Different Types of Worker’s Compensation Fraud

Accidents can happen anywhere, including your workplace. Sometimes, the nature of work or the working environment can deteriorate one’s health. When an employee files a lawsuit against the employer, the company’s reputation is put at risk.

The Worker’s Compensation Insurance is a program designed to take care of work related injuries and illnesses among employees. With a sound insurance plan, business owners can prevent employees from suing and dragging them to court; the employees get the benefits they need and the employer is saved from paying the expenses out of pocket. Worker’s compensation covers medical bills and lost wages for an indefinite time period.  

While the program was established for the wellbeing of business owners and their staff, many individuals try to manipulate it for personal gains.  Wheat Ridge, CO Worker’s Compensation Lawyer state that worker’s compensation fraud comes in different forms; anyone among the employee, employer, or healthcare provider can be held liable. 

Worker’s Compensation Fraud by Employees

Worker’s compensation fraud by an employee is the most common of all three. Sometimes workers fake an injury or illness to get time off without deduction of salary. Pretending to have a fever and submitting a fake doctor’s certificate for leave is something that is witnessed frequently at offices and workstations.

At times accidents do occur and cause mild injuries to employees. The employee may exaggerate the injury or illness to avoid coming in for work. For example, ordinary leg cramps could be described as intolerable pain, which is keeping them from standing up or leaving bed.

Some workers utilize injuries that were not inflicted on the job. An injury encountered elsewhere is demonstrated as one caused at the workplace, so the company pays for their medical expenses and lost wages.

Worker’s Compensation Fraud by the Employer

Many business owners only buy worker’s compensation insurance because it is a requirement of the state. The interest of their employees does not concern them, so they seek shortcuts to minimize the payables.

Presenting employees as independent contractors, wrongly classifying workers, or showing a lesser number than the actual quantity of staff are a few widely used strategies. Many companies misinterpret the job requirement and lie about environmental safety to qualify for cheaper premiums.

Although this technique helps them save substantial payments in the beginning, they have to pay heavy fines and penalties when they get caught. In some cases, higher taxes are imposed and employees have to be paid more for ‘extra work’.

Worker’s Compensation Fraud by Healthcare Providers

Healthcare providers, including doctors, nurses, and hospital accountants tend to take advantage of the system. Physicians give an incorrect diagnosis or represent a minor injury as a serious medical condition. They overcharge for patient care and bill the company for treatment that was neither necessary, nor provided.

By fooling the injured employee and their employer, they are able to extract a good load of money from the insurance program. A wrong procedure or unsuitable medication that harms the patient shall be considered as medical malpractice. Medics that are accused of insurance frauds and medical malpractice can lose their operating license. Medical practice lawsuits ruin the reputation of healthcare facilities and sometimes cost them millions of dollars.