workers’ compensation fraud

11 Warning Signs of Workers’ Compensation Fraud You Need to Be Aware Of

By Hoffman Brown Company | , , | No Comments
Share This:

Workers’ compensation offers financial compensation to employees who are injured while working on the job. The majority of people who file claims have legitimate injuries. There are others, however, who fake an injury and attempt to collect benefits. This type of fraud makes workers’ compensation insurance more expensive than it needs to be.

Here are 11 signs of workers’ compensation fraud that you need to watch out for:

  1. Monday Morning Blues

    Many work-related injuries are reported on Monday mornings. Either they just occurred within a few minutes of being on the job, or the employees came to work to report an injury that occurred on Friday evening before they left work.

  2. Changes in Employment Status

    Injuries that are reported before a strike or layoff are often fake. Seasonal employees may also fake an injury if their work is about to come to an end. This may also occur if a project is about to be closed.

  3. Job Termination

    If an employee is terminated, they may try to file a workers’ compensation claim by saying they reported the injury before being fired. It’s important to know if they have any workers’ comp benefits left or if they have already exhausted them.

  4. History of Frequent Changes

    If an employee is constantly changing their address, place of employment, or primary physician, they may be known for filing an excessive amount of workers’ comp claims with past employers.

  5. Medical History

    If an employee reports an injury, it’s important to look at their medical history to see if they have had similar injuries in the past or currently have a pre-existing condition that may mimic the symptoms they have now.

  6. No Witnesses

    Accidents that have no witnesses can’t be verified. Go through the employee’s statement to try and verify as much of their description of events as possible. Look through video footage, if any is available.

  7. Conflicting Descriptions or Accounts

    Compare descriptions of the accidents to one another to ensure the information given by the employee and other witnesses match. This is another time when comparing the testimony to a video is a good idea if it’s available.

  8. Multiple Claims

    If an employee has a long history of filing multiple workers’ comp claims, it’s a good bet that they will try and find another way to file an additional claim. Too many claims may make it hard for them to get insurance.

  9. Refuses Medical Treatment

    If a person is injured while on the job and will not seek medical treatment, it is a good indication that the injury may have been fabricated.

  10. Odd Coincidences

    If an employee experiences an injury about the time they are planning to take time off, it’s a sign that the injury may have been faked. This is especially true if their request for time off was denied.

  11. Financial Difficulties

    If an employee is having financial difficulties, they may fake an injury to see if they can get additional compensation. What they may not realize is that they will not receive a settlement upfront. They will only get a portion of their original wages and coverage for their medical expenses.

Contact the agents at Hoffman Brown Company. We have the answers to many of your questions.