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According to the Coalition, here is how the top five fake workers compensation claims are made:
• Hurt off the job. Workers get injured off the job but say they’re hurt at work so their workers compensation policy covers the medical bills. A person might hurt his neck lifting a heavy box while cleaning the attic or sprain an ankle during a softball game, then pretend the injury happened at the loading dock at work.
• Inflated injuries. A worker has a fairly minor job injury—maybe a slight twinge in his lower back—but insists his back is seriously sprained. This lets the worker collect more workers comp money and stay off the job longer.
• Fake injuries. Some workers simply invent injuries. Soft-tissue injuries, such as muscle problems with the back and neck, are popular scams. They’re hard to disprove and, thus, are easier to get away with.
• Old injury. Sometimes, a worker with an old injury that has never quite healed will claim he just got hurt on the job.
• Malingering. Basically, this is goldbricking. A worker stays at home longer by
pretending still to be disabled, even though he has healed enough to return to work.
If you suspect an employee of defrauding the workers compensation system, it is your duty and to your benefit to report him. The insurer will handle the investigation, and—if the employee is found to have an authentic claim—nothing is held against you for alerting the insurer about your concerns. |