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How can I tell if a worker fakes an injury?

When one of your employees gets hurt, your first thought is likely for the well-being of the worker. You want to ensure he or she receives immediate medical attention and that the employee completes the proper forms so he or she can obtain whatever treatment the injury requires. Because you are a compassionate person, you may act on your first thought.

However, your second thought is probably for your bottom line. Losing an employee, even temporarily, because of an injury, will slow down your production and may require you to pay overtime or hire someone to fill in. Your workers' compensation premiums may go up because of the claim. You may even begin to wonder if the employee is faking the injury.

Common indicators of fraud

Don't be so quick to dismiss your second thought. While the majority of employees claim workers' compensation benefits for legitimate illnesses and injuries, there are a few who manipulate the system for their own gain. Some of the signs of workers' compensation fraud include:

  • The employee is habitually unhappy, complains frequently or has problems with behavior or performance.
  • This is not the first workers' comp claim the employee has made.
  • The employee can't keep his or her story straight when asked how the injury occurred.
  • You can't contact the worker following the injury.
  • No one witnessed the accident that allegedly caused the injury.

An injury that supposedly happened on a Monday may actually have occurred over the weekend, and your employee may be trying to get workers' comp to pay for the medical treatment. Accidents that happen at the end of a Friday shift may also be suspicious. If your employee refuses any diagnostic tests, it could indicate that there is no real injury, and your employee knows an X-ray or MRI will reveal this.

Seeking assistance when facts are in dispute

Workers' compensation fraud is a challenge for any Kentucky business. You may have implemented policies to discourage workers from committing this crime. For example, creating a positive working environment may produce loyalty among your employees. Additionally, thorough background checks will improve the chances of building a trustworthy staff.

Nevertheless, if you find yourself facing a questionable injury claim from an employee, you will want every advantage to protect your business. You may gain this advantage by seeking advice from a legal professional with experience in workers' compensation defense as early as possible following an employee injury.

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