Workers Compensation Fraud Investigations

 AOE/COE INVESTIGATIONS

Interviews play a key role in the claims investigation process. Specifically, this includes AOE/COE investigations, which stands for “Arising Out of Employment or in the Course of Employment.” However, we’ve noticed that some investigators who specialize in this area fall short. For example, they may fail to gather information that could later support a fraud case, or they may leave out basic details that surveillance investigators need.

That’s why Corinthian Group uses experienced, highly trained professionals for every AOE/COE investigation. As a result, our clients receive a thorough, detail-rich report they can rely on. Our investigators typically bring either surveillance experience or a background in building fraud cases for prosecution. In our view, both types of experience are essential for the best possible claims outcome.

We approach every case with three clear objectives in mind. First, we make sure the defense attorney has all potential evidence needed to help mitigate the claim at the initial deposition. Second, we ensure that surveillance investigators and everyone else involved in the case have access to accurate, verified personal information. Third, we ask strategic questions during interviews that could later serve as evidence in proving fraud.

When one skilled investigator manages a case from start to finish, the benefits are clear. Because this investigator understands both short-term and long-term goals, the entire process becomes more efficient. Ultimately, this benefits everyone involved in the case.

Return to Work

Some employees seek full or part-time “under the table” jobs, often to earn extra cash while avoiding discovery. In fact, it’s fairly easy for a claimant to maintain or even improve their standard of living when combining part-time work with a guaranteed disability paycheck. Unfortunately, some individuals take this approach at the expense of others.

Here are just a few benefits claimants may receive while on disability:

• A portion of their monthly income while staying home
• Medical treatment for injuries that may or may not be work-related
• The potential for extra income through other jobs or job training in a new career
• More time with family and friends
• Extended time off, potentially with future paid vacation
• A significant payout if the claim goes unchallenged

Simply put, claimants have little incentive to return to work when claims go uninvestigated. However, this can change quickly. If our investigators uncover evidence showing a claimant is no longer injured and can return to productive work, benefits can then be terminated.

Based on our experience, most injuries are real and occurred as reported. That said, many claimants do exaggerate the severity of their injuries. As a result, employers and taxpayers often end up unknowingly funding a healed claimant’s extended time off.

Corinthian Group’s investigations frequently uncover the full picture. We work to confirm whether a claimant is working elsewhere, and we gather the strong evidence needed to support your case. Even when there isn’t enough evidence for a fraud referral to the District Attorney, our efforts often encourage claimants to return to work sooner rather than later.