In Cornelison v. TIG Insurance, claimant injured his back in 1996, while he was shoveling dirt at work. He underwent back surgery after his accident, but it did not help resolve his pain and medical conditions. He filed for workers’ compensation benefits, and the board determined he was permanently and totally disabled under a state law doctrine known as the odd-lot doctrine. His date of disability was 2001.
Claimant did not contest this PTD rating, and he also began to receive to Social Security Disability Insurance (SSDI) benefits. While it is okay for an injured worker to receive SSDI benefits in addition to his workers’ compensation benefits, he will be required to offset the payments by reimbursing the workers’ compensation insurance company, so as to avoid what is known as a double recovery.
Seven years after worker was declared disabled, the insurance company sent investigators to see if claimant was still disabled. As our Boston workers’ compensation lawyers have seen, insurance companies will often go to great lengths to try to prove someone is not able to work, or actually working and not reporting it. This is an effort to maximize profits for the insurance company. While it is true that claimants should always be honest on their claims, we have seen insurance companies claiming people are able to work and canceling benefits when it is obvious that the claimant is truly disabled and in need of benefits.
In this case, the insurance company hired private investigators to secretly record the claimant and that company edited the recorded footage and provided it to the insurance company as evidence the claimant was engaging in activities showing that he could actually work and was not in need of the workers’ compensation benefits he had been receiving for years. The investigators also drafted reports to go along with the video recordings.
The claimant asserted that this video was not accurate, because it was edited in such a way as to make him look capable of working when he actually wasn’t. The reason he claimed the investigator did this was because it made him look like a more skilled investigator and would make it more likely the insurance company would use his services in the future, since he was saving them money.
The claimant and his wife filed a lawsuit against the insurance company and the investigator’s company that asserted damages for colluding together to take a way his benefits, make him look like he was guilty of fraud, and for emotional distress against him. The defendants filed a motion for summary judgment, and the court granted that motion. The claimant appealed, and, on appeal, the court determined that there was a genuine dispute as to a material fact as to whether the videos were edited, and, if so, they were edited in a way to make him appear capable of working when he was not. The court also concluded that there was enough evidence for the jury to make such a determination as to whether or not claimant had suffered from emotional distress.
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Cornelison v. TIG Insurance, August 12, 2016, Supreme Court of Alaska
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Parr v. Breeden – Supervisor Co-Workers Not Liable Under Workers’ Comp Exclusive Remedy, July 3, 2016, Boston Work Accident Lawyer Blog