About Workman's Comp Fraud

Workers Compensation is a program in which all employees are protected financially if injury results while on the job working for the employer. Often referred to as Workers comp or Workman's comp---the compensation program also runs a high risk for fraudulent activity due to workers trying to defraud the system and seek benefits for a false injury and then not have to return to work.

Significance

Workman's comp fraud is a million dollar problem that affects the financial sector of the United States government. Thousands of workers are charged yearly with defrauding or attempting to defraud the workman's comp program. Instilling stricter guidelines, hiring more caseworkers and capping out benefits in certain cases work toward making less people each day trying to act fraudulently toward the system.

Types

The different types of workman's comp fraud include those who continue to collect benefits long after they go back to work on another job or work under the table where no taxes are taken out. Other types of fraud are employers assist employees to turn in claims for hours not worked, submitting fraudulent or false earning statements to the government, faking injury's and employees lying to their employers and the workman's comp employees. Some of the more serious cases involve workman's comp check fraud and multiple identity theft to collect checks and monies from employers and workman's comp.

Time Frame

Some people are on workman's comp for only a few weeks while others remain on it for months or years despite an injury or not. While periodic reviews of each case are carried through and reported on, some fraudulent activity still passes through the system undetected. The penalties for defrauding the workmans comp system can involve losing benefits for several months or even permanently, depending on the amount and length of the fraudulent activity. For lying to workman's comp it is considered a felony and one can receive a harsh probation of several months, jail time and loss of benefits as well as having to repay back monies illegally collected. For check fraud, prison time will likely be implanted along with lifetime banishment from the workman's comp program.

Identification

There are workman's comp fraud investigators who work internally within the government run system to help determine from physical and clinical data if a person may be lying on their claim. Often times government case workers accompany clients to doctors appointments and legal appointments and act as an advocate on behalf of the worker---during this time the advocate may pick up on signs or signals that would suggest the worker is hiding information, lying or trying to fraudulently cheat the system. Some signs of fraudulent activity would be a change in the physical condition of the worker, moving, not showing up for appointments and discrepancies in written and verbal information regarding the accident at work. All reviews are researched by an internal as well as external auditor who will determine if further investigation is necessary.

Effects

The effects of turning someone in or giving workman comp tips about an employee who is cheating the system will benefit not only the government and the workman's comp system but also the tax payer as well. When money is spent wisely amongst truthful claims when an employee needs the funding, cracking down on fraud will assure that monies and benefits will be available for years to come.

Resources

• Workman's Comp Fraud Information