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Why your employer might believe you're lying about an injury

Workers' compensation is supposed to be a no-hassle method of getting your medical care covered and your bills paid while you're unable to work due to a job-related injury or illness. In fact, the program is designed to be less expensive and easier for employers as well as injured employees.

Why would your employer (or your employer's insurance company) accuse you of inventing an injury? You know that your injury is legitimate. Unfortunately, you may have raised your employer's suspicions simply because you had the bad luck to trigger one or more "red flags" that employers are told to watch for to spot workers' compensation fraud.

Every insurance company and employer probably has its own list of triggers, but here are some of the most common:

  • You're injured in your first week of work. Employers often suspect you took the job only to purposefully fake an injury and claim benefits.
  • Your injury occurred on a Monday morning. Employers often suspect that those injuries really happened over the weekend -- on an employee's own time.
  • Your account of the accident changes. You may just have forgotten something, but your employer may believe that your story changed because you were lying.
  • You are injured right before a big change in employment. Employers see injuries just before layoffs, terminations, the end of seasonal work and even vacations as automatically suspect.
  • There weren't any witnesses to your injury. Employers often assume that these are fabricated events unless you have visible wounds.

There's little if anything you can do to control these suspicions. Injuries happen when they happen and not always conveniently in the middle of the week with multiple witnesses.

While you can try to minimize your employer's doubts by reporting your injury promptly and seeking medical care right away, you may ultimately have to be prepared to battle the inherent suspicions that employers and insurers have about certain work injury claims.

Source: EMPLOYERS, "Top 10 Warning Signs of Workers' Compensation Fraud," accessed June 13, 2018

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