Workers’ compensation, also known as workers’ comp, is a government program that provides much-needed benefits for employees who suffer injuries or illnesses due to the tasks they are performing. They receive money, healthcare benefits, or both.
As with any government program, fraud commonly occurs, whether it involves employees, employers, or health care providers. Regardless of how elaborate certain schemes are, the impact can damage a company’s bottom line and increase premiums for injured workers in the future.
Types of fraudulent activity
Fraudulent workers’ compensation schemes can take various forms and include:
Employees
- Employees who claim they suffered a job-related incident subsequently receive payments for so-called “medical costs.”
- Staff members who claim repetitive injuries while working and subsequently overstate or lie about the true impact of the physical damages
Employers
- Employers misclassify an injury or employees, effectively making them temporary staff or contractors to reduce their premium expenses
- Company owners who deliberately report inaccurate data on the actual number of employees to reduce workers’ comp costs
- Employers who falsely cite a current work safety program to lower workers’ compensation costs
- Employers failing to buy workers’ compensation insurance when their home state mandates it
Medical professionals
- Doctors and surgeons who submit bills for services that never occurred
Workers’ compensation fraud costs tens of billions of dollars every year. Employers attempting to sidestep the law face serious fines that could potentially put their enterprises out of business. Publicity of the allegations alone can damage a company’s bottom line. Help from a skilled attorney can help even the odds they face against powerful government bureaucracies.