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The Gray Area of Using Social Media to Investigate Workers’ Compensation Claims

Workers’ compensation was implemented as a way in which men and women could receive monetary compensation for injuries that occurred during the course of employment without protracted litigation. When a person could show that he or she was injured and that injury arose as a result of the duties and obligations of the employment that he or she is engaged in, generally he or she may be able to bring a workers’ compensation claim without argument. This is because workers’ compensation is no-fault, which means that an injury is an injury no matter the extent that the worker contributed to his or her own injury.

The Cost of Workers’ Compensation Fraud

However, the National Insurance Crime Bureau has estimated that workers’ compensation fraud costs the government more than $7.2 billion a year. As a result, the insurers are looking to combat fraud wherever possible and in any manner possible.

The Rights and Prohibitions of Investigators to Investigate Fraud

With the progress of technology and innovation, investigation of workers’ compensation fraud has used several technological methods to determine whether a workers’ compensation claim has merit. However, this has led to significant discussion about the appropriate methods by which to investigate workers’ compensation fraud and privacy rights of the individuals who claim an injury.

Investigation Without Probable Cause May Be Contrary to the Intent of Workers’ Compensation

The system that was put into place for workers’ compensation was put there to remove the administrative burden of litigating any and every claim of workers’ compensation. Companies explicitly buy insurance to cover any workers’ compensation claims that may arise during the course of employment. However, with the ever-increasing fear that fraud is becoming more and more present in workers’ compensation claims, administrative funds and resources are being directed to covertly investigate claims, even though that is counter to the system established in the first place.

How Investigators Use Social Media

major tool for insurers is social media. This lends itself to significant privacy issues, particularly when the insurers are spending valuable resources on surveying a claimant’s social media to determine whether that person is actually injured and/or the extent of the injury. For example, if a claimant states that he injured his back during the course of employment, but is seen in his social media webpage playing sports with family and friends, the insurer will have adequate evidence to demonstrate that he either was not injured, or that his injuries were not to the extent that would provide that he needed physical therapy or should receive paid leave resulting from his inability to work.

Social media may be used by investigators to prove that an injury did not occur or that it is not as debilitating as stated by the claimant, and social media may also help investigators find witnesses if they are considering prosecuting the claimant for fraud.

Limitations on the Use of Social Media

There are rules that investigators, lawyers, and law firms must follow if they are considering prosecuting a claimant for fraud. If a lawsuit is filed, the lawyer, law firm, and investigators are not permitted to “friend” or “follow” a claimant on social media as a means to obtain private information. Generally the rules require that the investigators can only use publically available information to bolster the evidence for their case, unless a warrant or subpoena for the information has been executed.

Charles County, MD Personal Injury Lawyers that Fight for You

If you or a loved one was injured during the course of employment, it is important to consult with an experienced personal injury attorney. Please call the Law Office of Robert R. Castro at (301) 804-2312 for a confidential consultation.

For Maryland Injury Lawyers:

When Can a Secondary Injury Fall Under Maryland’s Workers’ Compensation Act?

The Maryland Workers’ Compensation Act states that an employer must provide compensation to an employee who is accidentally injured as a result of his or her employment and during the course of the employment. The purpose of the Maryland Workers’ Compensation Act is to ensure that employees are adequately compensated for any injuries that arise out of an employment whose tasks and duties may be risky or inherently dangerous. This protection is there to protect employees who work in a risky or dangerous profession, but also to protect employees who may work in a profession not notorious for being dangerous. In either circumstance, if there is an accident that occurs in connection with employment, the employee is covered.

What is a Secondary or Subsequent Injury?

The issue of secondary injuries that occur in connection to the initial injury in a workers’ compensation case has recently arisen. In other words, a person may be injured at the office during the course of his or her employment, and then while on his or her way to physical therapy to help address the issues relating to the first injury, the employee may slip and fall on ice outside of the therapist’s’ office. Does an accident that is related to the first injury but that occurs outside of activities related to employment and not on official employer property constitute a secondary injury that would be covered by the Workers’ Compensation Act?

Maryland’s Approach to Subsequent Injuries in the Past

Maryland courts have dealt with subsequent injury cases in the past, and depending on how the secondary injury occurs, will determine whether or not that secondary injury is covered under workers’ compensation. For example, an employee in one of the earlier workers’ compensation cases had a heart attack during a deposition regarding a previous injury that occurred that the employee was attempting to claim under workers’ compensation. The court held that though the heart attack was related to the stress of being deposed during the workers’ compensation claim, however, did not provide benefits under workers’ compensation because the heart attack and the initial injury were only tangentially related.

Maryland’s Approach to Subsequent Injuries Recently

However, in recent years, Maryland courts have been more open to arguments proffering that the subsequent injury should be compensable if it occurs as a direct and considerable result stemming from the initial injury, for example, where the subsequent injury occurs close in time to the first accident. This situation would be more likely to be successful when a person is initially injured and then slips and falls on ice outside of his or her therapist’s office at the first appointment, rather than where the person slips and falls on ice three years after the initial injury.

The Application of the “But For” Test vs. the Application of the “Direct and Materially Related” Standard

According to Maryland courts, it is not enough that a claimant satisfies the “but for” test. The “but for” test requires a tentative connection between the first action and the second, for example, where a claimant is injured at work, and then on his or her way to the doctor, he or she is hit by car. The “but for” argument suggests that because the claimant was injured, he or she was in the wrong place at the wrong time to be hit by the car. There is a “but for” connection, but that does not mean that the claimant has shown a direct and causal relationship between the first accident and the subsequent injury. In other words, to win a claimant’s case, he or she would have to demonstrate that the second injury was caused (whether directly or indirectly) from the first injury.

Charles County, MD Personal Injury Lawyers that Fight for You

If you or a loved one was subsequently injured as a result of an initial injury that was covered under Maryland Workers’ Compensation Act, it is important to consult with an experienced Waldorf personal injury attorney. Please call the Law Office of Robert R. Castro at (301) 804-2312 for a confidential consultation.