What Is Workers’ Compensation Fraud?

Lawyer in McHenry County, Personal Injury, Workers Compensation

Workers’ compensation is simply insurance that takes care of an employee when injured during work or develops an illness due to work. For an employee to be eligible for worker’s comp, the injury must not be self-inflicted.

Also, the injury must not arise from violating the company policies, like being on marijuana or hard drugs that make work accidents likely to happen. After a work injury, the employee can file a worker’s comp claim that handles medical bills; even provide wage replacement in case they are out of work.

Most states in the US make it mandatory for employers to reimburse workers’ compensation to employees after a work-related accident. However, workers’ compensation fraud happens when an employee lies about their illness or injury.

Here are a few of the few workers’ compensation frauds.

  1. Made Up Injury Or Illness

This worker’s comp is prevalent and entails the employee lying about an injury or illness to get some financial benefits. If an employee pulls this stunt off, the company ends up losing in the long run. Most workers often make up hearing losses just to get compensated.

  1. Exaggerated Injury

A worker can have a small sore arm that still allows them to work. But most employees can exaggerate the injury or illness to access workers’ comp. In this type of workers’ compensation fraud, the worker can function but pretend it isn’t possible.

  1. Non-Work Related Injury

An employee can get an injury outside of work and still pretend the injury was work-related. Sometimes, it could just be an old wound that resurfaces. For example, an employee might have a skiing injury that happened even before employment. But since they want to make some money off the company, they can lie that they slipped on a wet floor while working.

  1. Providers Workers’ Comp

A dishonest health care provider can work with an employee to exaggerate an injury. It is done to charge money to your workers’ compensation insurance. A health care provider that isn’t honest can request for more treatment than the worker needs.

Spotting Fraudulent Workers’ Comp Claim

Finding out if an employee is telling the truth can be somewhat tricky. But if you pay close attention, you will uncover the truth. When an employee file for a workers’ comp claim, ensure they provide an account of what happens.

If the employee is lying, the story will not add up, and they often have no witness. If you can access the camera where the said incident happened, you will determine if the story is true.

It is best to keep an eye on your employees, including keeping in contact with injured workers. When you hire someone for the first time, ensure you outline the procedures for filing a workers’ compensation plan.


Workers’ compensation fraud is become the bane of society and can drain a business. If you suspect that your employee could be lying about an injury, don’t hesitate to get a workers’ compensation lawyer for expert advice.

Contact Franks & Rechenberg. P.C. Attorneys at Law to help with your personal injury case.