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Protect Your Business Against Workers' Compensation Fraud in WV

Safeguard Your Business From Workers' Compensation Fraud in WV by Recognizing the Warning Signs

For many injured employees in West Virginia (WV), workers' compensation insurance provides a way for them to recover successfully from a workplace accident without too much harm on their finances. However, some employees are committing workers' compensation fraud in WV and end up significantly harming the businesses for which they work. In fact, an estimated 10 percent of insurance claims are suspected to be fraudulent, according to the National Insurance Crime Bureau (NICB). Thus, as a business owner, it is imperative that you know the warning signs of workers' compensation abuse in WV and consult an attorney regarding suspected fraudulent activities to protect your business from employees who might be taking advantage of the system.

Types of Workers' Compensation Fraud in WV

There are many kinds of workers' compensation fraud in WV. 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 Benefit-Related Workers' Compensation Fraud in WV

According to NICB, "fraud is the second most costly white-collar crime" in the U.S. Thus, workers' compensation fraud in WV ultimately increases the costs of doing business. It is your responsibility as an employer to safeguard your business by identifying the following signs that your employee may be committing a benefit-related workers' compensation fraud:

  • An injury is reported first thing on Monday morning, or an employee reports he or she was injured late on a Friday but did 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 was allegedly 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 delays reporting his or her workplace injury for no reasonable explanation.

Moreover, workers' compensation fraud in WV may be perpetrated by health care providers. For example, your employee's physician may present medical records that have been previously submitted, file claims that include charges for unnecessary services, or impose an overpriced medical fee/rate.

The insurance law protects individuals and businesses against any type of WV workers' compensation fraud. In fact, the WV Offices of the Insurance Commissioner created its Fraud Unit and urges anyone to report suspected fraudulent activities.

Suspect Workers' Compensation Abuse? Contact an Attorney

Workers' compensation fraud in WV harms your business and makes it difficult for you to continue business operations profitably. If you suspect that one of your employees is committing workers' compensation abuse, contact one of the workers' compensation attorneys at Jenkins Fenstermaker, PLLC. Our attorneys have years of experience in handling cases relating to fraud. Contact us today at (304) 523-2100.

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