Skip to main content
Construction Insurance Bulletin

How Common is Workers Compensation Fraud?

By April 2, 2016No Comments

04-16-con-1If you work in construction for any length of time, you’re going to wind up dealing with worker’s comp, and if you deal with enough worker’s comp cases, you’re going to have a few that make you go “Hm…”

The good news is that worker’s comp fraud isn’t as common as many would think, and the even better news is that it’s usually pretty easy to spot when it happens. Anyone who’s able to fake their way into a nice steady stream of compensation would probably make more money going into acting. Here are some of the telltale signs that you may want to investigate further:

The Injury is Reported on Monday Morning

This is a clear sign of an injury that may have taken place over the weekend, and an employee who wants to collect some worker’s comp.

Nobody Saw the Accident Take Place

Obviously there are plenty of accidents that happen when nobody’s looking, but most experienced construction workers know better than to do a dangerous job with no backup.

A Long History of Claims

Unless your employee is named Moe, Larry or Curly, a long history of injury claims is usually a sign pointing to fraud.

Refusal of Treatment

If your employee is suffering a real injury actually sustained on the job, then they shouldn’t have an issue with letting a medical professional take a look at it.

Employment Change

If the accident takes place right before an employee suspected that they were going to be fired, or right before a strike takes place, there’s a chance that they may be trying to get it while the getting’s good.

Claimant is Hard to Reach

A claimant who is supposedly disabled but never seems to be at home to answer the phone or shoot an email back at you is quite often, well, not at home.

Any one of these signs is, in and of itself, not a big deal. If a union worker happens to fracture a toe right before he was going to go on strike, it shouldn’t be his tough luck that he’s now injured AND out of work. However, two or more signs in one case do start to look a little suspicious.

Again, worker’s comp fraud isn’t really all that common. We only see the worst-case-scenario in the news, because the fact that most claims are legit simply doesn’t make for a very entertaining read. But that doesn’t mean that we shouldn’t be vigilant.