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Keeping an eye out for work comp fraud

As an employer, you do everything you can to provide your employees with a safe and productive work environment. Doing so will not only protect your bottom line, but also serve to insulate you from potential OSHA fines, workers' compensation claims and increased workers' compensation insurance premiums. However, this is only one part of the equation, as you must also take steps to protect yourself from potential employee fraud.

What exactly constitutes employee fraud?

In general, when employees suffer debilitating workplace injuries -- back strain, neck trauma, foot pain, hand injury, etc. -- they turn to workers' compensation insurance for the funds they will need during their recovery. However, while the majority of injured workers submit legitimate work comp claims, there are some who will either fake or exaggerate the extent of their injuries, willfully submitting a fraudulent claim.

Interestingly, Employers Insurance -- a work comp provider that insures small business throughout the U.S. -- recently released a list of common indicators of potential work comp fraud that employers need to remain on the lookout for year round.

"While these are simply indicators, it has been shown that when many of these factors are present, there is a good chance the claim may be fraudulent," said the company.

Some of these indicators include the following:

  • Injury reports on a Monday morning
  • Shortages of witnesses to the injury
  • Inconsistent witness reports
  • Claimants with documented histories of submitting injury reports and/or changing their addresses, employment and treating physicians
  • Treatment refusal by the injured worker

"Understanding these indicators by taking a smart, informed approach to workers' compensation insurance not only protects valued employees and minimizes risks for the long term, it also protects businesses from taking on new costs," said Employers Insurance.

Workers compensation fraud/employee fraud is a very serious crime. If you suspect that such a crime has been perpetrated against your organization, you should strongly consider speaking with an experienced workers' comp defense attorney.

This post was provided for informational purposes only and is not to be construed as legal advice.


The Orange County Register, "Ten signs of workers comp fraud" March 29, 2012

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