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Signs that a worker is trying to game the system

While most workers who file for workers’ compensation do so with the proper intentions, there are some who try to game the system. This is harmful to the workers’ compensation provider, as well as the employer. For this reason, employers often opt to pursue a defense against claims they have reason to believe are fraudulent.

There are many signs that an employee is claiming workers’ compensation benefits they don’t truly need. In some cases, the link between the person’s job duties and the injuries can’t be determined, but this isn’t the only sign that something is amiss. The key to weeding out the fraudulent claims is paying close attention to the employee’s actions.

An employee who’s truly injured is going to seek out medical care, so failing to go to doctor’s appointments is a sign that the employee is trying to get over on the system. It’s especially important that they attend the appointments that are meant to determine their eligibility for benefits.

Some employees fail report their injuries in a timely manner. This is another point that could disqualify them from receiving workers’ compensation benefits. There are specific time limits that apply to various aspects of the workers’ compensation process. When any of these aren’t complied with, the claim can be denied.

Because the workers’ compensation laws in New York are complex, employers who are going to fight a claim need to ensure they fully grasp the legal concepts that are necessary to build their case. This might prove to be challenging so working with a lawyer who’s familiar with defenses against workers’ compensation claims might be beneficial.