Why Your Employer May Suspect You Of Workers’ Compensation Fraud

Your employer and their insurer are likely to cooperate with you in your workers' compensation claim process if they believe it's genuine. This means it's in your best interest to avoid anything that may make them suspect your case isn't genuine. Here are three behaviors that may make your employer suspect you of workers' compensation fraud:

Being Out of Reach

Many employers will suspect you are trying to play the system if you are constantly out of reach after your injury. If you are neither picking up calls nor replying to your emails, your employer may think you have something to hide. After all, an employee who is truly nursing their injuries is likely to be resting or recovering at home, so why can't you be reached?

Reporting an Injury Late

Any person injured on the job is required to report the injury promptly (to their supervisor), to see a doctor, and to file for workers' compensation. The prompt report helps insurers and employers to investigate the injury claims; you hamper the investigations if you delay. If you allow some time to pass, witnesses may be difficult to locate, and the scene of the accident may be tampered with.

Consider the example of a mechanic who reports a slip and fall accident caused by ball bearings on the shop floor. Reporting such an injury late may make the insurer or employer suspect a scam because it's difficult to tell the exact conditions on the floor on the day of the injury.

Giving Conflicting Descriptions of the Injury

If there were any witnesses to your accident, then their account should match yours, at least on the major points. After all, you are all talking about the same injury. Therefore, you shouldn't be surprised if your employer or the insurance company doubt your claim if your description of the accident differs markedly from witnesses' accounts. They may think that you are editing some parts that make you look bad, like the fact that you were engaged in misconduct at the time of your injury. After all, in some states, employees who get injured while engaged in misconduct are denied access to workers' compensation benefits.

The more genuine your case looks, the faster it will be processed. Therefore, gather and preserve any evidence you may need to process your claim. If there are specific steps your employer requires for reporting injuries, follow them to the letter.