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Avoiding The Appearance Of Workers' Compensation Fraud

Fraud can occur in several insurance situations. However, workers' compensation has a reputation for having more fraud issues than many. Read on and find out what workers can do to escape allegations of fraud when filing an insurance claim.

  1. Don't wait to get medical care. The longer hurt workers take to get medical treatment, the more likely it is that they can be suspected of faking an injury. When an injury is bad enough for worker's compensation coverage, the workers should go to the doctor or hospital immediately.
  2. Report even minor injuries. However, you should not hesitate to report even minor injuries to your supervisor in writing even if you don't intend to seek workers' compensation. You don't need to get medical care for minor injuries, but when you report them, you are setting up a trail of evidence in case you later have an accident that is much more serious.
  3. Don't exaggerate your condition. You don't need to make your injury seem worse than it is when you fill out your claim form, report it to your supervisor, and seek medical care. Doing so could make it appear that you are not hurt and are trying to gain benefits fraudulently.
  4. Be honest about other injuries. In some cases, the workers' compensation insurer will ask about previous injuries or medical conditions on the claim form. If you fail to mention them, the insurer may find out later and deny your claim when they ask for your medical records. Mention any major illnesses, hospitalizations, previous work injuries, and car accident injuries to avoid problems with your claim.
  5. Obey doctor's orders. If your workers' comp doctor orders you to remain home and recuperate, don't use the time as a vacation opportunity. In many cases, the workers' comp insurer employs investigators that will follow claimants around and photograph them while out in public. You may never know you are being surveilled, but the photographs could make it look like your condition is not as severe as you are claiming.
  6. Be careful with income. It can be difficult to cope with the reduction in salary for hurt workers. Most workers depend on every bit they make, and the partial salary benefits offered by workers' compensation can make things financially difficult. However, if you decide to take on a part-time job, be very careful not to do work that goes against medical advice and be sure to report all earnings to the insurer.

If your claim has been unjustly denied due to false allegations of fraud, speak to a workers' compensation lawyer about your case.