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Workers Comp Fraud Bill Now Tops US$5 Billion Each Year

Posted on 17, Jun, 2013

The United States is a wonderful country which does its very best to take care of its citizens, regardless of what state they live in. A big part of caring for the working men and women of our fine nation is providing workers compensation for people who are injured either temporarily or permanently while on the job. It's worth remembering that not every country in the world offers this type of benefit to its workers, but unfortunately the availability of worker's comp tempts tens of thousands of people to file false claims each year. As of now the total bill for insurance companies paying out on this type of fraud is in excess of US$5 billion every single year - an amount which is simply unsustainable.

Workers comp fraud is unfair on just about everyone else in the country except the person who has decided that they're so badly "injured" they can never work again. Law abiding, tax paying citizens then face increased insurance premiums and fewer job opportunities as a result. From a business perspective many companies can be forced to relocate or lay off workers to cover the cost of vastly inflated insurance premiums caused by these workers compensation claims.

So why do some people make fake worker's comp claims in the first place? The reality is that these people just don't want to work and expect the rest of us to take care of them. This means for every fake workers comp claim that is made, another person has to work harder to take up the slack - in effect honest people have to work harder to make the same amount as a dishonest person is being paid for doing nothing.

The Most Common Types of Fake Worker's Comp Claims






#1 Fake injuries

This occurs when a worker fakes an injury such as their back, joint or neck pain - all of which can be difficult to diagnose and prove.

#2 Injured at home

A fake claim like this revolves around a worker falling or slipping at home, getting injured but then pretending the injury actually happened at work. This is done by them knowing that workers comp will cover their medical bills.

#3 Old injuries

Some workers will claim that an old injury has flared up again, preventing them from working. Firm favorites in these claims are soft tissue and joint injuries, because they're difficult to prove or disprove.

#4 Malingering

Most people appreciate their health and the opportunities it offers them but a malingerer will happily stay on workers comp for months or years after they've healed. They don't care that they're not injured anymore and they don't care how much it costs their employer, fellow employees or the state itself.

#5 Exaggerated injuries

These types of claims involve a minor accident which is then exaggerated by a factor of about 10, until the employee loudly declares they're no longer able to work. Again people making these types of claims will cite nerve, spine or joint damage or in some cases neurological problems like migraines as a result of their working conditions.

Please bear in mind that as tempting as it might be to make a false workers comp claim, the penalties when caught can include fines, full repayment of all amounts paid to you by insurance and/or a prison sentence. The risks and penalties will far outweigh any potential benefits.

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