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Investigation of employees on disability

Region: Ontario Answer # 983

In some cases, employers or its insurers may be concerned that an employee involved in an accident while on the job is exaggerating either the extent of the injury, or the lack of recovery, in order to continue receiving benefits. In such cases, the employer or insurance company will often consider hiring a licensed private investigator to determine if fraud is occurring and to document it.

Investigators use a variety of legal methods to check on the validity of disability claims. These methods can range from interviews with the employee, to covert surveillance and monitoring.

The investigator will document many things, including:

  • the apparent degree of disability,
  • any physical restrictions or limitations the individual is exhibiting,
  • the employee’s daily activities,
  • the types of transportation the employee is using, such as driving a car or riding a bicycle,
  • if the person is getting assistance from a caregiver or housekeeper, or performing domestic duties on their own,
  • and whether the person is working at any other business to generate income.

Investigators must act within the law during their investigations and respect the privacy laws of individuals. For example, personal medical records in Ontario have substantial statutory privacy protection and can usually only be disclosed with the permission of the patient. Whether an employee must give that consent to an employer has been the subject of much litigation over the years. Courts and labour adjudicators have generally recognized individual privacy laws as an important factor to consider when deciding whether medical information should be disclosed. At the same time, tribunals have also considered the employer’s need to operate a business safely and efficiently.

If fraud is documented and proven, the employee may be fired “for cause” and lose his or her disability benefits.

Get help

For legal advice or representation, contact a lawyer.

To have someone conduct an investigation of an employee suspected of a fraudulent disability claim or other offence and for other investigation services, contact our preferred Investigators:

Smith Investigation Agency


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