Employers are justifiably concerned about the possibility of workers' compensation fraud. It is both illegal and costly for businesses when it occurs, and they do well to monitor for it. The general pattern employers watch out for is when an employee files a false claim, lying about sustaining a work-related injury in order to obtain injury benefits.
There are a number of things businesses are cautioned by experts to look out for. This includes claims, which list no witnesses to the accidents; claims in which the medical providers or legal consultants have previously dealt with suspicious matters; situations in which the story underlying the injury is not consistent; cases wherein the employee refuses to consent to a confirmatory diagnostic procedure.
There are other things employers will look out for. If enough suspicious factors are noticed, an employer usually conducts a more in-depth investigation. In principle, there is nothing problematic with an employer wanting to be sure about a claim. The real problem arises when an employer intentionally puts up roadblocks to a legitimately injured worker receiving the compensation he or she deserves. Or, the employer may decide the employee can return to work before he or she is medically able to do so. In some cases, an injured employee may be denied extended or permanent disability even though one has a severe injury.
Whenever issues like this come up, it may be time for the employee to consult an attorney who will help to assert their rights. Employees with particularly serious injuries may be more likely to find themselves in this situation.
Source: Business News Daily, "10 Warning Signs of Workers' Compensation Fraud," Nicole Fallon, February 11, 2014.