Social media can make it easier to detect workers’ compensation fraud

Workers’ compensation fraud can cost a state millions of dollars each year, and negatively impacts businesses.

Most employers in California are required to provide workers' compensation insurance to cover their employees' medical and job-loss expenses in the event of a workplace injury or illness. As can be expected, not all employees are forthright in their claims to receive aid. Illegal workers' compensation fraud negatively impacts business owners and governments alike. According to the California Department of Insurance, during the fiscal year of 2012-2013 fraudulent workers' compensation cases caused a potential loss of more than $212,000,000. During that time, there were over 5,100 suspected cases and 268 people were arrested for workers' compensation fraud, a felony in California.

The no-fault system for workers' compensation insurance in California can be attractive to fraudsters, ranging from employees to dishonest doctors and medical providers who work the system for their profit. It is also not uncommon for companies to be accused of workers' compensation fraud, whether or not the accusations are correct. In these cases, it is important for employers to know they have rights as well as employees.

Internet age making it easier to detect fraud

In the past, it was more difficult for employers who suspected an employee of workers' compensation fraud to catch the wrongdoing. An employer would have likely needed to invest a lot of time into accessing and poring over medical paperwork and other documents, as well as hiring an expensive private investigator. Today, it can be easier to catch someone who falsely claims to be seriously injured through the use of social media and other technology, states Business Insurance.

For example, many people allow public access to their photographs and posts from sites such as Facebook and Twitter. An employee who is receiving workers' compensation payments for a lengthy illness may inadvertently be caught living it up at a party through a picture posted on social media. While it is not permitted for an employer to trick a worker into accessing private information on social media sites by posing as someone else, an employer may use information that is posted publicly to prove workers' compensation fraud.

Former officer found guilty of falsely reporting injury

In other cases, good old-fashioned surveillance and paperwork is just as effective. Recently, a former California Highway Patrol officer was convicted of felony workers' compensation fraud, making false statements and filing a false workers' compensation claim. According to The Sacramento Bee, the officer had alleged a workplace accident caused a back injury that left him unable to walk without a cane or to bend, twist or perform everyday activities without help. Video surveillance showed the man was able to walk normally and even perform heavy yard work on his own. Case documents claimed he had failed to disclose an auto accident from years before that resulted in a back injury in the same place he indicated on his claims. He also reportedly amended his injury date to support the medical records for his pre-existing back injury.

Employers have the right to defend themselves against false workers' compensation claims, including cases in which when an employee is falsely attempting to take advantage of the system.

Keywords: workers' compensation, fraud