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How You Might Get Burned By Worker’s Comp Fraud

workers-compensation-fraud

Worker’s compensation is designed to help those who are injured at work and lose their income as a result. It could be an employee who fell at work and needs several months of physical therapy to recover. If the employer cannot pay for the victim to spend months out of work, worker’s compensation is an insurance policy paid for by all employers to assist their employees in this instance. If a victim chooses to accept worker’s compensation following an injury, they relinquish their legal right to sue their company or employer for negligence. No personal injury case will take place following the acceptance of worker’s compensation by any employee.

Unfortunately, worker’s compensation fraud is a growing trend, and it could burn those who are legitimately trying to collection wages from the insurance policy for a real and serious injury. Worker’s compensation fraud is simple. A person falsely reports an injury or situation in order to collect the money offered by this insurance policy. Lesser known cases include employers using their own employees to make false claims regarding the amount of money they pay their employees as a way to save money. It happens all the time, and many people are unaware their own worker’s compensation case could take longer than expected, backfire, or not even work for them because of fraud. If you’re not sure how someone else’s fraud case could affect your truthful case, here’s how you could end up burned.

Red Flags of Worker’s Compensation Fraud

Every worker’s compensation claim filed is investigated by insurance companies to see if the claim is legitimate. While many people are able to claim their case and receive their funds without any issue, others aren’t so fortunate. Something in their claim raised a red flag with the insurance company, and now they’re going to experience delays in the acceptance of their claim, if they receive approval at all. Some red flags include:

  • Using a Post Office box address on your application
  • You aren’t home to answer phone calls during the day from the insurance company
  • You refuse transitional duty at your place of employment
  • Your medical records show you miss many of your appointments
  • Your injuries are minor, but your doctor appointments are complete with complaints unrelated to the actual injury
  • You don’t claim your injury right away
  • You obtain an attorney prior to your report

None of these things means you’re lying or that you’re going to find your claim is denied, but these are common red flags associated with most fraudulent worker’s comp cases. There are some ways to prevent your case from being handled as a fraudulent case.

Strong Worker’s Claim Cases

If you are an employer with an employee injured on the job, work with them to help apply for worker’s comp. This involves creating a strong cases that doesn’t raise any red flags.

  • Gather all witnesses to the accident
  • Report the injury right away
  • Check to see if that employee has a history of making worker’s comp claims
  • Encourage your employee to seek treatment
  • Encourage your employee to be available to discuss their claim immediately

When you work with your employee’s to support their claims when you know them to be true, you can help prevent worker’s compensation fraud from occurring. People are far less likely to make false reports when employers make it their goal to work closely with their employees in a helpful capacity. As someone’s employer, you want them to get the compensation they deserve to help them survive financially while undergoing treatment or rehabilitation or recovery. Working with them increases this chance and allows your employee to maintain a good relationship with your company.

Learn more about Worker’s Compensation Cases.

MARK T. SADAKA, ESQ., MSPH

MARK T. SADAKA, ESQ., MSPH

Principal & Founder
This article was written by Mark Sadaka, a seasoned trial lawyer in nationally significant cases. He fearlessly champions clients impacted by fatal or severe injuries caused by others or corporations. Renowned for his expertise in complex litigation, he's featured in books, sought after by media for interviews, and a highly sought speaker. Notably, he exclusively represents individuals facing life-changing injuries or substantial financial losses.

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