Ever wondered why you are being surveilled for so long? Despite the fact that most (99%) of workcover claims are perfectly legitimate, workcover insurers will continue wasting hundred of thousands of dollars on ‘surveillance practices’ of injured workers, including avoiding the “good day – bad day” arguments/defence used by injured workers, by recording/surveilling the activities of injured workers over a long or longer period of time.
Workcover surveillance: filming longer to avoid ‘good day bad day’ argument
As we have mentioned before, there are many types of fraud investigation used by workcover insurers and their snooping firms, including: a general investigation, an activity check, a Sub-Rosa investigation, scrutinising medical records (incl. sweep of hospitals), workplace surveillance/monitoring and the popular virtual or Social Media investigation.
Workcover insurers are hoping to uncover any type of ‘fraudulent behaviour’ as a desperate attempt to mimimise an injured worker’s benefits and/or payout. Your case manager will go to great lengths to document ‘suspicious behaviour’ and will take immediate and rather intimidating ‘action’ in an effort to disprove your claim(s).
If the workcover insurer only has a short snapshot of the injured worker’s activities on surveillance footage, they know it is not an indication of the overall condition of the injured worker and in recent court hearings, more and more judges rule that the surveillance evidence is not enough to prove “inconsistent activity”.
In addition to undertaking prolonged surveillance, the workcover insurer case manager will also use various hard-ball tactics in order to discredit you, your claim or “prove” you are “exaggerating”. These tactics include abrasive, hard-core, and desperate communication with your treating doctor(s), including specialists. In fact they basically threaten your treating doctors!
For example, should the prolonged video surveillance show the slightest suggestion an injured worker is ‘doing more’ than claimed, or medically prescribed; the case manager will be the 1st one to jump on the ‘opportunity’ and express-post the video surveillance (usually a short version!) to your treating doctor(s)/specialist(s) together with a letter demanding whether the activity (if , errh, prolonged) is contrary to what the case manager/insurer are being told about the injured worker’s abilities! They will also use their own in-house so called “Medical Advisors” for a review and commentary of the video, and at times, the case manager or the medical advisor may make an appointment to “discuss” the video surveillance “findings” (This can be via telephone or in person).
The case manager and/or the insurers medical advisor will then “explain” the situation to your treating doctor(s)/specialist(s) and reinforce that this doctor/specialist has issued a workcover certificate of incapacity. For example, the case manager will state to your doctor ” “You indicated on a Workcover certificate of incapacity provided to Miss. Doe (injured worker) she was/is unable to work because she has/had very limited range of movement and significant pain in her dominant shoulder/arm. However, in light of the surveillance investigation videotape and PI report enclosed, could you please review this situation and determine whether Miss. Doe’s range of movement is still very limited/impaired. Our investigators (PIs) observed Miss. Doe on 3 consecutive days one week and 4 days another week, doing some gardening. Additionally, over last weekend she was observed by the PI playing with her dog for at least half hour at a time. According to the video, she was/is doing these activities without any apparent physical limitation(s).” A new workcover certificate (form) will also be included with the video and the cover letter, as well as a direct phone number to “discuss”.
The case manager and/or the medical advisor will basically ask the injured worker’s treating doctor (usually more than 1 especially if not happy with the answer provided) if they agree the injured worker is now able to perform her/his pre-injury (or suitable duties) job as XYZ and they will go as far as to request an amendment of the workcover certificate of capacity form. They will also use strong language, such as you have 24 hours to post or fax your report, or immediately, to the insurer’s office! So they will subtly (but surely) threaten the injured worker’s doctor if s/he does not make changes to the workcover certificate!
Again, what can we learn from the above?
Always abide by your medical restrictions! If you are planning on doing something else, i.e. try an “activity” such as for example, walking your dog with a back injury; tell your doctor and ask if it’s OK. Or at the very least inform your doctor for example that on X day you “attempted to walk the dog…” however experienced significant pain afterwards (and won’t do it again)…. or that “you had no option but i.e. put the garbage bin out because…” and did use your bad arm, again at the cost of 24 hrs in bed the next day… , whatever.
The most important thing is that you are honest with your treating doctor(s) and inform them of any “new” activity you feel you can now undertake, or any new activity you may want to try, or undertook at the cost of [pain] etc.
And we know it shouldn’t be like this, that we, injured workers, should not be big brothered like a bunch of criminals 24/7 just in the hope of hopes we “slip up”.
Remember that they are everywhere, and desperate to catch you out on something utterly trivial.
[Post dictated by Workcovervictim, and manually transcribed on a different day on behalf of WCV – many articles are prepared way in advance by WCV, on “better days” (indeed) and/or over the span of several days at least (difficulty using computers and lack of concentration), to be finalised and manually transcribed by a support person, when time.]
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