Employer Resources

These resources reflect common questions and situations employers face when information is limited or incomplete.

Practical information for Ontario employers managing WSIB and questionable injury claims.

Most workplace injury claims are legitimate. However, situations sometimes arise where reported limitations, available information and observed activity do not appear to align.

When that happens, employers need objective information before deciding what action, if any, should be taken.

This resource centre is designed for employers, human resources professionals, health and safety leaders and claims professionals dealing with workplace injury and disability matters.

The information below explains when an investigation may be appropriate, how surveillance is used, what employers should gather and how investigative findings are documented.

These resources are intended to help employers ask better questions and consider their options carefully, fairly and confidentially.

When Employers Use These Resources

Questionable Injury Claim Documentation Checklist

A Simple Way to Prepare Before Decisions Are Made

Before contacting an investigator, employers should review what information is already available and identify the specific questions that need to be answered.

The checklist helps employers organize:

• Incident details and relevant timelines
• Reported restrictions or limitations
• Return to work information
• Existing documents and communications
• Specific and objective reasons for concern
• Questions an investigation may help answer

The purpose is not to prove wrongdoing. It is to organize the available information so appropriate next steps can be considered fairly.

When Injury Claims Raise Legitimate Questions

Questionable Injury & WSIB Claims

Most injury and disability claims are legitimate. A concern should never automatically be treated as evidence of dishonesty.

Reasonable questions may arise when:

• Reported limitations change or appear inconsistent
• Observed activity appears difficult to reconcile with stated restrictions
• Incident details or timelines do not align
• Credible information suggests undisclosed activity
• Available documentation leaves important questions unanswered

One inconsistency may have an innocent explanation. Employers should consider the full situation before requesting an investigation.

Surveillance and Activity Verification

Surveillance is one investigative tool and is not appropriate for every claim.

When properly planned, surveillance may help document:

• Publicly observable activity
• Physical movements and apparent abilities
• The frequency and duration of certain activities
• Patterns that develop over more than one observation period

Surveillance does not diagnose an injury, measure pain or determine benefit entitlement. Its purpose is to provide objective information that can be considered alongside the other evidence available.

COMMON QUESTIONS AND DECISION POINTS

Employers often face similar questions when an injury or disability claim does not appear clear. The resources below address some of the most common ones.

WHAT MAKES AN INJURY CLAIM QUESTIONABLE?

A questionable claim is not necessarily a fraudulent claim. It is a claim in which specific and credible information raises reasonable questions that may require clarification.

Examples may include:

• Reported limitations that change over time
• Activity that appears inconsistent with stated restrictions
• Conflicting accounts of how an incident occurred
• Important gaps in the claim timeline
• Credible information about undisclosed work or activity
• Documentation that does not align

No single factor automatically proves wrongdoing. The complete situation should be reviewed before further action is considered.

WHAT CAN SURVEILLANCE ESTABLISH?

Surveillance can document activity that is observable from a lawful vantage point.

It may show:

• Where a person travels
• Activities performed in public view
• The apparent duration of an activity
• Repeated physical movements
• Patterns observed across multiple dates

Surveillance cannot determine whether someone is experiencing pain, diagnose a medical condition or independently decide whether a claim is valid.

The observations must be considered alongside medical, employment and claim information by the appropriate decision makers.

WHEN SHOULD AN EMPLOYER CONSIDER SURVEILLANCE?

Surveillance may be appropriate when an employer has a legitimate, specific question that cannot be answered through existing documentation.

It may be considered when:

• Reported restrictions and available information appear inconsistent
• Credible information suggests activity that may be relevant to the claim
• The employer needs objective information before making a decision
• Other reasonable efforts have not clarified the concern

Surveillance should be proportionate to the situation and focused on clearly defined investigation objectives.

IS IT LEGAL TO HIRE A PRIVATE INVESTIGATOR IN ONTARIO?

Ontario employers may hire a licensed private investigation agency for legitimate investigative purposes.

Private investigators and the agencies providing their services must be properly licensed in Ontario. Investigations should be conducted within applicable legal and ethical boundaries and with appropriate consideration for privacy.

Employers should use a professional agency, establish a clear investigation objective and avoid requesting surveillance that is excessive or unrelated to the concern being reviewed.

When an employer is uncertain about its authority or legal obligations, it should obtain advice from qualified legal counsel.

