How Can Employers Identify Potential Employee Fraud?

As long as workers’ compensation insurance covers employees, there will be those who take advantage of the system. It is often suggested that California employers be aware of potential employee fraud and abuse of privileges, and learn how to handle such problems if they arise. The failure to understand the methods used to defraud the workers’ compensation system can result in unnecessary increases in insurance premiums and a negative impact on company profits.

A recent case in another state is a good example of how employee fraud can be committed. A 54-year-old former police officer reported a knee injury in March 2011, claiming to have suffered the injury while on duty. Although his injury was confirmed by a doctor and reported to his employers in the appropriate manner, investigators allege that the injury did not occur in the line of duty. The officer retired from the police service in 2012 but continued to receive benefits payments for his injury.

The Workers’ Compensation Fraud Control Unit investigated the allegations, and the man was arrested on a recent Monday. An affidavit for the arrest warrant indicated that the man had received disability benefits in excess of $34,000 for a knee injury that was not work-related. A conviction on a felony workers’ compensation fraud charge could mean up to 20 years behind bars for the former cop.

With every workers’ compensation claim filed by a California employee, the company’s insurance premiums potentially increase, and if employee fraud is not addressed, the company may lose valuable funds while the employee enjoys benefits to which he or she was not entitled. Fortunately, there are California attorneys who focus their attention on protecting companies against fraudulent workers compensation claims. With the guidance of such a professional, an employer can learn how to identify fraudulent claims and what steps to take when it occurs.

Source: workerscompensation.com, “Retired Meriden Police Officer Charged with Workers’ Compensation Fraud”, 21, Jan. 12, 2016