Workplace injuries in Pennsylvania happen frequently; a worker may suffer back pain, carpel tunnel syndrome or be involved in a workplace accident. These injuries may prevent workers from performing their essential job functions to the extent they can no longer work.
Workers' compensation is employer-provided insurance that allows injured workers to obtain compensation for lost wages and pay medical bills while they can't work, so long as the injury occurred in the scope of the employee's job duties. Most employers use a third-party insurance company in order to provide for this safety net.
Insurance companies require proof of a worker's injuries when they are not obvious, which can be difficult for certain medical conditions. For example, carpal tunnel syndrome can be difficult to prove as it has fewer outward symptoms than some other conditions. Medical opinions and self-reported pain can be used as evidence, but insurance providers seeking to limit claims are often skeptical of such injuries.
Workers' compensation insurance companies have several methods to try to establish whether a worker is injured. They may require an Independent Medical Examination, which is performed by a physician hired by the insurance company to verify or seek to disprove the injuries. Some physicians perform IMEs as a significant part of their practice, meaning they derive a large portion of their income from insurance companies to evaluate claimants and render opinions about the compensability of their claims.
Insurance companies may also use private investigators to follow and videotape claimants in order to verify that an injury is as disabling as the worker claims. These investigators may also speak with neighbors or fake emergencies, such as a flat tire, in order to lure the claimant into actions which the claimant says he or she cannot do.
Pennsylvania law does allow employers to hire private investigators to follow injured workers who have made workers' compensation claims. However, there are limitations to what these private investigators can do. Investigators cannot enter into a claimant's property, or even take photographs or videotape them in their home. However, investigators can take videos of claimants who are in public, meaning that investigators may videotape claimants outside of their home, or follow claimants to the grocery store, for example, and videotape them in order to catch them engaging in actions they claim they cannot perform.
What constitutes a private place? In one Pennsylvania case, Tagouma v. Investigative Consultant Services, Inc., an investigator videotaped a workers' compensation claimant through a window for 45 minutes while he was praying at an Islamic Center. The tape was used in his case as evidence and his claim was rejected. He filed a civil complaint against the surveillance company in court, alleging that this surveillance violated his right to privacy. The court disagreed, and the Superior Court of Pennsylvania reiterated that houses of worship are public places and workers' compensation claimants have a lowered expectation of privacy because they should expect to have their claims verified when they put their abilities and limitations at issue in a workers' compensation case.
Making a case
Pennsylvania laws take workers' compensation seriously, as it can be an essential part of an injured worker's finances. And insurance fraud is a serious matter; a conviction is a serious offense and can lead to significant jail time. However, for workers who genuinely can't perform their jobs, the claim process can be difficult and frustrating. Workers who have been injured on the job should contact an experienced Pennsylvania workers' compensation attorney to ensure they know their rights and what to expect throughout the claims process.