Nolan Enterprises helps employers and insurance carriers with Sub Rosa Workers Comp Fraud investigations.

Workers Compensation fraud occurs when an employee misrepresents the severity of a workplace injury to gain a financial benefit. Examples include lying about an injury or an illness, exaggerating the extent of an injury, or working another job while accepting workers compensation benefits. Based on estimates by the National Insurance Crime Bureau (NICB), workers’ compensation fraud costs U.S. employers $30 billion annually.

Workers Comp fraud costs California employers $1 to $3 billion per year.  In addition, fraudulent claims result in higher premiums for all California employers. The surveillance team at Nolan Enterprises is experienced with Sub Rosa investigations.

Contact us to learn more about our experience conducting Sub Rosa investigations.

The most common forms of Workers Compensation Fraud include:

“Double Dipping” – an employee Claimant files a fraudulent claim, claiming they are unable to work. They begin collecting Worker’s Compensation benefits, but also get another job, and thus collects two incomes. If the claimant was genuinely injured, they would not be able to work due to the claimed injury. Nolan Enterprise is adept at locating claimants, tracking their activities in a legally permissible manner, and documenting the fraud.

Exaggerated injury or illness – An employee Claimant exaggerates the extent of a genuine injury or illness.

Fictitious injury or illness – An employee invents an injury or illness that never occurred.

Injury did not originate in the workplace – An employee is injured away from the workplace but misrepresents the origin of the injury in order to receive benefits. The employee may also exaggerate the extent of the injury.

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What is a “Sub Rosa” investigation?

Sub Rosa is Latin for “Under the Rose.”  The rose is an ancient symbol of secrecy.  In the context of Worker’s Compensation Fraud, a Sub Rosa investigation refers to legally permissible covert surveillance of a Claimant suspected of filing a fraudulent claim.  The goal is to not be detected and observe the Claimant acting naturally to determine if their level of activity and behaviors support or disprove the alleged injury or illness.

Is my employer allowed to perform surveillance on me?

It is not illegal for an employer to hire a licensed Private Investigator to investigate potentially fraudulent Worker’s Compensation claims.  As long as the investigator does not audio record the Claimant,  does not use telescopic lenses, and does not obtain footage in places where there is an expectation of privacy, such as restrooms or locker rooms.  As long as the investigation is conducted in a lawful manner that does not violate privacy, it is legal.

Resources

State of California Department of Industrial Relations, Workers Compensation Appeals Board

California Department of Insurance – Fraud Division