Red Flags That an Employee Has Filed a Fraudulent Workers’ Compensation Claim

It would be wonderful if all the employees took their jobs seriously and no one was ever out to get something they don't deserve. However, this just isn't always the case when it comes to filing workers' compensation claims. Sometimes employees looking for a way to stay home or collect a large settlement will file a claim, hire a great workers' compensation lawyer, and sit back collecting their monthly payments and fighting for a big payday at the end of the process.

So, as an employer, how do you know if an employee was actually injured on the job or if they simply filed a fraudulent claim hoping for a long vacation and a big settlement? While that's a hard question to answer and your situation should be reviewed by a workers' comp attorney of your own, there are many red flags common in many claims that were later proven to be fraudulent, including each of the following:

Red Flag: The Injury Happened When the Employee Was Working Independently

Often, fraudulent workers' compensation claims are made for injuries that happened when no one else was present other than the "injured" employee. While some people clearly do get injured on the job without any witnesses, a claim from an employee is suspect if they typically don't work alone or just so happened to get injured outside of the view of cameras or others on-site.

Red Flag: The Employee Has a Spotty Work History

If your new employee screening process is a bit lacking and you hired an employee who ended up having a very spotty work history, then it's entirely possible this isn't their first fraudulent claim. It is sometimes the case that an employee will call in sick a lot, file fraudulent injury claims, and, when it's proven there is no illness or injury, they simply hop to a new employer to start the process all over again.

Red Flag: The Employee Was in the Process of Being Terminated

If you have a meeting and speak with an employee about their lacking job performance and the following week they file a workers' compensation claim, then this is a huge red flag for fraud. Sometimes when employees can see the writing on the wall that their job is ending, they will file a fraudulent claim to provide them an income source until they have to find a new job.

Red Flag: The Employee Ignores Your Attempts at Contact Post-Injury

Finally, if an employee files a claim for workers' compensation and then disappears, this is also a major red flag. A truly injured employee has no reasons to dodge your calls and should be reachable because they should be at home recovering rather than out on the town. 

For more information about workers' compensation law, speak to a workers' compensation lawyer.


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