Legal Support for Insurance, Businesses and Individuals

Protecting your business against workers’ comp fraud

On Behalf of | Aug 28, 2018 | Uncategorized |

It is not always easy to find good workers who will be loyal, hardworking and trustworthy. When you do find employees like this, you are happy to offer them every opportunity for success. Unfortunately, there are those few workers who not only fail to meet the obligations of the job, but may also show little respect for you and the efforts you have put into building your Pennsylvania business.

When one of your employees reports an injury on the job, you respond as you should by directing the employee toward medical treatment and assisting the worker in any way you can in filing a claim with workers’ compensation. However, there may be times when you suspect your employee may be faking an injury and filing a fraudulent claim.

Signs of fraud

False claims against your workers’ compensation insurance can result in higher premiums for you, which ultimately hurts your bottom line. While you are happy to help your workers who have genuine injuries or work-related illnesses, you have every right to feel used and betrayed when a worker takes advantage of the system by faking an injury.

Some signs that a worker may be faking an injury include the following:

  • Reporting an injury on a Monday morning may mean the injury actually occurred over the weekend.
  • The employee’s version of the accident changes with each retelling.
  • No one else saw the accident happen.
  • The employee resists when doctors want to perform diagnostic tests.
  • You are unable to convince the employee to return to work with light duties.
  • You have gone through the workers’ compensation claims process with this worker in the past under similarly suspicious circumstances.

It may be easy to predict when an employee will attempt to fake an injury in order to obtain a payout from workers’ compensation. Employees who are frequently reported for other issues are more likely to seek easy money. You may also find that a worker who dislikes the job may want some time off with pay, so he or she fakes an injury to get an insurance payout. Workers have reportedly faked injuries at one job so they would have time to work at a second, higher paying job.

Responding to fake injuries

Workers’ compensation fraud costs you money, and it may also make it more difficult for you to obtain and afford the insurance you are required to provide for your workers. You can take steps to minimize the probability that an employee will commit fraud by maintaining a positive work environment, carefully screening potential employees and promoting safety in every department.

However, you still may deal with an employee whose injury claim arouses suspicion. For guidance in handling such situations, you would do well to seek the advice of a skilled attorney with experience in workers’ compensation issues.