Your claims adjuster is supposed to investigate your claim in good faith. 8 CCR 10109 imposes a continuing duty to investigate and to "conduct a reasonable and timely investigation upon receiving notice or knowledge of an injury or claim for a workers' compensation benefit." Further, "The administrator may not restrict its investigation to preparing objections or defenses to a claim, but must fully and fairly gather the pertinent information, whether that information requires or excuses benefit payment."

The requirement that "Insurers, self-insured employers and third-party administrators shall deal fairly and in good faith with all claimants, including lien claimants" is not always honored.

It is important to cooperate with reasonable requests for medical information and the details of how you were injured. Failure to cooperate can lead to delay and denial of your claim. If in doubt, seek legal advice. 

You should be aware that your social media pages are likely to be scrutizined as part of claims investigation, that investigators may become your Facebook "friends" in order to spy on you, and that many injured workers are put under surveillance.

Also, the Nurse Case Manger (NCM) sometimes acts as an investigator for the adjuster. Be careful what you say, and do not allow the NCM into the treatment room when you meet with your doctor. You have a right to privacy.

Please read my articles on surveillance: Some actual cases and How to Analyze Surveillance Videotapes For more on what private investigators are not allowed to do, read this article.

For some "war stories" about workers' compensation fraud, see Something Wasn't Right and Fraud and the Holy Ghost.