Fraud is a part of life, regardless of how much we wish it wasn’t. People will always try to get as much as possible without expending too much effort. For those who see workers comp as just an unlimited paycheck, it’s necessary to keep up with the news to see if there are new trends within the industry. Opportunity crime is everywhere, so if people see a loophole you can bet there will be more exploitation of it. The creativity used can be truly amazing, so learn to recognize signs now so you can prevent fraud later.
Several Schemes
If a worker starts collecting workers compensation for a legitimate injury, the temptation to continue collecting after healing seems to be strong. Two cases, one in Ohio of a married couple and one in Canada, recently show that people continue working (generally when they’re self-employed or the principal employee in the business) while still collecting checks.
It’s impossible to know if their original claims were thoroughly investigated before being approved, it seems clear that the money outweighed the potential negative consequences for the people committing the crimes. In this case, they had a dual income for quite some time. If you have an employee that you know can do his or her job at home, then you may want to take some extra precautions in these cases.
Also, another man in Ohio was charged with fraud soon after his sister was charged with the same crime. The couple and the siblings are good indicators of what a ripple effect can look like when one person receives clear benefits by taking advantage of the system. Keep everyone involved informed and be as honest as possible. If you suspect that an employee is not telling the full truth, as with a yet unsettled case from a cop who may have injured his knee while off the job, then sometimes asking questions is your best line of defense. People can be tripped up in lies fairly easily, so keep details straight and if something doesn’t add up then you’ll need to speak up to the proper people.
Both Sides Now
Unfortunately it’s not just employees who commit fraud. Employers have been in the news lately because they haven’t had enough coverage or have failed to provide adequate restitution to their employees. This may not have even been intentional fraud, so ensure that you’re not skipping any steps or taking any shortcuts when it comes to your business. You never know when a legitimate problem will arise and you’ll need to have all of your ducks in a row in order to have a sustainable outcome so you’re not hurt by legal fees or worse – jail time.
