How to spot worker’s comp fraud

by | Aug 25, 2015 | OSHA & Safety, Our Blog | 0 comments

Have you ever had a suspicious feeling about a worker’s injury? Here are a few red flags to look for when identifying a potentially fraudulent worker’s comp claim…

* Work is ending – When an injury is reported just before a work stoppage of some kind, the employee may be looking for a way to continue getting a check in the mail.

* When just returning from break – When an injury is reported early Monday morning (or the first day their scheduled week) and there are no witnesses, the employee may have injured him or herself at home or playing recreational sports and did not want the medical bills.

*Employee is new to the job – Although many injuries can happen when an employee is new and in the “learning curve,” some folks have no intention of doing the actual work and will do as little as necessary before filing a claim.

*Spotty work history

* When the employee is hard to reach on the phone – Give employees a call to see how they are doing. The good employees will appreciate your concern. Those filing a false claim may be hard to reach because they are not at home gaining their strength.

* If an employee changes doctors more than once – This may be a signal that the doctors are catching on to the employee’s false claim, so the employee keeps moving on in the hope they will find one that will buy in.

* When the employee’s version of events changes or they just do not know how something happened – Ask them what happened immediately after the alleged accident and then conduct a full investigation a day or so later. If the story changes, it may not be the truth.

Most importantly, it is crucial to conduct full investigations after each and every incident to help prevent them from happening again. If you find a fraudulent claim in the process, you could potentially save a lot more!