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Types of employee fraud in workers' compensation cases

As an employer that is required to either carry workers' compensation insurance in California or to be essentially self-insured, you have the right to know and trust that any claims that are made are legitimate. Unfortunately this is not always the case as employee fraud when it comes to workers' compensation is all too common. According to the California Department of Insurance, it is believed that this type of fraud may cost upwards of $3 billion annually in California alone.

Because employees are not required to prove that an employer was actually at fault for an injury in order to make a claim for workers' compensation benefits, the temptation to try and cheat or beat the system can be great. Many people may actually believe it is easy to do this. It may entail exaggerating just how bad a particular injury really is or it may even entail a person making up an injury that never really happened altogether. Even medical professionals like doctors, chiropracters and physical therapists may take part in defrauding the workers' compensation system through unethical billing or other practices.

In the 2014-2015 fiscal year, close to 6,000 suspected cases of workers' compensation fraud were either reported or identified by the Fraud Division. Out of a total of 240 arrests, 197 cases were sent on to prosecution.

If you would like to learn more about protecting your company from or fighting against suspected employee fraud related to workers' compensation claims, please feel free to visit the false or inflated claims page of our California workers' compensation website.

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