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When a claim becomes workers' compensation fraud

Experts agree that the rate of workers' compensation fraud continues to increase in California. The rise is seen in both contended claims and the amount of injuries that are filed. An employer that suspects an accident or injury has been claimed in an attempt to commit workers' compensation fraud may research the best possible method for investigating the situation.

A recent conference discussed the rising problem and how the actions of employers can be important when a worker files an injury claim. An employer can help prevent workers’ compensation fraud by asking questions and recording information immediately following an accident or injury. Unfortunately, not all business owners may be able to discuss a work injury before a claim is filed to help guide a victim and influence honesty.

Proving a workers’ comp claim is fraudulent can sometimes be difficult and require professional review of medical records and other information. The claim can become fraudulent when the employee has lied about an injury in an attempt to collect insurance benefits. A person that is also dishonest or misleading with their physician for the same purpose may also be guilty of committing fraud.

Fraudulent claims affect employers, insurance companies and those that have legitimate injuries. The negative financial impact can be seen through rising insurance premiums as well as benefit payouts and other expenses the employer may feel obligated to provide. A California business that has been damaged by workers' compensation fraud may seek to gain restitution from the dishonest worker and ensure the perpetrator is held responsible financially.

Source:, "Workers' compensation insurance fraud -- what it is and how to avoid it", Carol Lawrence, Aug. 28, 2014

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