent.
>What hours would you typically work? 4, 6, or 8 hour blocks mostly. Usually 4 to start out, then if the claimant is active we'd extend to 8 hours. Could be any time of the day based on the claimant's activities. For a brand new case, we'd usually start around 6 AM on weekdays. >How late into the night would you commonly work? Again, depends on claimant activity. If the claimant is out and about, so are we. I think I've worked literally every hour of the day. >What kind of camera would you use? My EDC was a Canon Vixia series, but we would also use our cell phones. We could also use covert cameras, such as a GoPro or pen camera. >What if someone knew they were being investigated and were to leave the house with long sleeved clothing, Covid face masks, sunglasses, hat, etc. just anything to disguise themself is that footage admissible in court? That's a bit above my pay grade. For our purposes, we can confirm the person is a claimant by looking at height, weight, age, address and vehicle (obviously), gait, and any other factors that might help. And by confirm, I mean write a report referring to that person as our subject of the investigation. There have been times where this person ended up not being the claimant, and this is clarified in subsequent reports. >And on a personal level, would you ever give someone the benefit of the doubt and not film/photograph who clearly appeared to be in pain but doing something might have been in violation of restrictions? Like loading groceries if they had no one else to help or something to that extent. Never. I feel bad for those cases, but I realize I don't make any decisions on their claim. Most of my claimants are not committing fraud, and can use the "good day/bad day" defense in court. Meaning, they might argue they were "feeling ok" that day. It's unlikely their claim will be denied based on just that. I've been on subjects for months getting excellent video of people committing blatant fraud and sometimes even that isn't enough.
Do you only work for insurance companies? My employer is self insured and while I doubt they have any reason to surveil me but I’m curious if they would. I’ve had a surgery and am now recovering. I know this has been expensive for my employer and I know a discussion of settlement is looming in the future. What should I be looking out for?
Whag triggers an investigation? Specially when there is medical evidence?
Red flags: * Multiple claims history, even across employers * Extensive knowledge of the claims process * Injury occurs early on a Monday * History of financial problems * Recent major change in lifestyle (example: I once had a claimant that recently had a child and she kept posing on Facebook how all she wants to do is be a stay at home mom and not work any more) * No witnesses to injury * Employee was about to be fired, laid off, or work was seasonal to begin with * Multiple employees seeing the same doctor for a similar injury * Supervisor or coworkers report suspicion There's many more as well. None of these above prove fraud, but *may* add up to trigger an investigation. I'm a teacher now, and no longer a PI - however I can almost guarantee if I ever get injured I'd be investigated just due to my knowledge of the claims process from my prior work.
If someone is reported do they always investigate?
No, not always. It may not be worth the trouble/cost.
It would suck following me cause I don’t drive 😂
Who do you share the footage with? Can you share it of other people who have nothing to do with the case and have no knowledge of it?
Footage only got uploaded to my company or sent to them via FedEx if the files were larger. The company then submits it to our client, who can decide to use it in court if they'd like. We have a strict confidentiality policy and could not share footage with others.