What to Do if You Suspect Your Employee is Faking an Injury in Florida
Dealing with fraudulent Workers’ Compensation claims is important for employers in Florida. If you suspect that your employee is faking their injuries, what should you do?
If you believe a worker is faking their injuries after a workplace accident in Florida, inform your carrier. Employers can also perform a pseudo-investigation themselves to somewhat confirm their beliefs and take their findings to their insurers. Contacting the Bureau of Workers’ Compensation Fraud is also necessary so that detectives can investigate Workers’ Compensation violations and prove that a claim is fraudulent. Hints that a worker might be faking their injuries include refusing to seek care from approved doctors, changing their story, or claiming that they have injuries that are inconsistent with a specific workplace accident.
Learn how our Florida Workers’ Compensation insurance brokers can assist you by calling NPN Brokers today at (866) 340-9120.
What Can You Do if You Suspect Your Florida Employee is Faking an Injury?
Fraudulent claims can cause employers a wide range of issues, namely unnecessary increases in Workers’ Compensation premiums. If you suspect one of your employees is faking an injury and was not harmed during the course of their work, there are a few things you can do. First, allow our Florida Workers’ Compensation insurance brokers to contact your carrier to inform it of your suspicions. You can also investigate a recent workplace accident and report possible fraud to the Bureau of Workers’ Compensation Fraud in Florida.
Contact Your Carrier
As soon as you suspect that an employee might be faking their injuries or mispresenting the severity of their injuries, contact your carrier. It is important that your Workers’ Compensation carrier be brought into the loop to look more closely into the circumstances of an accident and ask for additional information from a claimant. Without your insight into matters, your carrier might not otherwise suspect possible fraud and pay out a claim to a worker who has been faking their injuries or lying about the fact that their injuries were sustained at work.
Perform an Investigation
Navigating suspicions of fraudulent Workers’ Compensation claims is a delicate matter, as employers must be cautious when asking questions about an employee’s disability and recovery. While your carrier and other agencies might investigate possible fraud, there’s no harm in you doing the same as long as you are careful about how you proceed. You can review surveillance footage, ask other employees about an incident, and investigate in other ways to determine if an accident took place that actually harmed a worker. You might learn that an employee intentionally injured themselves to get benefits or lied about their injuries altogether, giving you proof of a fraudulent Workers’ Compensation claim.
Contact the Bureau of Workers’ Compensation Fraud
Anytime an employer suspects an injured worker’s story and has reason to believe they are faking their injuries, the employer should contact the Bureau of Workers’ Compensation Fraud in Florida. This part of the Florida Department of Financial Services is tasked with investigating and uncovering different types of Workers’ Compensation fraud in Florida, including fake claims. Comprised of detectives, the Bureau of Workers’ Compensation Fraud can look into criminal violations of Florida’s Workers’ Compensation code. Detectives might work with local law enforcement agencies or other groups to determine if an employee is faking their injuries or has otherwise filed a fraudulent Workers’ Compensation claim in Florida.
Reasons You Should Suspect that Your Employee is Faking Their Injuries in Florida
The fact that an employee has filed a Workers’ Compensation claim is not enough reason to suspect that they are faking their injuries. However, if an employee has filed multiple Workers’ Compensation claims in the past, changed their story several times, or has injuries that are inconsistent with an accident, you should further investigate their incident and report your suspicions to the necessary agencies.
Employee Has Prior Claims
When hiring an employee in Florida, employers are allowed to ask about their previous Workers’ Compensation claims history. If a worker has filed many Workers’ Compensation claims in the past and has a history of getting hurt on the job, it could be that they are faking their injuries. In this case, you might be suspicious of possible fraud and should follow that feeling by taking the necessary steps.
Employee Has Changed Their Story
Injured employees in Florida should be able to recount how an accident occurred. Suppose an injured worker has changed their story several times, or their account of an accident substantially differs from witnesses’ recollections. In either case, our brokers can contact your carrier to alert it to possible fraud. Interviewing workers that witnessed an accident and asking injured employees to recount their stories several times can help employers catch this type of Workers’ Compensation fraud in Florida.
Employee’s Injuries Are Inconsistent with the Accident
While serious injuries can happen during any accident, certain injuries are more likely to happen in specific situations. If an employee’s injuries seem totally unrelated to an accident they claimed happened at work, they could either be faking their injuries or could have been injured outside of work. In either instance, the claim they filed with your Workers’ Compensation insurance carrier would be fraudulent.
Employee Refuses Care from Approved Medical Professionals
In order to get Workers’ Compensation benefits in Florida, employees must typically seek medical care from approved doctors. Suppose an employee refuses to be assessed by medical professionals approved by your carrier. In that case, that might be a hint that they are faking their injuries or the severity of their injuries. Regardless of whether a claim is fraudulent, refusing to seek care from approved doctors is a reason to deny a Workers’ Compensation claim in Florida.
Contact Our Florida Brokers for Workers’ Comp Insurance Today
To get coverage for your company, call the Florida Workers’ Compensation insurance brokers at NPN Brokers at (866) 340-9120.
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