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Signs of Worker’s Compensation Fraud

Worker’s Compensation insurance is supposed to be used to protect employees who are hurt on the job, paying for medical expenses, lost wages, and other expenses until the worker can return to work. Only a very small percentage of employees will commit worker’s compensation fraud, but those that do cause a lot of damage.

The reason people will commit worker’s compensation fraud is obvious – the money. Worker’s compensation gives essentially free money to injured employees until they are able to return to work. Sometimes workers will even take on another job to obtain wages whiles still claiming to be injured and collecting money from their original job. Others will use the money obtained from worker’s compensation to pursue hobbies or make home repairs or other activities while still claiming to be injured and unable to work.

Fake Claims

There are several fake claims that can and will be used by a worker committing worker’s compensation fraud. One common one is getting injured off the job and claiming the accident happened at work. A worker may sprain an ankle playing football with his children, but claim that the accident happened on the loading dock at work. Thus he may receive worker’s compensation money for an injury that happened somewhere else.

Inflated Injuries

Inflated injuries are another fake claim that is commonly used. If a worker strains her neck slightly from looking at the computer, but claims she is severely injured and receives more money and stays off the job for longer without having to work.

Similar to inflated injuries, some workers will simply create an injury to get out of working. Muscle problems with the back and neck are common scams since they are hard to disprove.

Old, often non-work related injuries are also used as an excuse to receive worker’s compensation money. When the knee the worker broke in college playing football begins to act up later in life, he can claim that the injury was sustained recently on the job.

Malingering

Malingering is related to all of the above tactics. Even if the worker legitimately was injured on the job, if they are healed enough to return to work and are still pretending to be disabled so as to college worker’s compensation money, then they are committing fraud.

Sometimes doctors will also commit fraud by billing insurances for injuries that did not happen, or over exaggerating the amount of damage was done in order to receive more money from the insurance companies. This is one of the hardest types of fraud to catch, as the person being treated is not always aware that he is being taken advantage of. Beware the doctor who seems to suggest over the top and treatments that are not completely necessary.

Suspect Worker's Compensation Fraud?

Worker’s compensation fraud is dangerous for everyone involved. High insurance premiums, lower wages, and lost jobs are common results of worker’s compensation fraud. If you suspect an employee of worker’s compensation fraud, do not hesitate to hire a private investigator to help you safely and legally come to the right conclusion. At Tim D. Wilson investigations we are able and ready to help protect you and your business from workers’ compensation fraud. Call 1 (800) 820-7006, in Houston (713) 956-1111, or contact us online today.


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Houston Investigations:  (713) 956-1111
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