Fighting Workers’ Comp Fraud? A PI Can Help.

For a generation, employers have relied on Barefoot Professional Investigations when they needed employee background check services in Charlotte, NC. However, they’ve found our services indispensable at other points in the employee lifecycle as well, whether it’s backing your IT department when it’s time for computer forensics, or determining whether an employee’s workers’ compensation claim is a valid one. With fraud rising, it helps to understand the signs, to know how to proceed, and that you have a qualified professional in your corner to help you get to the facts.

 

Workers’ Compensation Fraud: a Growing Threat to Business

The National Insurance Crime Bureau estimates that businesses lose $30 billion per year to fraudulent workers’ compensation claims. As they point out, no workplace is immune from employee injuries — even white-collar employees can suffer repetitive strain injuries, slips, and falls, after all — so every business needs to be vigilant. And because a claim often results in medical, rehab, and wage loss payouts, your employees aren’t the only ones you’ll need to watch out for. Unscrupulous attorneys and doctors are more than willing to benefit from your largesse, too. That raises insurance premiums and care costs alike.

 

Identifying Workers’ Comp Fraud

Workers’ compensation fraud may be committed by employees and healthcare providers alike. Here are some signs to look out for:

 

  • Physicians who bill for services they didn’t provide
  • Duplicate billing
  • An unusual increase in the frequency of doctor visits
  • A long course of treatment with no improvement
  • Accidents with no witnesses
  • A refusal to seek a second opinion
  • A failure to report an accident or seek treatment
  • Conflicting statements from employees as to what happened during an accident
  • Frequent changes in jobs or primary care physicians
  • Accidents that coincide with holidays or the start/end of a major project
  • Accidents reported on Monday mornings, especially if the incident supposedly occurred toward the end of Friday’s shift
  • Employees that suddenly go incommunicado
  • Evidence that an “injured” employee is working another job, or is working at home

 

Of course, there are some caveats. To begin with, the list above is by no means comprehensive. Also, each of these warning signs can — and often do — have innocent explanations; some employees delay reporting their injuries because of wounded pride, and of course, some accidents happen precisely because someone isn’t close by and someone decides to take care of a two-person job on their own. But when you see evidence mounting, or you have a suspicion you simply can’t shake, it’s time to call for help.

 

Working With Barefoot Professional Investigations

There’s never a bad time for an employer to work with Barefoot Professional Investigations. In fact, the earlier, the better; employee background checks can help you identify patterns of workers’ comp claims or other suspicious activity in a prospective employee’s past that can help you make better hiring decisions. 

 

If that horse has already left the barn, it’s still not too late to call. We can use witness interviews to piece together the events leading up to an injury, and its aftermath. We can also conduct discreet surveillance of employees’ social media and their activities, and we often uncover evidence of fraudulent claims, from employees who have simply taken up work with another employer, to those who are doing physical labor at home or living it up somewhere on your dime. The help you need, and the peace of mind you deserve, are just a phone call or email away.