WHAT SHOULD AN EMPLOYER PROVIDE TO THE INVESTIGATOR?

A well planned investigation begins with clear and relevant information.

Useful information may include:

• A summary of the injury or incident
• The relevant claim timeline
• Reported limitations or restrictions
• Return to work information
• A current photograph or lawful identifying information
• Known vehicle information
• The specific reason for concern
• The questions the investigation

should attempt to answer

Only information relevant to the investigation should be shared, and it should be handled securely.

WHAT HAPPENS DURING A SURVEILLANCE ASSIGNMENT?

Before surveillance begins, First Recon reviews the available information and confirms the investigation objectives with the client.

The investigator then:

• Identifies the correct subject and location
• Conducts discreet observation from lawful positions
• Records relevant activity in detailed notes
• Captures photographs or video when appropriate
• Documents dates, times and movements
• Reports both activity and inactivity accurately

The investigator’s role is to document what occurs, not to create a particular outcome.

HOW LONG SHOULD SURVEILLANCE CONTINUE?

There is no standard number of surveillance hours or days that works for every claim.

The appropriate scope may depend on:

• The investigation objective
• Known activity patterns
• Appointments or scheduled events
• The nature of the reported limitations
• The results of earlier surveillance
• The need to avoid relying on one isolated observation

A professional investigator should recommend a reasonable and proportionate plan based on the circumstances rather than automatically extending surveillance without a clear purpose.

WHAT MAKES A SURVEILLANCE REPORT USEFUL?

A professional surveillance report should allow the reader to understand exactly what was observed.

A useful report includes:

• A clear chronological timeline
• Exact dates and observation times
• Objective descriptions of activity
• References to supporting photographs and video
• Periods when visual contact was lost
• Relevant limitations encountered during the assignment
• A concise summary of the findings

The report should avoid exaggeration, speculation and unsupported conclusions.

HOW IS PRIVACY CONSIDERED DURING AN INVESTIGATION?

Privacy should be considered throughout the investigation.

A professional investigation should:

• Have a legitimate and clearly defined purpose
• Collect only information relevant to that purpose
• Use lawful observation methods
• Avoid trespassing or unnecessary intrusion
• Store reports, photographs and video securely
• Limit access to people who genuinely require the information

Surveillance should be used to answer specific questions, not to collect information without a defined reason.

HOW DOES FIRST RECON WORK WITH EMPLOYERS AND CLAIMS PROFESSIONALS?

First Recon begins by listening to the concern and reviewing the information available.

We then:

• Clarify the investigation objective
• Identify the questions that need to be answered
• Recommend a proportionate approach
• Assign appropriately licensed investigators
• Provide updates when necessary
• Deliver clear reporting with supporting evidence

First Recon can work directly with employers or alongside claims professionals, insurers and legal counsel. Our role is to gather and document facts, not to make employment, medical or legal decisions.

WHAT IF SURVEILLANCE SHOWS NO SIGNIFICANT ACTIVITY?

A surveillance assignment may produce limited activity or no activity relevant to the investigation objective.

That result does not prove the claim is legitimate or illegitimate. It only establishes what was observed during the particular dates and times covered.

An accurate report should document:

• The observation periods completed
• Whether the subject was seen
• Any relevant activity observed
• Conditions that limited the investigation
• Whether additional surveillance may or may not be useful

First Recon reports the results honestly, even when those results do not support the client’s original concern.

WHAT MISTAKES SHOULD EMPLOYERS AVOID?

Employers should avoid:

• Treating suspicion as proof
• Requesting surveillance without a clear objective
• Sharing sensitive claim information unnecessarily
• Confronting an employee before the facts are established
• Relying on a short video clip without reviewing the complete report
• Asking an investigator to exceed lawful or appropriate boundaries
• Making decisions based on assumptions rather than verified information

A measured approach protects the integrity of the investigation and supports fairer decision making.

WHEN SHOULD AN EMPLOYER HAVE A CONFIDENTIAL CONVERSATION?

An employer does not need certainty or proof before speaking with First Recon.

A confidential discussion may be helpful when:

• Something about a claim does not appear to align
• The employer has received credible information
• The available documentation leaves important questions unanswered
• The employer is unsure whether surveillance would be appropriate
• Objective information is needed before deciding what to do next

An initial conversation can help determine whether an investigation is appropriate, what it should focus on and whether another course of action would be more suitable.