We’ve all heard horror stories of people committing worker’s compensation fraud. In this blog post, we’ll look at five ways employers can identify potential instances of worker’s compensation fraud within their business operations so they can be proactive about stopping it.
Read on to learn more about protecting your company from these costly forms of fraud.
1. Nobody Else Saw the Incident Happen
One of the ways employers can spot worker’s compensation fraud is if nobody else saw the incident, even if the worker says an injury occurred in the workplace. If no other employees witnessed the incident or corroborated the worker’s story, it should be a red flag for employers. It pays to investigate any worker’s compensation claims further with witness statements and surveillance footage before proceeding with any compensation plan for affected workers. It’s important to know where and when the incident occurred and how it was reported.
2. The Story Keeps Changing
Another red flag is when employees keep changing their stories of how their injuries happened. Employers can make sure to look out for this by listening carefully to the details of each worker’s story and checking in often with them after any accidents have occurred.
3. The Evidence Doesn’t Support the Employee’s Story
If the evidence doesn’t support the employee’s story, it’s a good idea to look more closely into what happened. There are a few tell-tale signs of worker’s compensation fraud; reviews of surveillance footage, inconsistencies between medical reports and claims filed, changes in injury descriptions over time, lack of consistency with how different professionals reported symptoms, fraudulent medical records, and bills that the worker didn’t authorize are all indications that worker’s compensation fraud is afoot.
4. The Employee Has a Pre-Existing Medical Condition Similar to the Alleged Work Injury
If the worker has had any pre-existing medical condition, such as a serious injury or chronic illness similar to their work injury, it could indicate an instance of worker’s compensation fraud. Employers must understand that worker’s compensation is designed to protect workers from being injured or sick due to workplace hazards or the job itself.
5. The Employee Says the Injury Happened Days Or Weeks Ago
Lastly, employers may have difficulty finding definitive proof of when the injury occurred, but there are specific ways that employers can spot potential worker’s compensation fraud in these cases. For example, if an employee claims to have injured themselves three weeks ago on the job but was seen participating in sports over the weekend and came into work the next day with an injury, that should raise some red flags. Employers should also trust their instinct and question inconsistencies in the employee’s story to ensure they’re not being taken advantage of.
Worker’s Compensation Fraud: In Conclusion
As skeptical as you may be of your employees, most are not trying to commit fraud. However, there are a few bad apples out there that will try to take advantage of the system. To prevent worker’s compensation fraud from happening in your business, it is essential to have procedures and policies in place. You can protect your business and your employees by being proactive and having a solid plan. Thanks for reading.