Case Study: The Ghost Injury That Cost a Company Thousands

Uncovering a history of pre-existing conditions in a high-stakes workers’ compensation claim.

The Client’s Challenge

A mid-sized logistics company in Ohio was facing a significant workers’ compensation claim. An employee, let’s call him “Mr. Smith,” reported a severe neck and back injury, supposedly from a minor slip-and-fall at the warehouse. The injury seemed disproportionate to the incident, and the potential payout was substantial, threatening to increase the company’s insurance premiums for years to come. The company’s HR manager suspected something was amiss. Mr. Smith had a history of short-term employments and there were whispers of prior, similar claims. They needed concrete evidence, and they needed it fast. That’s when they contacted Gravitas Investigations for a discreet but thorough workplace investigation.

The Investigation: A Needle in a Haystack

The challenge was to legally and ethically uncover whether Mr. Smith’s injury was pre-existing. Our team of licensed private investigators in Ohio initiated a multi-state Hospital Canvass, a meticulous and systematic search of medical facilities. This wasn’t a simple background check; it was a deep dive into a long history of potential medical treatments across dozens of hospitals and clinics in both Indiana and Kentucky, where Mr. Smith had previously resided. Our investigators, well-versed in HIPAA regulations, knew how to obtain information without crossing legal or ethical lines. The initial search was like looking for a needle in a haystack. Many facilities reported no records, and the sheer volume of locations made the task daunting. We were looking for a “ghost”—a medical history that the claimant had conveniently failed to disclose.

The Breakthrough: A Pattern of Deception

After canvassing over thirty facilities, our investigators had their breakthrough. A small, overlooked orthopedic clinic in a rural part of Kentucky confirmed that Mr. Smith had been a patient. And not just for a minor check-up. The records, which we legally obtained with the client’s authorization, revealed a long history of chronic neck and back pain, stemming from a car accident over a decade ago. We didn’t stop there. Our team cross-referenced this information and found two other diagnostic facilities where Mr. Smith had received treatment for the very same “injuries” he was now claiming were from the workplace incident. This was the “smoking gun” the client needed. The pattern of deception was clear. This wasn’t a new injury; it was a ghost from the past, resurrected to defraud the company.

The Outcome: Justice and Savings

Armed with the irrefutable evidence from our investigation, the insurance company was able to successfully challenge the fraudulent claim. The result was a saving of hundreds of thousands of dollars in potential payouts and legal fees. The company’s insurance premiums were protected, and a clear message was sent to other employees about the seriousness of workers’ compensation fraud. This case highlights the power of a professional private investigator in Ohio to protect businesses from fraudulent claims. Whether it’s an insurance fraud case in Indiana, a need for surveillance in Florida, or an asset search in Kentucky, Gravitas Investigations provides the evidence and peace of mind that our clients need to make informed decisions.