Workers’ compensation is an excellent resource for your employees to use if they are injured on the job. It is also valuable to you as the employer because you can protect your company and its reputation if an accident occurs. However, sometimes your employees may be tempted to take advantage of workers’ compensation benefits. Your vigilance can help you recognize fraudulent behavior before it is too late.
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.
Oftentimes, the prevailing attitude amongst many workers in Los Angeles is that they are entitled to workplace benefits. Given the effort they put into their careers, they may feel justified in occasionally embellishing the details of an injury in order to obtain more time off of work or collect a little more in workers’ compensation benefits. The danger in this line of thinking is that it may persuade some to attempt to “game the system,” continuing to collect benefits while not having to return to work.
It is well known that a healthy workforce is a productive workforce, which is why you may have no issue with sick employees choosing to not come in to work in Los Angeles. Yet the issue of paying employees while they are out on sick leave can often be a tricky one. An amendment to the Healthy Workplace Healthy Family Act of 2014 made it mandatory for employers in California like yourself to offer paid time off to sick employees (or those caring for sick family members). Yet based off feedback we here at Sacks and Zolonz, LLP have received from clients, there is still much confusion surrounding this new “Paid Sick Leave Law”.
As an employer in Los Angeles, you likely want to do all that you can to ensure that your staff members are able to complete their jobs to their utmost abilities. Oftentimes, due to a disability caused by an injury or existing medical condition, an employee may tell you that he or she needs certain accommodations to continue working. The Americans with Disabilities Act requires you to make such accommodations. Yet doing so can have an impact on your business. Thus, the question becomes whether you are required to accommodate an employee for his or her stated disabilities without medical documentation supporting his or her claims?
If you are employed in California, you should be able to trust that workers' compensation benefits may be available to you if you should ever be injured in an on-the-job accident or if you should ever develop a work-related illness. If you must file a claim for these benefits, you should know that your claim will be reviewed carefully as, sadly, there are people who attempt to cheat the system. For this reason, the workers' compensation program must assess every claim with this in mind.
The following scenario has been relayed to us here at Sacks and Zolonz LLP several times before: an employee slips and falls at work, resulting in knee injury. After a while, word comes out that he or she is also experiencing neck and back pain due to the accident, and suddenly needs more money to cover medical expenses and compensate for time off of work. If this describes the same situation you are currently having with an employee, you may be facing a bit of a conundrum: On the one hand, you may feel sympathetic to his or her suffering and simply want him or her to improve. On the other, you may be wondering how one single incident could produce so many health issues.
Most California employers are mandated by law to carry workers' compensation insurance. This insurance is to provide benefits to employees who are injured on the job or who develop work-related illnesses. In addition to being required to carry appropriate insurance coverage, employers are supposed to report employee status and injury per regulations. These laws help to keep the system working fairly for all employers.
Since your employees may be tempted to abuse your workers' compensation benefits, you should be proactive about preventing fraudulent claims. You can take this precautionary measure through clear procedures regarding workplace injuries, as well as regular communication with your employees. Here at Sacks and Zolonz, our objective is to protect you from unnecessary and fraudulent claims.
As the owner of a business in California, one of your jobs is to ensure that all operations are completed accurately so that the company can grow and progress. Unfortunately, dishonest employees can make this difficult and, in most cases, there is no way to prevent them from doing it. Forbes.com reports on the danger that is payroll fraud.