Corporate Canada and small business are beginning to realize that employee related fraud is detrimental to performance, customer service, outputs and the economic health of a company. Employee, or workplace fraud, come in many forms including: flagrant absenteeism; economic fraud; workplace harassment and/or violence; and lost productivity due to substance abuse. Moreover, the most difficult workplace fraud for an employer to address is fraudulent WSIB claims. These issues can be extremely delicate for an employer to deal with; however, expertise is available from Investigative Risk Management (IRM) and The IRM Solution is the pragmatic way to problem solve and reduce corporate exposure.
The mitigation of risk through effective management of WSIB claims is important because mishandling a claim can be costly. Fraudulent absenteeism claiming an inability to return to work can adversely impact production, operational effectiveness and employee morale. Additionally, the mismanagement of WSIB claims can seriously increase the premium employers pay and non-compliance with regulations, such as return-to-work policies, can result in significant financial sanctions.
It is fundamental that employers become familiar with the red flags which can indicate misuse of the WSIB system. The most prevalent red flag is a more extended period of absence than would be expected for the injury or situation. At times, reluctance on behalf of the employee to return to work is also an indicator. Another source of suspicion can result from third party information, intelligence or even rumors which indicate the employee has been working outside the company or seen participating in physical activities inconsistent with the type of injury sustained.
When situations such as these occur, it becomes very sensitive, especially in a unionized environment, and employers should seek professional advice to mitigate exposure and strategically plan next steps. The IRM Solution provides such expertise and can assist in the reduction of fraud. As part of due diligence require during the decision making process, the following guidelines should be considered before engaging The IRM Solution:
- What other proactive steps were taken before surveillance was authorized?
- Were the suspicions of fraud reasonable?
- Was the employee’s work history taken into consideration?
- Would surveillance contravene any contractual obligations?
- Were other alternatives considered before conducting surveillance?
Once a determination is made to conduct surveillance, a professional private investigation firm will ensure it is achieved with little intrusion and no infringement on the employee’s right to privacy. The determination of whether the absence is legitimate or fraudulent is the ultimate goal of The IRM Solution. The facts are gathered and maintained for tribunal presentation in the form of video, audio recordings, photographs and investigators personal observations. If the absenteeism is fraudulent, such direct evidence usually results in a successful conclusion and often avoiding a WSIB tribunal.
The IRM Solution provides consultation to guide the employer regarding timing as delays can protract a claim and engagement of surveillance at inappropriate intervals can be ineffective. Therefore, the investigator must work in partnership with the employer to strategically plan the surveillance taking into account all pertinent circumstances. It is prudent to conduct a minimum of three consecutive days of surveillance as one day of observation can be disputed by the claimant stating their physical activity caused them to be bedridden for the two days following. A continuum of continuity is fundamental to a successful surveillance. The IRM investigator, in consultation with the employer, will plan surveillance anytime, day or night, and at a variety of locations designed to obtain a multitude of activities in different environments.
IRM utilizes only the most modern and technologically advanced equipment. High definition video equipment with time and date stamping is not only preferred, it is the standard. Clear, concise and positive subject identification, factual establishment of the activity duration, and detailed video of the exact physical activity is fundamental to an investigation. Moreover, detailed written reports describing the observations will attest the claimant’s credibility, capabilities and daily activities. The investigational report will be authenticated through a certificate of authenticity. When/if required, the IRM investigator will provided credible, factual, professional and trustworthy evidence if a WSIB hearing ensues.
The IRM Solution can also been proactively engaged to investigate the circumstances surrounding an alleged accident. This can be particularly beneficial when the injury is serious or if there is doubt whether the injury occurred in the workplace. IRM investigators are experts in obtaining statements, photographs, measurements and other information relevant to the occurrence. An investigation of the actual incident should take place as soon as possible to secure facts and obtain statements before recollections deteriorate and/or evidence is destroyed. It is essentially prudent to engage a professional investigation firm to obtain an independent account of the incident; rather than a review from the employer which could be misconstrued as bias.
In conclusion, the protection of the Ontario workforce is a fundamental benefit to society and a much needed bureaucracy. However, is equally important that the system be protected from fraud and abuse. If not, sufficient funding will not be available for those who legitimately require assistance. Fraudulent claims are not only detrimental to companies through lost productivity and increased fees, it also impacts the taxpayer and innocent families of Ontario. A proactive human resource strategy utilizes a two pronged approach; protection and full support of the worker who is legitimately injured in the workplace, and zero tolerance for fraudulent claims and abuse. The Investigative Risk Management and The IRM Solution can proactively or reactively assist corporate Canada with professional and trustworthy advice, guidance and investigations all designed to mitigate risk. At IRM, personal client service and customer satisfaction is not just a notion; it is the cornerstone of our partnership with the client.