Reviewing Workers Comp Claims

November 14th, 2018

How many workers comp claims have been filed by your clients’ employees this year? Did you suspect any of them were fraudulent? Occasionally, an employee will exaggerate or fake an injury. Let’s look at some ways you can better spot those questionable claim.

What is your client hearing through its employee grapevine? That gossip could warrant a closer look. What are the details of the injury? Are they clear or confusing? Do they make sense? Who else saw the injury?

When was the injury reported to your client? A claim on a Friday is likely more accurate than one on a Monday morning. How much time has passed since the injury happened? If it has been over a week, it could be questionable.

Is the injured employee complying with medical testing required for their injury?

The answers to these questions will not automatically mean you can consider the claim to be fraudulent. Instead, consider how the answers tie together to paint a questionable or legitimate injury and claim.

A good way to prevent workers comp claims is to encourage your business clients to hold regular safety meetings. If your clients aren’t sure how to start such meetings, consider running a free seminar. Walk them through an example safety meeting or meet with them individually to discuss those safety concerns at their locations with tips and recommendations on how to keep their employees safe, especially new employees. It is also a good time to review with them what needs to happen when a workers comp claim surfaces.