Worker's Compensation Fraud on the Job Site is Pervasive... and Illegal News & Opinion

Worker’s Compensation Fraud on the Job Site is Pervasive… and Illegal


When you think about worker’s compensation fraud, we’re usually talking about faking an injury to get worker’s comp rather than an employer trying to avoid a claim. The thing is that claims on your worker’s comp plan can really jack your rates up, so employers have some motivation to cover it up if they’re not worried about getting caught.

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How prevalent is worker’s compensation fraud on the job site?

I heard a firsthand account of an example recently and it’s not that uncommon.

Worker’s Compensation Fraud on the Job Site: A Real (and Common) Example

A good worker has an accident and splits his knee open. The super sees him bleeding profusely and tells him he’s got to get to the ER to let a doctor stitch him up. There’s just one problem.

This guy smoked a joint the night before and it’s going to show up in his blood test since it’s a workplace accident. We can debate how long the effects of marijuana stay in your system another time. For now, this guy says he’ll just resign rather than get that positive drug test on his record.

So far, there’s not a major issue. But this guy’s solid so the super tells him to hold on and starts making a few phone calls. By the time he runs it up the line – way up the line – they make a decision to say he didn’t come into work that day and that he just had an accident at home.

Health insurance covers the cost, there’s no effect on the worker’s compensation policy, and the company keeps a key employee. It’s a win-win all the way around except for the issue of worker’s compensation and health insurance fraud.

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Rick CKenny KoehlerDuburban Recent comment authors
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Rick C
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Rick C

When I was working for an institutional employer with very good insurance, the common wisdom was to do everything possible to not ever claim workers’ comp. Management and workers all half-joked, “If I tear myself upon the job, drag me off the premises before you call the ambulance.”

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Duburban

Was that the end of the article? Is this part of a series? I’m sure more can be said on this issue