Fraud in workers’ compensation cases

While some employees in Pennsylvania and other states might rely on workers’ compensation benefits when an on-the-job injury occurs, others take advantage of the insurance employers are required to purchase for their workers. The National Insurance Crime Bureau estimated that fraudulent workplace compensation claims total as much as $7.2 billion annually. Surveillance and social media helps companies ensure that injury claims are valid.

A claim may raise suspicions if there are conflicting reports about how an injury occurred, a worker has a history of claims or there are no witnesses to an incident. Using surveillance is somewhat risky as it can be expensive to have someone watch a claimant for hours, but this can still be useful when researching and preparing beforehand to ensure that there is a likelihood surveillance will find something.

Investigating via social media is relatively easy compared to surveillance as a claimant’s activities may be documented on various sites. One attorney speculated that a profile on Facebook could list 40 pieces of personal information. Social media sites might help one verify a claimant’s disability status and find witnesses along with providing information about an alibi, facts of loss and policy application information.

In one case of fraud, a woman fell at a gas station near her work then claimed she fell in the company parking lot. The real story was discovered because she posted the truth about the accident on social media.

Any attempt to mislead employers or lie about an injury might result in criminal charges, but workers’ compensation could help employees in a wide array of situations when an accident is legitimate. For example, attorneys will tell their injured clients that they are generally still eligible for compensation even when an accident is their fault.