Sometimes You Need an Investigator Who Can Think Inside The Box

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There are certain cases where “normal procedure” will produce no usable product while subjecting the investigator to potential difficulties. Subjects that live in very bad neighborhoods and drive as if auditioning for the demolition derby fall into this category.

This was a claim of bilateral carpal tunnel on its way to a finding of total disability. The first pass through the neighborhood in which our subject lived was not encouraging – very minimal parking in an area manned by drug dealers and their runners virtually 24 hours a day. The crack cocaine industry does not tolerate surveillance cameras or non-customers hanging around. (more…)

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Full Court Press

There are times when the claim reeks of fraud from the beginning. The examiner or the employer can react to red flags immediately. When this condition arises, simultaneous assignment of both AOE/COE and surveillance investigations can be an extremely effective. Chief among the many benefits of assigning an AOE/COE investigation and surveillance together is the certain knowledge of where the subject will be on the day the statement is to be taken.

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While we have handled many cases in this manner, one standsout as a particularly good example. The EE was claiming almost 100% knee disability. She had her statement with our AOE/COE investigator and a doctor’s appointment scheduled for the same day, so we knew she would be active. Our investigator arrived early and was alerted to a slight movement at the door of the second story entrance to her home. Quite suddenly, the EE exited and dropped a file of papers down her steps. The investigator obtained excellent film as she moved quickly, gracefully and without apparent difficulty to retrieve the documents in several trips. Her walking and bending skills, demonstrated on steep steps, appeared completely unimpaired. (more…)

Home Run King Strikes Out

Featured imageThe subject we were hired to investigate had numerous subjective back related complaints, supposedly the result of a fall from a loading dock. The injuries could not be verified by medical exam and he had been released back to work under modified duties (lifting restricted to 10 pounds, restricted bending and twisting).

The subject continued to report to work but was regularly leaving early complaining of pain. The subject’s general appearance (big, strong, apparently healthy) and the subjective nature of the complaints were the “red flags” that triggered bringing in an investigator. (more…)

Ms. Drama Queen

Featured imageThrough years of investigations, I have often found it to be true that “A claim is a solution to a problem, so what is the problem?” In other words, if you find out what the problem is that the person is having, you have the solution to your fraudulent claim.

Something didn’t seem right. A nurse had claimed a significant knee injury. She returned to work, then had to take off again, then back to work, then off again. (more…)

What Did You Say About My Overhead Projector?

Featured imageThere was a male claimant who worked in the audio/visual department of a large teaching hospital. For a year this man kept a secret diary of any and all negative comments made by his coworkers regarding the audio/visual equipment used at the hospital.

After a year of keeping his secret diary of these negative comments, the man filed a “stress” claim due to the nature of the comments made by his co-workers. He claimed that these negative comments had caused irreparable harm to his psyche, and that as a result he had suffered an inability to work or function in any workplace or common social situation. (more…)

Adrenaline

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Normally investigations don’t involve an excess of adrenaline in the blood system. Or if they do, one has messed up big time. But every now and then, the only way to get a produce requires that an investigator walk where angels fear to tread, which in turn can cause an elevated heart rate.

A recent file of mine is an example of the above. (more…)

The Case of the Correct Diagnosis

Featured imageStress claims are not the claimant/PI Attorney bonanza they were once upon a time, but they have not disappeared altogether.

This claim was based on workplace trauma and incident alleged to be so severe that our traumatized claimant could not work and filed for financial relief courtesy of the Worker’s Compensation carrier. According to her claim she could not leave her house or speak to anyone outside her immediate family.

She began treating with a psychiatrist as well. As the weeks rolled by, she showed no improvement.The examiner on the claim was among the people she could not speak to, and the claimant’s mother had to act as her representative. (more…)

Sweet Little Old Lady…NOT

Ladies of a certain age come in all varieties, as do 20-somethings and 30 somethings. The baby boom generation of ladies, like all generations of women and men alike, includes the good, the bad and the ethically challenged.

Featured imageMy inclination is to give little old ladies the benefit of the doubt, having had a very kindly grandmother who was good for cookies, cake and the occasional dollar bill slipped into my pocket when Mom wasn’t looking. However, if “grandmother” is the cover and distraction used to get away with a fraudulent claim that comes my way, my fondness for my grandma isn’t going to help you. If your claim is bogus, I will bust you. (more…)

Dude, Where’s My Disability Check?

