Identifying a fraudulent claim

Studies commonly show that roughly 90% of all workers’ compensation claims filed are legitimate. However, it is still important for an employer to watch for these red flags that may indicate a fraudulent claim:
  • Filing multiple claims
  • Longer absences than anticipated by the employee, combined with an unwillingness to return to work
  • Unwillingness to be assigned to other, lighter jobs within the company or to complete partial duties
  • Constantly missing medical appointments
  • Employee will not provide the date, time, or location of the incident that caused the injury
  • Employee has no recollection of services provided for related medical bills
  • Lack of witnesses to an accident or incident
  • Employee cannot produce specific information about the nature of the injury
  • Employee has a history of short-term employment
If any of these red flags occur, it by no means makes the claim automatically fraudulent. These are simply guidelines to keep employers proactively evaluating the legitimacy of a workers’ compensation claim. 
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