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How to Detect a False Workers’ Compensation Claim That Could Harm Your Business

During the course of running a business, there will eventually come a time when you might have to contend with an accident that befalls your employee. A workers’ compensation claim is not necessarily bad for your business, considering that this is a measure that protects employees. Not only is it an employer’s obligation to ensure that workers have a safe environment, but it is also a show of goodwill towards an injured worker.

However, not all injured workers file a workers’ compensation claim in good faith. In fact, some of them may file a false workers’ compensation claim for the financial benefit when they shouldn’t be entitled to compensation. This is not going to sit easy with any reasonable business owner. After all, nobody wants to have to pay for an accident that they had nothing to do with. With this in mind, what are some signs of a false workers’ compensation claim?

Monday Morning Report

The reason why a Monday morning report is automatically suspicious is because of the possibility that the accident took place during the weekend. It’s not uncommon that employees who aren’t covered by a health insurance policy might use the workers’ compensation benefit to pay for their medical treatment.

Injured Worker Refuses Diagnostic Procedures

Another obvious sign of a fraudulent workers’ compensation claim is when the injured worker refuses to undergo diagnostic procedures like MRI or X-Ray scans. There is no reason why an injured person would refuse to undergo a diagnostic, especially when you let the employee know that the test is free.

Hazy Accident Details

It can be suspicious when details are self-contradictory and when there is a lack of clarity surrounding the events of the accident. While this does not automatically mean that a worker is lying about having an accident, this should be indicative of a need to investigate the accident further. This also means that you might want to ask other members of the same department about the accident.

No Witnesses

Another sign that you might want to be on the guard is when the worker claims that there were no witnesses to the accident. This is especially difficult to justify with big companies that hire thousands of employees. Again, this isn’t a reason to outright disqualify a worker from compensation, but rather it is a sign that you need to delve deeper into the issue.

Claim Reported Over 7 Days After the Accident

A worker that doesn’t report an injury immediately is bound to have his or her integrity questioned for the simple fact that if the injury was indeed serious enough to file a workers’ compensation claim, then the worker would not have waited too long to file it.

While these red flags do not automatically indicate a false claim, they should be treated as signs to investigate the circumstances surrounding the accident further. It’s also a good idea to seek legal help from professionals like this Baltimore workers compensation lawyer to help you defend yourself from fraudulent claims, especially since they can carry a heavy penalty.

BIZCATALYST 360°
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