10 Tips for Employers for Recognizing False WCB Claims.

For most employees safety is a top priority. Providing a work place environment that is safe, secure and trusted optimizes employee productivity. However, despite even the best of efforts employee injury is inevitable in the workplace.

Unfortunately there are those individuals who try to beat the system by filing fraudulent workers’ compensation claims. As an employer you may have wondered how can you ensure that all employee injuries and WCB claims are legitimate. Start by becoming aware of some of the tell-tale signs of workers compensation claim fraud so you can help to weed out the dishonest employees and save you, the employer, from paying higher premiums as a result of fraudulent claims.

1. Vague or general recollection of details: Most claimants can recall details of their injury. If the claimant’s responses seem to be unclear or vague then keep a close eye on the progression of the claim.
   
   
2. Delay in reporting their injury or accident: Most employees will report a claim on a timely basis. A delay could mean that the story details are still being decided upon.
   
   
3. Inconsistencies in the story: Upon investigation, the claimant keeps adding, removing or changing their information.
   
   
4. No witness: Not every claim has a witness and this should not be used solely to determine fraud, but if there are other inconsistencies and if other warning signs are present it will be hard to dismiss the lack of a witness.
   
   
5. Disgruntled employee: A frustrated, unhappy, underperforming employee is more likely to place fraudulent claims than an employee with high job satisfaction.
   
   
6. Financial hardship/Homelife pressure: Workers compensation benefits are often seen as a way to remain on the payroll yet use the time spent at home dealing with personal matters.
   
   
7. Home phone never answered or always needs to call back: If the claimant is rarely at home when you call or needs to always "call you back” there may be a possibility of fraud.
   
   
8. Missed doctor or therapy sessions: Most employees and legitimate claimants want to get back to work and will make their rehabilitation a priority. Consistently missed sessions could be a sign that no significant injury exists.
   
   
9. Employee is engaged in activity that is not consistent with the injury sustained: If your employee reported a injury and co-workers have noted that he spoke about a golf trip a month ago or was renovating his basement, there is a good reason to suspect this might be a false claim.
   
   
10. Repeat offenders: If an employee is always going out on claim year-after-year or submitting many claims in each year then it could be that they are taking advantage of the system.

Employers consistently state that their employees are their number #1 asset. The last thing employers want to do is suspect that one of their employees is trying to take advantage of them and the WCB system.

During these tough economic times, companies are reliant on a lean, productive workforce. A fraudulent claim within the workforce costs money, loss of manpower, erosion of team morals and a lack of confidence in management. Hardworking employees are left to pick up the slack. If you don’t take swift action to correct the situation your good workers will start to lose respect for management and begin to only see your inability to take action and your failure to correct the wrongful behavior caused by the bad employee.

For more information about Shadow Investigations, or to discuss a WCB claim filed by one of your employees or how we can help further assist you with your Corporate Investigative or Personal Services please contact an experienced private investigator or call (604) 696-2000.