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Avoiding Accusations of Workers' Compensation Fraud


Workers’ compensation insurance companies go to great lengths to avoid paying out on claims. If you have been injured at work and you are facing medical bills, time away from your job and lost wages, you don’t want to jeopardize your claim. There are ways to avoid being accused of fraud, and by knowing what insurance companies are looking for, you can prevent it.

Your workers’ comp insurance provider will assess if you are:

  • Exaggerating Injury or Symptoms: A slip and fall, a bump on the head, or a strain may have occurred at work, but employees sometimes exaggerate their injury by faking the severity or the duration of recovery, including acting dizzy, disorientated, lethargic, or as if they are in worse pain than they are.
  • Fabricating an Injury: Whether an employee was injured prior to employment or an injury was fabricated altogether, if there are no witnesses to an injury, or if the severity is questionable, you may be denied coverage.

What Not to Do

If you are involved in a workers’ compensation settlement claim and are recovering from injury at home, there are ways to prevent being accused of fraud, including:

  • Be careful of what you post online: If you have a leg injury, do not post pictures of yourself completing a marathon while on leave for recovery. Be aware of what might look fishy… anything involving playing sports, hiking, running on the beach or weight lifting would indicate that you should be back at work. Practice safe posting to avoid investigation.
  • Stay out of the gym: If you have an injury that prevents you from doing a physical job, that injury would most likely prevent you from normal workouts. Physical therapy and gentle exercise are probably ok but be careful what you do because you never know who is watching.
  • Hire a gardener: Yardwork is physical activity! If you are recovering from knee injury, a torn rotator cuff or a back injury, you probably should not be mowing the lawn, trimming your trees or gardening.

If you are aware of what might look like a fraudulent claim to employers and workers’ compensation insurance carriers, you can prevent fraud investigation in your case.

Contact Us if You Are Accused of Fraud

Don’t risk your settlement, or your claim. If you are dealing with workers’ compensation insurance and you are worried about the status of your claim, we can help you determine the best plan of action to ensure your claim is not denied. Our team of Glendale workers’ compensation lawyers is experienced in fighting for employees who have been denied claims. We know what to watch for, what to avoid and how to ensure you are awarded the settlement you need to recover and get back on track.

Contact us for a free case evaluation at (818) 946-0608.

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