Encyphir Risk Management

AOE/COE & Workers' Compensation

Compensability Investigations Built for the File.

We conduct AOE/COE compensability investigations inside the 90-day window. Services include recorded statements, scene work, witness interviews, and prior claims research. All work is built to the standard your SIU, counsel, and the Appeals Board expect.

90-DayGood-Faith Investigation Window
AOE/COECompensability Determinations
RecordedStatements & Transcripts
Court-ReadyScene & Witness Evidence

AOE/COE and Workers' Comp Claim Investigation

The Investigation the File Needs, Inside the 90-Day Window

California's 90-day investigation window, and comparable good-faith requirements in other jurisdictions, means carriers, TPAs, and self-insured employers cannot afford a slow start on a disputed claim. Our claims investigators are built for this. We run AOE/COE compensability investigations, take recorded statements, document the scene, locate witnesses, and pull prior claims and medical history. Reports are ready for adjuster decision, appeals board review, and defense counsel use.

AOE/COE Compensability Investigation

Full AOE/COE analysis from intake through written determination report. Built to California Labor Code 3600 / 3208 standards. Cross-jurisdictional coverage for multi-state carriers.

Recorded Statements

Recorded statements from claimants, witnesses, supervisors, and co-workers. Taken in compliance with one- and two-party consent rules, transcribed, and prepared to evidentiary standards.

Scene Investigation & Reconstruction

On-site scene work for workplace injuries: photography, measurements, diagrams, and equipment documentation. We cover slip-and-fall, machinery, forklift, ladder, struck-by, and caught-in-between events.

Witness Locate & Interviews

Locating and interviewing neutral, hostile, and reluctant witnesses, including neighborhood canvass, co-worker interviews, and locating witnesses who have moved or gone silent.

Prior Claims & Medical History

ISO ClaimSearch, CLUE, NICB ForeWarn, PMP / prescription monitoring, and medical canvass. Covers prior injury, pre-existing conditions, and apportionment. HIPAA authorization managed end-to-end.

Suspicious & Disputed Claim Investigation

Late-reported, Monday-morning, post-termination, and unwitnessed claims. Scoped to support compensability determination and, where warranted, fraud referral.

Doctrines & Defenses

The AOE/COE Questions That Drive Claims

Most AOE/COE fights come down to a short list of recurring doctrines and affirmative defenses. Investigating the right facts, in the right order, and documenting them correctly is the difference between a compensability call that holds up and one that gets reversed on appeal.

Key Doctrines We Investigate

  • Going and Coming Rule
    Commute injuries are generally not compensable. But three exceptions frequently apply: special mission, commercial traveler, and employer-provided transport. Each requires investigation.
  • Personal Comfort & Parking Lot
    Break, restroom, meal, and parking-lot injuries often fall within the course of employment. Location, employer control, and the claimant's activity at the time determine the outcome.
  • Defenses: Intoxication, Horseplay, Willful Misconduct
    These defenses can defeat compensability. But they only hold up when the investigation shows the conduct caused the injury, not just that it occurred.
  • Telecommuting & Work-From-Home
    Remote-work injuries create compensability questions that older case law never addressed. We investigate the home-office setup, what the claimant was doing at the time of injury, and the extent of employer control.

Who We Support

Carriers, TPAs, Employers, Counsel

Carriers & SIUs

AOE/COE determinations, recorded statements, and scene investigations inside California's 90-day window and equivalent good-faith requirements across the western states.

TPAs & Self-Insured Employers

TPAs and self-insured employers use us for independent compensability investigations. We're especially useful on claims with fraud indicators or apportionment disputes.

Workers' Comp Defense Counsel

Investigation work product prepared for deposition, trial, and appeals. Includes IME/DME coordination, medical canvass, and witness preservation.

Why Encyphir?

  • Rapid intake inside the 90-day window
  • HIPAA-authorized medical and prior-claim records
  • Licensed investigators nationwide
  • Recorded statement audio, transcript, and sworn report

Request a Free Consultation

Fill out the form and we'll reach out via your preferred contact method within 24 hours.

  • Licensed & insured investigators
  • All inquiries are strictly confidential
  • No obligation - just answers
  • Available for emergency consultations

For emergency or expedited services,
please call us directly:
(888) 965-5150

An investigator will reach out within 2 business days. If you need something sooner, please call us at (888) 965-5150.

Disputed Claim on the Desk?

Don't run out the 90-day clock. Send us the referral and we'll build the compensability record you need: statements, scene, witnesses, and prior-claims history. Your adjuster and counsel get a report they can act on.