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How can I identify workers’ comp fraud?

According to Business News Daily, fraudulent workers’ compensation claims cost a staggering $7.2 billion per year. That’s why it’s crucial that employers are able to properly identify common red flags indicating a work injury is not all it seems. The following are a few signs you can look out for if you suspect your employee is making a false claim in order to receive compensation. 

While work injuries can occur at virtually any time, many false claims have a pattern of falling on certain days. For instance, a worker in search of an extended weekend might file a claim first thing Monday morning while claiming the accident or injury actually took place on Friday. Work injuries should be reported to the appropriate parties as soon as they occur, and it stands to reason that workers would want the matter attended to quickly. That’s why unexplained delays are often considered suspicious.

After any injury, timely medical care is necessary to make a full recovery. However, those faking or exaggerating injuries are usually reluctant to undergo medical care, as physical exams are likely to return unfavorable results for their claims. Be wary of any worker who repeatedly refuses medical care despite claiming severe injuries. Equally suspicious are conflicting reports from the medical staff and the injured worker. For example, the doctor might claim a slight or nonexistent injury, while the worker claims it’s quite severe. 

Lastly, consider the description of events that led to the injury. Do these seem to conflict with what the worker is saying happened? Are there any witnesses to what occurred? An injury that doesn’t seem logical or possible based on the situation is usually a cause for alarm. This highlights the importance of prompt medical care, which would be able to determine the scope and extent of any injuries that occurred. 

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