Was that worker’s injury real or fake? Many employers may have asked themself this question after an employee filed a workers compensation claim. Whilst the vast bulk of claims are genuine, the small percentage off fraudulent workers’ compensation claims cost the Australian economy millions of dollars each year
Top 10 Warning Signs
The following behaviours may indicate an employee has falsified their claim
- The injury allegedly occurred on a Monday morning. The worker may have sustained an injury over the weekend when they weren’t working.
- The employee keeps changing his or her story about what happened – these might be only small details – but it leaves you with the feeling that something doesn’t stack up.
- There is an eye witness who gives an account which matches that of the injured worker exactly. Remember it is rare for anyone to actually see an accident – usually witnesses are looking elsewhere and see/hear the aftermath. Also, when a person is injured they often state that they are not injured. EG, a part of a machine hits a worker on the shoulder and he cries out in pain – a witness might say, ‘Are you okay?’ The injured person replies, ‘I think so,’ rather than, ‘I just hurt my right shoulder.’
- There were no witnesses to the injury. This can be a red flag if the employee normally works with other workers, and the injury occurred during a narrow time frame when the employee was alone.
- There is a significant delay in reporting the injury – this could be days, weeks, even months – even though the injured person is aware of the correct reporting procedure.
- The worker is unhappy or has workplace behavioural issues. An employee who is dissatisfied with his or her job may be more likely to submit a claim and exaggerate the extent of injury.
- The worker is difficult to reach and slow to respond to calls, texts or emails.
- There is a reluctance on the part of a worker to have medical tests. For example, an employee declines an MRI that could confirm the existence of a degenerative condition.
- The worker has submitted a number of worker’s compensation claims. Anyone can be unlucky, but most people go through their working careers without ever claiming an injury.
- There is an unreasonable reluctance on the part of the injured person to submit to an interview to clarify the circumstances of injury.