Workers Comp Fraud

When is comes to employer-employee relationships, one thing to ccnsider is the fact that the work place become a place for workers comp fraud.

Workers’ compensation fraud is the most common and discussed form of fraud. Employers can easily deal with and prevent workers’ compensation fraud, but only if they are careful, diligent, and quick to attack it from every angle. Otherwise, it can cost businesses several salaries’ in fees. The most common form of claimant fraud occurs when an employee knowingly lies about an injury in order to collect benefits from the work place. Often times they will claim an injury occurred at work when in fact, it occurred at home. Others will exaggerate injuries, or continue to work after collecting benefits as a way of making extra money.

It is important to remain empathetic and compassionate when dealing with your employees. It is not fraudulent to collect benefits if an injury is in fact work-related. Keep in mind that most injured employees will not return to work until their doctors advise them to do so, so elongated periods of absence are not necessarily a sign of fraud.

disability test used for workers comp

If workers who exhibit one or more of the following behavioral patterns make any claims, contact your carrier immediately. Doing so may seem paranoid, but it will only help you save a great deal of money in the long run.

Remember that there is rarely an exact science to discovering and proving claimant fraud. There are a variety of things to look for, however, when a claim is made, or when you think a claim is about to be made. Disgruntled employees are often the most likely to act erratically. Many workers who are denied vacation time, demoted, or laid off will be in danger of fraudulent behavior. Keep an eye on such employees.

If an staff member becomes difficult to contact while collecting benefits, there is a chance that they are working another job at the same time. Keep track of the time it takes to get in touch with your employees.

Some claims will be made that involve an injury taking place without the presence of other witnesses. If that is the case, find out exactly what the employee was doing, why they were alone, and if it is in their job description to be in such a situation.

Statistics show that new employees are more likely to take advantage of their employers than those who have been with a company for an extended period of time. Keep a close eye on new workers, and keep track of their behavior. Statistics also show that a significant percentage of fraudulent claims involve accidents taking place on Mondays and Fridays.

Keep an account of the exact description of your employee’s accident. Some workers will give a different account of their injury to their employer and doctor. Inconsistency in retelling gives cause for suspicion.

Author: Budda Oliver

Mr. Oliver is a marketing agent of Stamp Out Fraud. The Virginia insurance fraud program provides help in stamping out insurance fraud throughout Virginia. For more information on their Insurance Fraud Program please visit their website.

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