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Workers’ compensation fraud: why we all end up paying

On Behalf of | Apr 24, 2015 | Workers' Compensation

In general, workers’ compensation exists to help employees who suffer legitimate job-related injuries cover medical expenses and other related costs until they are able to return to work. Unfortunately, there are some workers who attempt to take advantage of the system and, according to the Coalition Against Insurance Fraud, annually are responsible for “tens of billions of dollars in false claims and unpaid premiums.”

When unethical workers take advantage of the workers’ compensation system, everyone ends up paying. Money stolen through acts of workers’ compensation fraud mean that insurance premiums increase for employers who are often forced to cut salaries and even jobs in an attempt to cover these expenses.


It’s crucial therefore that employers and insurance providers take action to defend against false workers’ compensation claims. Examples of false claims may include a worker who asserts that an injury is work-related when he or she in fact suffered the injury while off the job.

A dishonest worker may also claim that an injury is a newly suffered work-related injury when in fact he or she simply aggravated an existing old injury. For example, an individual may have injured his back while playing basketball and then, one week later, aggravate or reinjure his back at work.

In other cases a worker may fake an injury to secure benefits or claim that an injury is much worse than it is in an attempt to secure additional monies. In many cases, false injury claims relate to musculoskeletal injuries and similar injuries that are difficult to both prove and disprove.

Employers and insurance companies who suspect that a worker filed a false injury claim would be wise to take action to reject the claim and to discuss additional options with an attorney who handles workers compensation defense matters.