The territorial workers' compensation board (WCB) is pursuing the recovery of several hundred thousand dollars described as overpayments to one injured worker, representing the largest attempted claw-back in its history.

The Worker's Compensation Appeal Tribunal ruled last week the Yukon Workers' Compensation Health and Safety Board overpaid the claimant by $620,768 over 16 years, minus what he received "legitimately.”

Board president Valerie Royle said staff will first have to wait to see what the board of directors has to say about the ruling at its meeting next week, though she doesn't anticipate there'll be any direction to appeal the decision.

Once the board of directors reviews the ruling, staff will have to calculate what the injured man was entitled to receive after his injury in August 1994 based on the tribunal's findings of legitimate payments and expenses, she said.

Royle estimates the WCB will still be attempting to recover over $500,000.

A lien was placed on the individual's home when the board learned he and his wife were trying to sell it, she explained.

She said the home was worth more than the amount of overpayments at the time the lien was filed.

Under the law, Royle pointed out, the board has the authority to recover the overpayment by whatever means are available or necessary.

The name of the claimant, now 41, is not being released, nor is the location of where he now lives.

Derek Holmes, the worker's representative at the appeal hearing in August, was out the office this morning and unavailable to say whether the injured worker intends to file an appeal to the Yukon Supreme Court.

The file indicates the worker was on a one-month term with a local survey company when he was working alone and fell down the steep bank of a gravel pit, causing head and other injuries.

He was on compensation for several months and put through re-employment training until the end of December 1994.

According to the evidence before the tribunal, the employer questioned from the very beginning whether the mishap even happened, having visited the gravel pit and found no indication of the fall.

For a period of three years beginning in 1995, the claimant served as manager of a financial investment firm, and went through periods of part-time work until he complained of medical problems.

An assessment by a doctor found the injuries incurred in the 1994 incident were the cause the problems, which left him unemployable. His WCB claim was reinstated, and payments were made for periods he was eligible for back to December 1994.

Further medical assessments through the next couple of years concurred with the finding the worker was unemployable as result of the injuries.

In 2004, however, an assessment by a neuropsychologist retained by the safety board found the man was able to work, and had likely been able to work from the time the initial claim ran out at the end of 1994 based on evidence from a CT brain scan taken in 1994 and a subsequent MRI in 1998 that showed no signs of abnormalities.

Furthermore, according to the doctor, the results of standard verbal tests were so abnormal as to suggest the claimant was faking his responses

But while the report was submitted to the WCB in 2004, it was not passed on to the board's investigative unit until 2009, according to the tribunals findings.

In its decision last week, the three members of the tribunal – chair Ed Sumner, Helmer Hermanson, and Cary Gryba – were critical of the safety board's management of the file and for letting matters go on as long as they did.

Medical evidence submitted to the tribunals from assessments through the early 2000s indicated he was not employable as a result of the injuries suffered in 1994.

A further assessment last spring by a doctor retained by the claimant supported the finding of unemployable.

But once the file was turned over in 2009 to the WCB's investigative unit, the team came up with evidence and photographs suggesting the claimant was involved in activities contrary to what he maintained he was unable to do.

According to the evidence before the tribunal, for instance, the worker claimed the head injury left him unable to focus for extended periods.

The injury, according to the evidence, left him unable to climb less than a metre up a ladder without someone hanging on to provide security and comfort, for instance.

The issue of heights and vertigo brought on by the injury triggered extreme migraine headaches, the worker indicated to medical professionals.

Yet, undercover investigators found photographs taken by the claimant from a 35-metre tower during a three-week trip to England and Scotland. He had no trouble driving on the wrong side of the road, navigating through heavy traffic or climbing over an eight-foot fence.

The claimant told investigators while there were no negative reactions during his vacation, when he returned home, he was extremely ill for a week.

The worker's advocate argued at the hearing in August the investigation by the WCB's team was substandard, and much of the key evidence presented shouldn't be allowed to stand.

There was a photograph taken from the tower, all right, but the investigators provided no evidence of who took the photo, the advocate pointed out.

He told the tribunal there was no evidence presented to the tribunal regarding the extent of the claimant's involvement in the book published by himself and his wife.

In fact, argued the advocate, the undercover investigation has further harmed the man, who has become a couch potato because he doesn't want to leave the house for fear of having someone jump out from behind the hedge to take his picture.

Furthermore, the advocate told the tribunal, the board has only inflamed the circumstances by continuing to pay the claimant for five years after receiving the assessment he was fit to work.

In its decision, the tribunal upheld the advocate's concern about the lack of WCB's decision to continue the claim once it had the information.

The board's staff did commit "egregious errors” in the management of the file, the tribunal found.

Nonetheless, the tribunal concluded the evidence indicates the man was capable of working from the end of 1994, and has directed WCB to recover the overpayment.

The board's president said even though the WCB continued the claim for five years while it was aware there was a suspicion of fraudulent behaviour, the claimant will be required to pay everything back.

The claimant, she said, was not entitled to the money, and he has to pay it back.

To allow otherwise would not be fair to the injured workers, other workers and employers of the Yukon, Royle insisted.

She said steps are now in place to avoid similar delays in investigating suspicions of false claims, including the creation of two full-time investigators who were not in place when the 2004 medical assessment was received.