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Common Types Of Workers’ Compensation Fraud

Workers’ compensation fraud is a huge problem in the United States. Every year, businesses lose a lot of money due to fraudulent claims, and some of these types of fraud are more common than others.

Making a false claim

Another common type of workers’ compensation fraud is filing a false claim. This means that the person claiming to be injured is actually not injured, or they’re exaggerating their injuries. This type of fraud is often committed by people who are in financial trouble and need the money from a successful workers’ compensation claim. Sometimes, people knowingly make false statements on their claims in order to get benefits they aren’t entitled to. For instance, they might lie about their income in order to get more money from disability benefits.

One way to catch this type of fraud is to have the person claiming to be injured undergo a medical examination. If the examination shows that the person’s injuries are not as severe as they claim, it’s likely that they’re committing fraud.

Another way to catch this type of fraud is to investigate the person’s work history. If someone has a history of filing false workers’ compensation claims, it’s likely that they’re doing it again.

Employer fraud

Unfortunately, not all cases of workers’ compensation fraud are committed by individuals. Sometimes, employers commit fraud by making false statements in relation to their employees. For instance, an employer might falsely report that an employee doesn’t work for the company in order to avoid having to pay workers’ compensation benefits. Or, an employer might misclassify their employees in order to lower their workers’ compensation premiums.

Sometimes, employers work with insurance companies employees to commit fraud. For instance, an employer might pay an insurance company employee to deny legitimate claims. So, a worker of one of the New York power plants with asbestos poisoning might not receive insurance money for their surgeries or other forms of treatments.

There are a few ways to catch employer fraud. One way is to look at the company’s workers’ compensation insurance rates. If the rates are unusually low, it could be because the company is misclassifying its employees.

Inflating the cost of medical treatment

Sometimes, people will try to commit workers’ compensation fraud by inflating the cost of their medical treatment. This means that they’ll either bill for more expensive treatments than they actually received, or they’ll bill for treatments that they didn’t receive at all.

Sometimes, this type of fraud is hard to catch. However, there are a few ways to investigate it. One way is to look at the medical bills and see if they match up with the treatments that were actually received. Another way is to talk to the person’s doctor and see if they confirm that the person received the treatments that they’re billing for.

Filing multiple claims

Sometimes, people will try to commit workers’ compensation fraud by filing multiple claims using different identities. This means that they’ll use different names or Social Security numbers to file multiple claims.

One way to catch this type of fraud is to look for red flags. For example, if someone has multiple claims filed in different states, it’s likely that they’re committing fraud. Another red flag is if someone has multiple claims filed in a short period of time.

Filing a claim for an injury that occurred outside work

Usually, workers’ compensation only covers injuries that occur while on the job. This means that if you get hurt while playing sports or doing something else outside of work, you can’t file a claim. However, some people will try to file a claim anyway, hoping that the insurance company will just pay out without investigating too closely.

One way is by looking at the person’s social media accounts. If someone is claiming to be injured at work, but their social media shows them doing activities that would be impossible with their injury, it’s a pretty clear case of fraud. Also, there are ways to show that an injury occurred outside of work, such as surveillance footage or witnesses.

Although some types of workers’ compensation fraud are obvious and easy to catch, others are more difficult to detect. However, there are ways to investigate all types of fraud. If you suspect that someone is committing workers’ compensation fraud, you should contact the appropriate authorities so that they can investigate.

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