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Home > Blog > Workers Compensation Fraud: How It Works - Part 1
FRIDAY, NOVEMBER 18, 2011

Workers Compensation Fraud: How It Works - Part 1

Today we present the first Part of an article on Workers Compensation Fraud. Check back soon for Part Two on how to Prevent Workers Compensation Fraud.

Hurt WorkerEmployers everywhere agree that a worker who is injured on the job through no fault of his or her own, has every right to be compensated for those injuries. Unfortunately, there are unscrupulous workers out there who take advantage of these very fair workers compensation laws in order to benefit. Whether they fake an injury (such as a difficult-to-diagnose back injury) or work with a crooked medical service provider to bilk the complicated workers compensation system, workers comp fraudsters are out there, and your company could be a target.

Understanding Workers Comp Fraud

Why is workers comp such a tempting target for the less than scrupulous worker or medical professional out there? Simply because most states favor workers when it comes to on-the-job injury and, as a result, have implemented strict laws to protect them. In fact, most states require that employers pay 100% of medical and rehabilitation expenses incurred form work-related injuries, and even that they also pay up to two thirds of the employee’s lost wages while he or she is unable to work. The chance to take a long, paid vacation—or even double dip and work a second job while collecting worker’s compensation—can be too much of a temptation for some people.

Medical service providers have a similar motive for committing workers compensation fraud. For them, falsifying workers comp claims can quickly become a very lucrative cash cow. How do they do it? In the simplest case scenario, they might simply inflate the nature of a real injury when submitting it to the insurance company, costing the company money while the unknowing worker receives normal treatment for his or her injury. In other cases, they might work with an injured employee to exaggerate the severity of the injury.  When this happens, workers get more time off than merited and the doctor submits inflated medical bills to workers compensation insurance providers, netting cash for work they never did. Some so-called medical service providers have taken workers compensation fraud much farther, going so far as to fabricate their credentials, their clinic and the fact that the worker in question was even injured. Some even use cash to recruit workers to fake injuries.


At Bourg Insurance, we believe growing our business is important to our company, but maintaining our strong relationships with our customers is paramount. Call us today for a Baton Rouge Workers Compensation Quote at (225) 490-5678!

Posted 11:57 AM

Tags: insurance, business, commercial, worker compensation, workers, comp, baton rouge, louisiana, la
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