As a stalwart steward of your business and its assets, you are tasked with ferreting out and denying false and fraudulent claims for workers’ compensation benefits. While most of your employees will likely be upstanding and honest, all it takes is a few bad apples to start eating into your profit margin.
Because there truly is no free lunch, those false claims for compensation must be identified. Otherwise, your company will start feeling the pinch from increased premiums for workers’ compensation insurance.
How to fend off fraudulent claims
Suppose your worker claims to have twisted his knee stepping down off a ladder. He suspects that his ACL might have popped, necessitating an expensive surgical procedure with a lengthy recovery period.
Before rubber-stamping that claim as “Approved,” take a look at the security video from the morning the accident occurred. There, you clearly see your “pre-injured” worker hobbling across the parking lot from his truck to your door, clearly favoring the knee he will later claim got wrenched on the job.
Watch out for malingerers
Let’s say that you watched the morning video and your injured guy appeared to be fine and uninjured. So, it’s likely the injury did indeed occur on company time and during the scope of the employee’s duties. It’s legit.
But your worker doesn’t appear to be getting better at the normal rate of recovery for such an injury. Every doctor visit has notes indicating there is little to no improvement. You could be dealing with a malingerer.
These sorts will go to great lengths to milk a claim. From intentional re-injury of healing tissue to failure to complete required physical therapy, they will attempt to prolong a claim as long as possible.
Understand your legal options for false claims
Addressing your concerns about such claims with your legal counsel can leave you better poised to deal with any blowback from denying or limiting a worker’s claim for compensation.