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Though there are legal safeguards in place to protect workers in any industry, here’s what statistics tell us:

One employee is injured every three minutes in Washington State.

While many injury claims are legitimate, the reality is, some employees misrepresent the cause or nature of their injury. This is called workers’ compensation fraud. In some cases, employees may cheat the system in an attempt to reap the personal and financial rewards that come from an on-the-job accident, when their injury did not actually occur at work… or they aren’t actually injured at all. Regardless, employers must follow a specific protocol when any injury is reported.

What Happens When an Employee Reports an Injury?

When employees claim to be injured on the job, they will have to file a report on the accident with the Washington State Department of Labor and Industries (L&I). At this time, you will need to fill out a report about the accident as well. You will be notified in writing if your employee takes out a claim for workers’ compensation coverage. You are allowed, as the employer, to both protest and appeal claims decisions. Any claim decisions can impact your premium for workers’ compensation insurance, which means even if a claim is false, you may end up paying more. For this reason, it’s critical to act as soon as possible if you have a sound reason to believe a claim is false.

How Can You Tell if a Claim is False?

Sometimes, it’s simply that the story of the accident doesn’t quite match up with the nature of the injury. Or perhaps you overhear details before or shortly after the incident that lead you to suspect you don’t know the whole story. Talk to other employees, particularly those who were present or working at the time of the accident and those who socialize with the injured party. Include as much information as possible in official company records, such as human resources reports and interviews.

Does the Evidence Fit the Story?

Does something about the story seem askew? If your company has comprehensive security systems, there may be camera footage of the event and the time leading up to it that can provide insight. Perhaps there’s footage of the injured party arriving at work, already limping from a preexisting injury. Maybe there’s footage of them staging a fall. This is where the process can become sensitive and time-consuming. It’s important to work with an expert to carefully review any evidence left behind from the accident and other applicable materials as you move forward.

What To Do If You Think a Claim Is False

Now is the time to enlist the help of a professional firm such as Stop Claims to begin gathering evidence and fully investigate a fraud allegation. Services may include conducting a private investigation, performing a thorough case review, providing general expertise to follow up on the likelihood of fraud, and (ultimately) potentially saving your company money.

Stop Claims Can Help With Appeals

If you believe an employee has filed a fraudulent workers’ compensation claim, Stop Claims is here to help. We partner with medical and investigative professionals who can help disprove fraudulent claims with credible evidence and ultimately save your company money. We also have a strong track record of demonstrated success — so don’t allow yourself to fall victim to a potentially damaging scam! The choice is easy.