In February 2023, a journeyman alleged neck and upper back strain while lifting a 6-foot pipe. He sought medical treatment a week later and was placed on modified duties. He continued to work for his employer until the business was sold, and he was laid off two months later.
In his statement to the ICW Group Claims Examiner, the injured worker stated that he is normally very active in sports and other hobbies but did not mention any involvement in bodybuilding. He admitted to stopping his activities since the injury.
He continued to be treated for his injuries more than a year after the incident, which called into question the extent of his injuries, given how minor they appeared to be. His medical restrictions included a lifting restriction of up to 20 lbs., push/pull up to 30 lbs., and no repetitive or over-the-shoulder lifting.
Social media posts tell a different story
A social media investigation was launched, and it found that he had various social media accounts, which made no mention of any injuries, medical problems, or disabilities but did show that he participated in several bodybuilding competitions and cardio drumming classes since the date of injury. His wife’s Facebook page showed photos in April 2024 of him and his family hiking, skydiving, and surfing in Hawaii.
That same month, the injured worker reported to his physicians that he had ongoing neck pain and headaches. He described the pain in his neck as bad as being stabbed in the eye and that his pain had been worsening in the last three months.
His statements and complaints appeared to contradict the activities he was engaging in and posting to social media, so the case was referred to the ICW Group Special Investigation Unit, which referred it to law enforcement for review due to reasonable suspicion of insurance fraud.
