PREVENTING FRAUD

Although not every workers’ compensation claim is fraudulent, the number of employees who try to cheat their employers is on the rise. Employers can reduce their number of fraudulent claims by taking the following steps:

1. Review each claim separately. Become involved with the reporting procedures utilized by your workers’ compensation insurance carrier. Interview the injured employee yourself, if at all possible, and satisfy yourself that you know exactly what happened.
   
   
2. Review each notice of injury, regardless of severity, with an eye towards identifying problem areas in the workplace or specific procedures utilized by your company that are routinely blamed for injuries. Once identified, these injury causing factors should be corrected or modified in order to reduce the likelihood of future claims. Employee education programs should be required in situations where the characteristics of the company's physical plant or the procedures utilized in the daily operations of a business cannot be altered.
   
   
3. Require routine drug testing at the time an employee is injured. This testing can easily be made part of the routine medical exam which is performed after an injury is reported. These test results provide the employer with a sorely needed advantage when dealing with an employee who reports to work in an impaired condition.
   
   
4. Require routine pre-employment drug testing. The benefits of this procedure are well-documented. Although it represents an additional cost associated with the employment process, the savings and long-term benefits are substantial and have been validated in the workplace. The cost should be viewed as an investment rather than an expense.
   
   
5. Require all new employees to complete a thorough, personal profile during the pre-employment screening process. This profile should include the following:
   
   
   • basic personal information (name, address, social security number, date of birth, etc.);
   • the prospective employee's actual physical address as well as his mailing address;
   • a complete medical history;
   • a complete claims history (this can be verified by the employers workers’ compensation carrier);
   • a clear copy of the prospective employee's driver's license;
   • a list of all former addresses for the past ten years; and
   • the name of his family doctor or the last physician who treated him.

An honest, credible job applicant will not hesitate to provide a potential employer with this personal information. If an applicant refuses to furnish this information or if he says he cannot for some reason, the employer should weigh this lack of cooperation against the person's potential worth to the company.

These pieces of information are very valuable when dealing with a suspected case of fraud. The cost of investigative services is automatically reduced when this basic information is provided prior to the time the investigation is initiated.

REPORTING FRAUD

If you suspect a case of fraud, please contact our claims department at (800) 311-0997. For Louisiana claims, you may use the online form provided by the Louisiana Office of Workers' Compensation.