WORKERS’ COMP OR WORKERS’ CON?

HOW TO PROTECT YOUR BUSINESS FROM FRAUDULENT CLAIMS

When it comes to workplace injury claims, diligence is non‑negotiable. Most employees who file workers’ compensation claims are legitimately injured and deserving of support. However, employers occasionally encounter reports that appear inconsistent, exaggerated, or strategically timed — situations where clarity requires more than routine HR review.

Equites Private Intelligence specializes in uncovering the truth behind sensitive claims. Our investigators bring disciplined methodology, advanced surveillance capabilities, and intelligence‑driven analysis to help organizations evaluate questionable or high‑risk cases with precision and discretion.

Below is the structured approach we recommend when navigating potential fraud or misrepresentation.

STEP 1: DOCUMENT IMMEDIATELY AND THOROUGHLY

Start with verified facts. Establish a detailed record of the incident, including:

• Time, location, and any witnesses

• Reported symptoms or injuries

• Environmental or workplace conditions

• Available surveillance footage or access‑control data

A timely, structured incident report becomes the backbone of any subsequent investigative review.

STEP 2: REVIEW MEDICAL CONSISTENCY

Compare the reported injury against the job duties, incident description, and medical documentation. Common indicators of concern include:

• Delayed reporting of symptoms

• Vague, shifting, or non‑specific complaints

• Resistance to independent medical evaluation

The objective is clarity — not confrontation. Consistency matters.

STEP 3: CONDUCT A PROFESSIONAL INTERVIEW

Engage the employee respectfully and methodically. Key questions may include:

• Can they clearly describe the moment of injury?

• What specific tasks were they performing?

• Have they experienced similar symptoms or filed prior claims?

Tone is critical. The purpose is fact‑finding, not accusation.

STEP 4: LEVERAGE SURVEILLANCE & OSINT

When appropriate, discreet surveillance or open‑source intelligence (OSINT) can provide essential context. Indicators of potential misrepresentation may include:

• Activity levels inconsistent with reported physical limitations

• Social media posts contradicting medical restrictions

• Patterns of behavior that conflict with the claimed injury

Equites Private Intelligence employs ethical, legally compliant investigative methods — including covert surveillance, digital activity analysis, and structured intelligence review — to validate or challenge reported limitations.

STEP 5: REPORT, EVALUATE, ACT

Once evidence is collected, EPI assists clients in:

• Compiling findings into clear, litigation‑ready investigative reports

• Determining whether escalation to insurers, legal counsel, or internal leadership is warranted

• Maintaining defensible documentation for compliance and future reference

Every case is unique — and each must be handled with impartiality, discretion, and strict adherence to regulatory standards.

PROTECT YOUR ORGANIZATION WITH INTELLIGENCE‑DRIVEN CLARITY

When workers’ compensation concerns arise, Equites Private Intelligence provides the investigative rigor, discretion, and evidentiary strength needed to make informed decisions.