Scheduling Surveillance on the Date of a Medical Appointment: Benefits & Drawbacks

The IME date is set… the PT schedule is in… now what? Should surveillance be scheduled before, during, or after? What is the best method to obtain the most accurate video account of the claimant’s level of activity? 

In order to defend a case, you need to have the most comprehensive information pertaining to the claimant’s capabilities. Medical appointments are a great opportunity for surveillance specialists to gather video of claimants’ activities, as well as learn about residency, vehicle information, and much more. However, with the benefits come certain drawbacks, and you need to be equipped with the right information in order to make the best informed decision for your case. 

Scheduling surveillance is a science. We are providing... a cheat sheet. 

The Benefits of Covering Medical Appointments

The first, and in my opinion most important, benefit of scheduling surveillance on the date of an IME or FCE is the high percentage of claimant activity. It might not be 100%, but it’s darn close. Unless cancelled in advance, claimants are usually required to attend these medical appointments. Getting a claimant in our sights can be vital to a successful investigation.

A second benefit to covering a medical appointment is the ability to confirm residency. Often times, we deal with transient claimants. Some claimants provide employers and medical providers a mailing address only. We need to know where they are sleeping if we want to be successful on future surveillance dates.

Recently, we handled a case for a client who had no information about the claimant’s residency. Once assigned the case, our case prep process revealed that the claimant had a transient lifestyle. We used the IME to our advantage and confirmed the claimant’s identity, developed vehicle information, and discovered that the claimant was residing with his girlfriend.

This information allowed us to schedule further surveillance and led us to develop crucial information for the case… the claimant was operating his own HVAC small business while out on a worker’s comp claim. Needless to say, scheduling surveillance on the day of the IME paid large dividends.

A third benefit would be the ability to document the claimant’s activities after the appointment. Once a claimant is out of the house, they are likely to complete other errands. This allows for us to observe their mobility and document their restrictions. Sometimes, the claimant’s physical movements at a medical appointment will serve as a measurement stick to compare to future activity.

We had a claimant show up at a medical appointment utilizing a cane as he limped in and out of the doctor’s office. Less than 2 hours later, we observed him lifting a refrigerator off of a pickup truck. These two contradicting displays of physical ability raised questions to the claimant’s credibility.

Drawbacks to Covering a Medical Appointment

With all positives come certain negatives. On most occasions, the benefits will outweigh the drawbacks, but it is important to keep these possibilities in consideration.

The drawbacks will not apply to all investigations, but you will see that they all have a common theme: Don’t schedule surveillance solely on the day of a medical appointment – the results may be misleading!

One major drawback is that a medical appointment presents an interruption in one’s daily routine. The claimant may regularly visit the local fitness center in the morning or partake in a part-time job in the afternoon. Surveillance investigators may not have the opportunity to document a claimant’s regular activities as a result of the interrupting IME. 

A second drawback, similar to the first, involves the depiction of the claimant. The claimant may have been instructed by medical providers to wear a brace or utilize an orthopedic device, such as a cane. If so, there is a strong chance they will follow these medical guidelines when visiting a doctor- probably a stronger chance than that of a day with no medical appointments. While this is a great opportunity to use their actions as a measuring stick, please do not rely on this as your only observation of the claimant. This day may not be a true depiction of the claimant’s entire physical capabilities.

The final drawback is that a claimant’s sense of awareness may be heightened. Most claimants have no reason to take note of their surroundings; however, that may not be the case on the date of an IME or FCE. We’ve learned that represented claimants are sometimes informed of the possibility of surveillance and therefore, coached to take note of their surroundings. This drawback, in turn, may encourage a claimant to limit his/her activities on the day of the IME, or encourage them to be on the lookout for surveillance operatives.

What is the underlying similarity of these drawbacks? You may not be gathering a full picture. Be sure not to limit your scheduling of surveillance to dates of medical appointments. You might be missing out.

Benefits Outweigh the Drawbacks

Ultimately, take advantage of scheduling surveillance on the dates of medical appointments, but know what to expect. If your objective is to confirm identity and/or residency, let’s schedule it during the IME. However, if you are trying to document daily activities or possible off the books employment, let’s schedule strategic surveillance on a non-therapy date. Consider scheduling several days of surveillance to cover both appointment and non-appointment days. In a best practices scenario, we would like to schedule surveillance on a date prior to, a date of, and a date after a medical appointment.

At Prime Source Investigations, we schedule strategic surveillance in an effort to give our client’s a thorough understanding of their claimant’s capabilities. Contact us to discuss our Big Picture Investigation to gather a thorough understanding of your claimant.