Investigation and Surveillance

What is the role of an investigator in NY workers’ compensation?

In New York State Workers' Compensation, an investigator plays a crucial role in detecting fraud, verifying claims, and gathering evidence to ensure the integrity of the system. Their responsibilities typically include:

• Surveillance & Field Investigations: Conducting video and photographic surveillance to verify whether a claimant’s reported injuries align with their activities.
• Background Checks: Reviewing a claimant’s history, including prior Workers’ Compensation claims, employment records, and social media activity for inconsistencies.
• Interviews & Statements: Interviewing claimants, employers, and coworkers to gather information about the injury and work conditions.
• Medical & Employment Verification: Confirming that medical treatment and work restrictions are consistent with the claim.
• Fraud Detection: Identifying potential fraud, such as working while collecting benefits, exaggerating injuries, or misrepresenting the cause of an injury.
• Reporting & Testimony: Preparing detailed reports and providing testimony in administrative hearings or court proceedings.

Investigators may work for insurance carriers, employers, law firms, or state agencies, and their findings can be used to challenge questionable claims, adjust benefit payments, or refer cases for legal action.

At Asch Workers’ Compensation Strategy, we often recommend the strategic use of surveillance as part of a comprehensive claim management approach—beginning with the reported injury and continuing throughout the claim when appropriate. While we do not conduct surveillance ourselves, we have investigative services on our team and advise employers and insurers on when it may be a valuable tool, especially in cases where there is a concern about potential fraud. From initial interviews to ongoing claim evaluation, we help you build a smart, defensible strategy from start to finish.