There is no sure-fire way to identify fraud without proof or evidence, however, there are several red flags. Employers should call their carriers (the insurance company handling their Workers Compensation Policy for their company) immediately if they identify two or more of these flags.

1. Disgruntled employee. The employee has a motive to fabricate the claim. Perhaps he or she was denied vacation time, demoted or fired.
2. Employee is difficult to contact at home. Any employee that is on Workers Compensation benefits past the point of being able to work light duty, should be spending their time mostly at home trying to heal their injuries. If you cannot reach them at home most days, the employee may be working another job, under the table, while collecting benefits from the employer. This practice, called “double-dipping,” constitutes fraud.
3. New employee. Statistically, the newer the employee is, the more likely the claim is fraudulent, especially if other red flags appear. Many times, employees seek out job positions where they can work for the allocated amount of time to qualify them for Workers Compensation Benefits. Once that time has arrived, the employee will fake an injury and attempt to stay home and collect from the employer.
4. No witnesses. Make note of alleged accidents with no witnesses, especially if the employee’s duties rarely call for him or her to work alone.
5. Varying accounts of accident. The injured employee may describe the accident differently to the employer and the doctor, or witnesses’ accounts may differ from the injured worker’s account.
6. Accidents on Fridays or Mondays. Accidents that occur on Fridays or Mondays should raise suspicion, especially if other red flags appear. Many times, employees will fake and injury just to get the weekend or days before or following a weekend off with pay.