What is the role of the investigator assigned to pursue issues of compensability?

• A. determine all of the facts
• B. determine proof of claim being fraudulent
• C. determine compensability from all facts gathered
• D. determine if benefits are due to the injured worker

Answer: (A)

The essential role of the investigator in pursuing compensability is to assemble a complete factual record. This means gathering and verifying all relevant details about what happened, when and where it occurred, who was involved, the medical evidence, employment records, statements from the employee and witnesses, and any other documentation or discrepancies. With all the facts in hand, the decision maker can assess whether the claim arose out of and in the course of employment and meets the rules for compensability.

This is why this option is best: it focuses on building the full factual picture the claim decision will rely on. It’s not primarily about proving fraud, determining compensability itself, or deciding whether benefits are due—that latter step comes after the compensability question is resolved. The investigator’s job is to provide a solid fact base for that determination.