Surveillance on a Workers' Comp Claim: An Employer's Playbook

Claimant attorneys post videos warning injured workers that they are being watched. They call surveillance a dirty trick. From the worker's chair, it feels like spying. From the employer's chair, it is one of the few tools that answers a question paper cannot: what is this person actually doing?

Carriers order surveillance every day. The question is whether anyone orders it on your claims. Most of the time, the answer is no, not because the file did not warrant it, but because nobody asked.

What surveillance actually is

In workers' comp, surveillance means a licensed investigator documenting a claimant's public activity. That usually means video of daily comings and goings, checks of social media, and sometimes background research. Investigators work within clear legal boundaries: public places, no trespassing, no harassment. Their reports and footage are built to hold up at a hearing.

It is not an accusation of fraud. Think of it as a second opinion on the facts, the same way an independent medical exam is a second opinion on the medicine. Plenty of surveillance comes back showing nothing unusual, and that is useful too. It tells you the claim is what it says it is, and you can manage it accordingly.

The red flags that justify it

Surveillance pays for itself when the file has questions that documents cannot answer. The classic triggers:

• The story keeps changing. The mechanism of injury shifts between the incident report, the ER intake, and the hearing testimony.
• Restrictions do not match observations. Coworkers or supervisors have seen activity the medical file says is impossible.
• Social media tells a different story. Weekend activities, sports, travel, or side work that contradict reported limitations.
• Reports of other work. The claimant may be earning wages elsewhere while collecting lost-time benefits.
• The drifting file. Months of treatment with no objective findings to explain ongoing disability, no measurable improvement, yet no resolution either.
• Selective availability. Unreachable for scheduled medical appointments or claim calls, but active everywhere else.

Any one of these alone might be nothing. Two or three together are a reason. Write them down with dates, because you will need them in the next step.

What it costs, and the math that matters

Several days of surveillance typically costs a few thousand dollars, depending on your market and how many days of coverage you authorize. That number sounds like a lot until you put it next to the alternative: a single questionable claim can carry six figures in reserves for years, and every dollar of it feeds your experience mod.

Do the comparison on your own files. If footage shortens one claim by six months, supports one denied benefit, or gives an IME doctor the context to find maximum medical improvement, the return is not close. Surveillance is one of the cheapest investigations in the entire claims process relative to what it can resolve.

How to get your carrier to order it

The carrier can order surveillance on its own authority. In practice, on most files, nobody asks. The adjuster is managing hundreds of claims, and yours gets attention when you give them a specific, documented reason.

Send the request in writing. List the red flags you documented, with dates. Then use language like this:

"We have noticed the following inconsistencies and would like to discuss whether surveillance is appropriate to clarify the claimant's current activity level."

Frame it as case management, not accusation. Accusations put adjusters on the defensive. A factual request for an investigative tool gets a professional response. Ask for the decision in writing either way. Adjusters who have to document why they declined surveillance tend to take the next request more seriously.

If the adjuster says no and you disagree, escalate to the adjuster's supervisor or your broker. You are the customer. A documented pattern of ignored red flags is also useful later if the claim goes sideways and you need to show the carrier did not act.

What to do with the footage

Footage sitting in a file helps no one. Put it to work:

• Send it to the IME doctor before the exam. A physician who can compare reported limitations against observed activity writes a far more useful report.
• Share it with defense counsel before a hearing. There is a difference between arguing about credibility and watching it.
• Use it in settlement discussions. Objective footage changes the negotiation math for everyone.
• Keep it in the file. Even footage showing nothing unusual has value: it closes the question and lets you manage the claim on its medical merits.

What not to do

A few boundaries that matter. Do not conduct surveillance yourself, and do not ask a supervisor to follow anyone. Use licensed investigators only. They know the legal lines, and their work holds up when it counts. Do not use footage to harass or embarrass a worker. And do not expect surveillance to fix a claim that is really a medical management problem. It answers one question, what is this person actually doing. That is all it does, and sometimes that is everything.

The employer's edge

Here is the structural advantage you hold: the red flags are visible to you first. You know the worker, the workplace, and what does not add up. The carrier sees a file number. Surveillance is simply what happens when someone acts on what you noticed. The files where nobody acts are the ones that drift for years.

One written request, listing what you have seen with dates, is often the difference between a claim that gets investigated and a claim that gets processed. Be the someone who sends it.

CompShield is a workers' compensation claims-defense and cost-control firm. This article describes surveillance in workers' compensation claims in general terms and is not legal advice. Investigation laws vary by state; consult counsel before ordering or using surveillance.