Red flags to consider when a claim is made:

1. Delays reporting the claim without reasonable explanation.
2. The reported accident occurs immediately before or after a strike, job termination, end of a big project or the conclusion of seasonal work.
3. An employee’s medical provider or legal consultant have history of handling suspicious claims.
4. There are no witnesses to the accident and the employee’s description of the accident doesn’t add up.
5. The claimant has a history of a making claims.
6. The claimant frequently changes physicians, addresses or jobs.

Tips to Prevent Fraud:

1. Promote a fraud-free workplace. Talk to employees about workers’ compensation, what it is, how it works and zero tolerance stance on fraud. Most importantly, let them know how they can report fraud anonymously.
2. Thorough hiring practices. Running a thorough background check on potential employees will stop most fraud from the start.
3. Proper surveillance installed. Monitoring the workplace with video equipment can catch fraud in the act.
4. Have a plan if someone is injured. Designate someone in charge of all employee injuries and the procedure to follow to gather all the information: description of accident and injury, recommend medical provider, preserve any workplace evidence and get names of witnesses.
5. Start a safety program. Hold regular safety meetings to go over procedures. Use posters, flyers and newsletters to stress these points.
6. Pay attention to the gossip. Keeping your ears open to what other employees have to say may have some truth to it.
7. Know the red flags (above).
8. Pave the way for return for work. Let employees know attempts will be made to get injured employees well again and back to work. Have a plan that includes temporary or alternative duties if necessary.

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