Workers’ Comp Fraud

Studies commonly show that roughly 90% of all workers’ compensation claims filed are legitimate. However, it is still important as 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 date, time or location of the incident that caused 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.