What is the primary responsibility of an investigator assigned to evaluate claims of compensability in a workplace?

• A. Determine all of the facts
• B. Identify any fraudulent claims
• C. Assess compensability based on all facts gathered
• D. Evaluate if benefits are due to the injured worker

Answer: (A)

The primary responsibility of an investigator assigned to evaluate claims of compensability in the workplace centers on assessing compensability based on the totality of the facts gathered during the investigation. This involves not only discovering the circumstances surrounding an injury but also understanding how those facts relate to the policies and regulations governing workplace injuries.

A thorough investigation seeks to compile all relevant information, including witness statements, medical records, and accident reports. Once this comprehensive picture is formed, the investigator can then accurately assess whether the claim meets the required standards for compensability. This process is essential for ensuring that decisions are made based on complete data rather than partial or skewed information.

While the identification of fraudulent claims and determining if benefits are correct are aspects of the investigator's duties, they ultimately serve to support the broader goal of accurately assessing compensability. Therefore, the correct answer emphasizes the importance of gathering all pertinent facts to ensure a well-rounded and fair evaluation of the claim.