Why These Three Innocent Actions May Lead To Suspicions Of Workers Compensation Fraud

Workers' compensation fraud is causing the American economy tens of billions of dollars every year. This is why insurance agents are always alert to signs of fraud whenever workers raise compensation claims. Unfortunately, there are some innocent actions that may make you seem like a fraudster even if you have a genuine claim. Here are four examples of such actions:

Refusing Treatment

There are many legitimate reasons why one would refuse a particular treatment. For example, it may be that the treatment involves blood transfusion, but your religious beliefs are against it. Another example is if you are convinced that the potential complications far outweigh the benefits, and you are looking for alternative treatments.

Unfortunately, refusing treatment is one of the red flags of workers' insurance fraud. The insurer's assumption may be that you can only refuse treatment if you aren't truly injured. In such a case, it's good to move fast and explain your situation clearly. It may also be beneficial to get your approved treatment as soon as possible.

Being Out Of Reach

There are many legitimate reasons why you may be unreachable after your injury. For example, it may be that a freak storm damaged communication infrastructure in your area, and you forgot to furnish your workers' compensation insurer with your cell phone number.

This can easily be misconstrued to the effect that you are hiding something, or you don't want the issue to be fully investigated. Therefore, ensure that you are reachable at all times by giving out all possible channels for communications by which you can be reached. Provide emails addresses, home phone numbers, cell phone numbers, mail address and even alternative numbers. If you happen to go out of town, perhaps for treatment, then make it your duty to inform the relevant parties of your whereabouts.

Experiencing an Employment Change

A change in employment is another red flag for workers' compensation fraud. For example, if you report an injury shortly before or after getting fired or participating in a strike, then your report may raise a red flag. If you submit the report before the employment change, then the suspicion may be that you were anticipating the change and wanted to make some money before it occurred. On the other hand, submitting a claim after an employment change may be viewed as an act of retaliation.

However, injuries can occur at any time, and it may all be a coincidence. In that case, you have to work extra hard to convince your employer and insurer of your injuries. This means reporting your injury immediately, describing your injuries accurately and seeking prompt medical care. The availability of witnesses will also strengthen your claim.

For more information about to file a successful workers' compensation claim, contact a lawyer used to dealing with such claims, like the Erickson Law Office.


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