There are millions of workers’ compensation fraud schemes so employers may want to be aware of potential bogus claims employees – and medical professionals – may make at their expense. According to the Coalition Against Insurance Fraud, billions of dollars in false claims and unpaid premiums are stolen every year.
“Scams are forcing premiums higher, draining business profits and costing honest workers their pay and jobs,” the Coalition said on its website, noting that scams also cause businesses to raise prices, which affects general consumers.
According to the Coalition, there are several types of fake injury claims:
Hurt off the job – Workers are injured outside of work, but say they get hurt at work so workers’ comp covers medical bills.
Inflated injuries – Workers suffer a minor job-related injury, but insist their injury is worse than it really is. This allows them to collect more benefits and stay off the job longer.
Fake injuries – This is just as it sounds: Workers falsely claim to sustain injuries on the job. Injuries in the back and neck are popular fraud schemes because they are difficult to disprove.
Old injuries – Workers claim an old injury has been agitated and was re-injured on the job.
Malingering – The Coalition calls this “goldbricking,” meaning the workers stay home longer than necessary and pretend they are disabled when, in reality, they are well enough to return to work.
Unscrupulous doctors may also take part in assisting a workers’ comp fraud scheme by billing insurers for more costly treatment than necessary, inventing injuries, and even working with dishonest workers to seek additional damages from employers.
Employers who suspect fraud are encouraged to call the SCF Arizona Workers’ Comp Fraud Hotline, at 800.526.5226, immediately