If there is a question concerning the validity of your Nevada workers compensation claim, an investigation may occur in an effort to prevent workers’ comp fraud. During such a probe, the insurer may call and ask questions or may even request surveillance of your activities. You should cooperate with the adjuster in regard to any questions or investigations, though you may wish to find out more before providing answers to the requested questions. Because conversations with the adjuster may be recorder, it may help to hire the assistance of a qualified attorney to help if your claim is being investigated.
Is a Surveillance Investigation Legal?
In an effort to reduce workers compensation fraud, it is legal in the State of Nevada for an adjuster to hire an investigator to watch you to see if your injuries are legitimate. It is equally legal for any investigators to video tape you performing activities at home and in public. The investigator may park in front of or near your home and film you doing everyday activities. These recordings are used to verify your injury and activity restrictions with your medical care provider.
Should I Cooperate with the Adjuster?
It is always wise to cooperate with the adjuster regarding your Nevada workers compensation claim. Be polite and provide truthful and direct answers to any questions. You should speak respectfully to the adjuster for the best chance at receiving an approval for benefits on your claim. However, you only need to provide answers to the questions. There is no need to provide additional information that is not requested so that this information cannot be used against you. If you are not sure on the exact details, tell the adjuster and offer to get back to them with the correct information.
Why is the Insurer Investigating my Claim?
Before granting permission to give a recorded statement to the adjuster, you may wish to politely ask why a recorded statement is necessary. You may wish to see if the concern lies with information provided by your employer or medical care provider. If you know where the adjuster’s concerns lie, you can offer to provide any additional information that will make it easier for the adjuster to approve your claim for Nevada workers compensation benefits.
Will My Workers Compensation Claim Be Denied?
Your conversation with the adjuster may offer clues as to whether or not your claim may be denied. The most common reasons for denial of benefits occurs due to:
- • There were no witnesses to accident or injury;
- • You were recently hired;
- • The accident or injury occurred on a Friday but you did not make a report until Monday;
- • You have a bad relationship with your employer;
- • Someone else at your job knows that you have existing medical problems;
- • You filed injury claims with more than one employer.
If you think that your claim may be denied, you may wish to consult with an attorney before you agree to make any recorded statements with the adjuster.
Surveillance Investigations and Recorded Statements
Surveillance investigations and recorded statements are used by the State of Nevada in an effort to reduce the number of fraud cases involving workers’ comp benefits. By recording activities and statements, the adjuster can determine if your actions and answers are consistent with your alleged injury or if you are trying to commit fraud to receive benefits to which you are not entitled. Recorded surveillance activities are frequently sent to your physician to make sure you are not able to perform activities that are inconsistent with the doctor’s recommendations.
Legal Resources for Nevada Workers Compensation Surveillance
One of the problems with surveillance investigations is that the injured worker does not receive a copy. Any damaging evidence is not apparent until the claim is denied or benefits stop. The injured worker does not have a chance for a defense until the evidence has already had a negative impact and potential fraud is determined. If you are subject to an investigation of your claim or your benefits, the Morris / Anderson Law Firm is available to help. Do not risk losing your benefits or having your workers’ comp claim denied without being able to provide a defense. One of the experienced attorneys can make sure that you obtain the proper information and any additional medical examinations that are necessary if you are eligible to receive benefits.Go to the Next Article