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DeRidder, LA (WorkersCompensation.com) -- If a company or carrier suspects an employee of making false statements to obtain or extend workers’ compensation benefits, having a private investigator film the claimant’s activities prior to and after the exam might be the key to succeeding.
That’s how a Louisiana timber company cut down a logger’s benefits for good in Medley v. Bennet Timber Co., No. 24-164 (La. Ct. App. 11/27/24).
The logger injured his back while working on Feb. 23, 2019. He fell from a logging skidder and suffered injuries to his neck and back, for which he later underwent surgery.
By April 2022, an independent medical examiner concluded that the employee had recovered and could work. He recommended conducting a functional capacity evaluation. The claimant, perhaps inspired by his many years working with wood, arrived at the FCE using a long walking stick to get around.
At the FCE, on Aug. 17, 2023, the claimant walked very slowly, and complained of increasing back and leg pain and lack of dexterity while trying to lift, carry, walk, bend, crouch, and kneel. He said he could not complete many daily tasks such as carrying his child and that he relied on the walking stick to ambulate. He could not, for example, walk over a curb without the stick.
The company terminated his benefits based on misrepresentation. The claimant challenged that decision in court.
To terminate benefits under La.R.S. 23:1208(A), the court explained, a company or carrier must show:
- That there was a false statement or misrepresentation;
- That the employee willingly made the false statement misrepresentation; and
- That the employee made the false statement or misrepresentation for the purpose of obtaining any benefit or payment under the Workers' Compensation Act.
While the claimant appeared to make a convincing case, there was actually a movie version of this story which told a different tale. That’s because, on August 1 and 17, 2023, two separate private investigators took surveillance footage showing the claimant doing with ease nearly all the activities he claimed he could not do.
In fact, arguably exercising great judgment, the company had an investigator video the claimant’s activities just prior to and just after the FCE. Footage showed him entering and exiting the facility where the FCE took place, walking slowly and using his walking stick. The FCE lasted four and a half hours. After he left, he was seen driving his truck around town, and, miraculously, walking to a restaurant without his stick, carrying his son in one arm into the restaurant, and walking over a curb without the stick. Other surveillance footage showed him lift a bag of bottles over his head and place it into the back of his pickup truck.
“At no point after Claimant left [the FCE facility] is he shown on surveillance footage using his walking stick,” the court wrote.
The court agreed that the claimant misrepresented his injuries in an attempt to prolong his benefits by severely exaggerating. The claimant’s misrepresentations about his reliance on the stick, difficult walking, and inability to carry his child were directly contradicted by the videos.
The court affirmed the termination of his benefits.
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