Talk to a workers compensation lawyer and you might be surprised to learn that workers compensation fraud is actually a multi-billion dollar problem. Across many states in the United States, state governments are seeking to implement tougher rules so as to ensure that they end this illegal practice. However, the more surprising thing you are likely to learn is that there are so many different forms of workers compensation fraud. The most well-known kind are those committed by everyday blue collared workers. Construction workers for example are a big source of false claims. Accidents on building sites are often fabricated or exaggerated. In addition, many people are unaware that employers and health care service providers are also in on the racket.
Here are the kinds of worker compensation fraudulent activity in which each of these groups engages.
1. Employee worker compensation fraud
Employees are most commonly the ones involved in workers fraud as per the workers comp attorneys who have an understanding of these matters. Unscrupulous employees seek to use worker compensation rules to get extra earnings that they do not deserve. The most common acts are claiming an injury that never occurred or exaggerating what the impact of the injury was. Contracting companies are often victims of these false claims as the job style is a very physical one where every day minor injuries occur. These claims are also high in states with a no fault workers compensation scheme where people do not have to prove the injury.
Other common acts of fraud are where employees claim an injury that is not work related as being work related. There are also employees who will claim compensation through lawyers for work related injuries that never occurred. Falsifying mileage reports is also very common amongst many employees seeking to bilk the system for just a little more.
2. Employer worker compensation fraud
Employers are also benefiting from this illegal activity. The biggest fraudulent activity on this side is that of under reporting of employee wages or miss-classification of the same. Employers are doing this deliberately so as to get much lower health insurance premiums. Keep in mind that they are required to provide health insurance by law.
Other employers are deducting the premium rates that they are charged from the wages of their employees. The most egregious act of fraud however falls to employers who deliberately and knowingly fail to acquire the workers compensation that they are expected to have.
3. Medical or health care service provider fraud
The companies that are supposed to provide the medical care to the employees are also employing fraudulent tactics to increase their earnings. The simplest way that they do this is to provide tests and treatment to workers that they do not really need. They are able to inflate the total number of medical services and treatments that they provided thereby increase their overall margins.
Unscrupulous medical service providers have also been abusing the workers compensation law by billing the work insurances for services that they actually never provided. Since they send the records directly to the workers compensation insurer they are able to charge for services that they never provided without anyone noticing.
One of the most ingenious ways that medical care providers are benefiting where they should not is by double billing. This is where they bill both the health care insurer and the workers compensation insurer.
In conclusion, local governments will have to tighten up the net on workers claims to help keep the system clean.
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