Welcome

A growing population and our biggest concern.  We have uncovered an unbelievable amount of professional workers comp claimants.  Some cross insurance boundaries and have multiple comp claims while also pursuing unrelated civil personal injury/auto claims, some for accidents they themselves caused for the purpose of financial gain.  It's mind-blowing.  

What's worse is, after successfully scamming without detection, they not only continue their own scams but teach others how to "beat the system."  For that reason, we often have many cases/claimants concentrated within a neighborhood - we call these claimant havens...a whole community of scammers, fraudulently living on workers comp or other bogus litigation money.

Workers get injured off the job, but say they're hurt at work so their workers comp policy covers the medical bills. A person might hurt his neck lifting a heavy box while cleaning the attic. Or maybe sprains an ankle during a softball game.  

Crooked workers often secretly take a second job or open a side business while falsely claiming they're too injured to work their current job. Thus they receive lost wages from their workers comp policy — and illegally earn extra money from their secret job.  Some just consider it extended paid vacation.  This is called Double-Dipping.  Great for ice cream, not for fraud.

Laziness is a huge motive.  Some claimants want nothing more than to do nothing and are just lazy.  Their conscience allows them to lie to doctors, lie to their attorney, and lie in commission hearings, all while faking or exaggerating an injury to stay home and do nothing.  We like these claimants because they're easy to catch.  Too lazy to work often means too lazy to attend required doctors appointment or too lazy to keep up the façade outside of the house (using crutches, faking a limp etc.).  

A happy workforce reduces the odds of workers comp fraud at your business. So help to create a safe and supportive workplace. Specifically...

Show you care about safety and your employees. Build strong teamwork among your employees about safety. Equally important, be clear that you won't tolerate fraud.

Build partnerships with employees. Create a safety program. Listen to employee complaints. Correct safety problems now. Show you care about good working conditions.

Zero tolerance. Inform employees that your company has zero tolerance for fraud. Scams cheat their company — and threaten their jobs.

Check job applicants carefully. Criminal backgrounds and a history of suspicious injury claims can be good predictors of potential fraud.

Report accidents. Require workers to report all job accidents immediately — and get them treatment promptly.

Report fraud. Show workers how to report suspected fraud confidentially. Prominently place your insurer's fraud hotline number around the workplace, but don't go overboard. Honest workers may find it offensive if all workers comp claims are treated with suspicion.

Alert your insurer. Let your insurance company know about suspicious claims immediately. Encourage active investigation of suspect claims.

Provide procedures. Give employees written safety and anti-fraud policies & procedures.

Reward fraud tips. Consider an employee reward program for reporting suspicious claims that lead to conviction.

Know the warning signals. Employers should know the warning signals of suspicious claims. Obtain a list of fraud indicators from your workers comp insurer.

Verify your insurer. Make sure your workers comp insurer is licensed in your state. Contact your state insurance department. You don't want to be sold fake or unauthorized insurance. 

 Workers

The high cost of fraud can damage your employer. It can also cost you in lower pay — and even jeopardize your job. Help your employer fight workers comp swindles.

Contact supervisor. Contact your supervisor or insurance company's fraud hotline immediately if you suspect someone's committed a scam. Include as many details as possible. Don't wait; the trail may get cold.

Watch for medical mills. Be wary if a doctor wants tests or treatments that seem excessive for your injury... Avoid lawyers who aggressively recruit you for treatment at a specific clinic... Keep records of your visits and treatments, and compare to the statements the insurer sends you.

If you're hurt on the job, seek the treatment and compensation you deserve, and know your rights as an injured worker in your state.