Signs of Workers Compensation Fraud

Signs of Workers Compensation Fraud

Contrary to popular belief works compensation fraud has more to it then an employee faking an injury or working for more money on the side when disabled. Though this does occur, employers can also be the ones that underreport their payroll so they get a lower premium. This means that the health care providers are billed for services that were never done.

What exactly is workers compensation fraud? It occurs when someone by their own will makes a false claim or hides a claim in order to receive benefits or avoid claims that one may deserve. Here is a list of some types of indicators that fraud may be taking place.

Employee Fraud

  • Over exaggeration of symptoms
  • Continuing to work when technically disabled and not reporting of income
  • Claiming that they were injured on a job, but it never occurred
  • Claiming both a work and non work related injury
  • Inaccurate mileage reports

Employer Fraud

  • Underreporting to payroll or claiming employees under a different or lower insurance premium
  • Deduction of dollar owed from employees wages
  • Employer has no workers compensational insurance

Medical or Health Care Fraud

  • Giving unnecessary tests or treatments to an employee to gain financial benefit
  • Billing for tests or treatments that were never done
  • Billing the insurer and the workers health insurer for the same service