How You Can Uncover Repeat Workers’ Compensation Claim Offenders

How You Can Uncover Repeat Workers’ Compensation Claim Offenders

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Ways to discover repeat workers’ comp claim offenders.

 Most employees that are injured at work are honest and want to recover quickly to return to their jobs. As a business owner who hires people they trust and respect, it’s only natural to assume the best in your employees. There are workers, however, who are repeat workers’ compensation claim offenders, who manipulate the system and create headaches for their employers. Not only is this time-consuming for you, but their claims can be expensive, too. Here are some steps you can take to determine if a worker is committing workers’ comp fraud and how to stop them from repeating injuries.

  • Investigate all injuries

However minor, look into each injury and build a case of what occurred. You’ll want to gather as much information about the incident as possible. The steps should include:

  • Gather statements about the injury – not just from the injured but from witnesses
  • Determine causation
  • Take pictures of the scene
  • Keep all documentation logged and safe

 

  • Talk to the treating physician

You may get some valuable insight into whether there is a specific problem causing frequent injuries with the worker. You may also determine that the worker is physically incapable of doing the job without risking injury.

  • Consider root cause analysis

You may want to look closely at all the circumstances surrounding the incident, especially if the worker is repeatedly injured doing the same types of tasks. For example, the worker may put the ladder he uses at the same height as another colleague who is much taller. That could force the worker to have to reach above his head, putting him at risk of injury. His physique may be such that the equipment he’s using is inappropriate for the specific task. Uncovering such a simple cause can be easily rectified.

  • Talk to the injured employee

Talking to the worker may uncover simple revelations. He/she may be unhappy in their job or with their supervisor, they may have personal challenges at home, financial concerns, psychological issues, or otherwise.

If your investigation leads you to believe that the worker is a frequent claim filer, you should still treat them with respect but make their fraudulent claims more difficult. Any issues that you have uncovered should be told to the claim adjustor.

Do you have more questions regarding workers’ compensation insurance? Talk to the team at Hoffman Brown Company today! We are happy to help.