It is amazing what you can do in plain sight in terms of getting film on Southern California beaches. The subjects who file for disability and then head to the ocean to engage in recreation inconsistent with their claimed injuries do not seem to react to camcorders in their vicinity. Perhaps it is the other tourists on the beach taking film to show friends back in snowbound Iowa that provides the camouflage.

In this instance, the subject, if he noticed at all, may have had dreams of being discovered by the movie industry and coming off disability to a starring role. This guy looked so good after two years of being off work, it seemed impossible that anyone had interviewed him as the payments went on and on.

The subject obviously considered himself completely safe from scrutiny after two years. Our first surveillance resulted in excellent film of more than an hour ’s worth of cleaning the home garage, complete with bending, lifting and sweeping. A good start.

Coming back on the weekend, I found him on his way to the beach with a surfboard on top of the car. The weather had been warm so fortunately I was dressed for the beach – shorts, Hawaiian shirt and flip flops. I found a good spot on the beach, set down a towel and proceeded to film the ocean while our subject got ready to surf. Once he was out on the waves, he was completely oblivious to me and the film was perfect.

He finally came out of the water and I thought I was done. Good thing I didn’t leave because he headed directly for the sand volleyball courts and within minutes, he was diving into the sand to save points, leaping above the net to spike, and generally making the activity of surfing appear to be restful.

I was well and truly sunburned by the time he packed it up. But I had some great film, and this guy’s claim was toast. Ultimately the film was turned over to the DOI for prosecution.

The appearance of vibrant good health, a great tan and physical evidence of membership in a well-equipped gym do not normally appear in lists of red flags, but perhaps an addendum would be in order.

A Rural Challenge

A first rule of surveillance in rural areas is: When in Rome do as the Romans do. Or perhaps better stated: Look like what a Roman would expect a stranger to look like. For the last several years in many situations, that has meant: look like you are interested in buying real estate. [Editor’s note: this investigation was done in 2006.]


Our assignment involved a claimant alleging total disability and he was located near a small (population 400) farming community in the middle of Missouri. I arrived just prior to Labor Day weekend and quickly realized this was not going to be a walk in the park.

First, the Mapquest to the claimant’s only known address led to the fifth row of a cornfield. Second, Labor Day was approaching rapidly and every store and public facility in town was closing. We knocked on the door of the tiny City Hall, the only known repository of records, but got no answer. It looked like it was shut down tight already. Main Street was deserted. But the experienced investigator knows where he can get information even when faced with such daunting absences – the nearest bar.

Finding the bar was easy, but soon I was striking out once again. Asked about land I “heard” our claimant had for sale, the bartender knew nothing. The few patrons in the place knew nothing. I stepped back into the dusty street with an uneasy feeling and not one good idea of where to go next.

But I was rewarded for not staying in the bar to enjoy several cold ones and feel sorry for myself. A woman approached and asked if I had knocked on her door. Turns out she was City Hall staff, by herself in the office and on the phone, thus unable to answer the door. One thing led to another and pretty soon I was studying a map showing the location of every house in town.

I soon arrived at the residence I found on the map, and confirmed it was the home of our claimant. But the test of investigator will was not over. There was no activity. I waited and still nothing, totally quiet. Some digging was in order and once again I resorted to an establishment purveying liquid refreshment.

This time, closer to the residence, I came up with what I needed. The claimant was possibly building a house in a nearby town, and was known to be in Southern Missouri attending a wedding. Best of all he was expected to be home later that night.

The next day I followed the claimant from his house out to a farm ten miles outside of town. That was easy, but it turned out this assignment, as a test of investigator will, was the proverbial Bar Exam or SAT. There was no place to park outside of obvious view. Farmhouse, fields and the road –

that was all there was. No trees, no stone outcrops, not another parked car within five miles. No hills with vantage points from which to view the farm.

Your tireless investigator proceeded to the last resort — staging a vehicle breakdown off the side of the highway just beyond the claimant’s farm (and disconnecting the battery in case the claimant proved to be a helpful type, which he did not). The claimant ignored the vehicle with its hood up and just continued with his farm work. I was thankful for this attitude as I sat in the back with video rolling.

As any professor of agriculture (or five year old child) will tell you, farm work is not an appropriate use of time for the totally disabled. Just looking at the video of our claimant cruising by on a tractor, bouncing around over rough ground, and manhandling bales of hay makes me want to lie down and take a nap.

Our video was the end of that claim. And in my estimation, a pass with flying colors on this particular test of investigator will.