Know the signs of workers’ compensation fraud in West Virginia

Businesses should be aware of the many signs that one of their employees is fraudulently manipulating the workers’ compensation system.

For many injured workers in West Virginia, workers' compensation insurance provides a way for them to recover successfully from a workplace accident without too much harm on their finances. However, some workers take advantage of this system through fraudulent activities and end up significantly harming the businesses for which they work.

Types of workers' compensation fraud

There are many different types of workers' compensation fraud. For example, some employees will knowingly file a bogus claim on their employer's workers' compensation policy to receive benefits. To accomplish this, employees may falsely claim they were hurt at work, inflate the injuries they incurred in a job-related accident, exacerbate an old injury, or pretend they are still disabled when they are capable of returning to work.

Common signs of fraudulent activity

There are many signs that can indicate an employee is committing workers' compensation fraud. These include some of the following:

  • An injury is reported first thing on Monday morning or an employee reports he or she was injured late on a Friday, but does not mention it until Monday morning.
  • An employee reports he or she was injured in a workplace accident before a layoff occurs or at the end of a big project. This can also occur at the end of seasonal work or after a job termination.
  • An employee reports that he or she was injured at work, but there are no witnesses who can back up these claims.
  • The employee who allegedly was hurt on the job provides information that conflicts with that included in the injury report or his or her personal medical history.
  • The employee has a history of getting hurt on the job and filing workers' compensation claims. These claims are often spaced closely together.
  • The employee waits to report his or her workplace injury for no reasonable explanation.

Workers' compensation fraud may also be occurring if the employee is hard to reach after the accident occurs or if he or she refuses to undergo diagnostic treatment to solidify the existence of the injury. Additionally, an employee may be committing insurance fraud if he or she has a history of changing doctors, addresses, and jobs.

Contact an attorney

False workers' compensation claims can harm businesses in West Virginia and make it difficult for them to continue their operations profitably. Those who suspect their business is the victim of workers' compensation fraud and those who insure employers for workers' compensation and administer West Virginia claims should contact an attorney in their area who can provide them with legal assistance.