What "red flags" could indicate a potentially fraudulent workers compensation claim?
Trust your instincts if you feel something doesn't seem right. However, here are a few things to look out for which might indicate a possible fraudulent workers compensation claim:
Are there cross-outs, white-outs and erasures on documents regarding the circumstances of the injury?
Has the injured worker filed for benefits in another state other than principle location of the alleged industrial injury or occupational disease?
Are you unable to reach the Injured worker because he or she is never home or is reportedly sleeping and cannot be disturbed?
Did the injured worker move out of state or country shortly after filing claim?
Did the claimed injury occur immediately prior to a strike, layoff, plant closing, job termination or job completion?
Has the Injured worker refused diagnostic procedures to confirm injury?
Is the injury inconsistent with the nature of work done?
Is the date/time/place of the injury unknown?
Are details difficult to obtain?
Where there no witnesses to accident?
Have you received tips from co-workers that the claim may be fraudulent?
Other Workers Compensation Fraud FAQs
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Q:
What if an employee exaggerates his or her injuries or files a fraudulent workers compensation claim?
A: If an employee knowingly make any false statements or file any false claim with the purpose of receiving or denying workers’ compensation benefits, he or … More
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What to do When You've Been Injured at Work