Workers' Compensation

Workers’ Compensation

Workers’ compensation provides compensation benefits to employees for disabilities due to personal injury or disease sustained while in the performance of their duty. The purpose of Alabama’s Workers’ Compensation laws is to ensure proper payment of benefits of employee’s injuries on the job or who contract a work related illness and encouraged safety in the workplace. These benefits include payment of medical expenses and compensation for wages loss. Dependents are also entitles to payment of benefits of employees who die from work-related injuries or diseases. An employer that has five or more employees is required to have worker’s compensation insurance. Workers’ compensation is designed to protect workers and their dependents against the hardships from injury or death arising out of the work environment.

The majority of workers’ compensation claims are legitimate; however employees as well as employers can commit workers’ compensation fraud. Nevertheless, workers compensation fraud, whether it is medical fraud, claimant fraud, or employer fraud, adds to the cost of conducting business, harms the economy and tarnishes the reputations of legitimately injured workers. Compensation claims can drain time and other resources meant to assist workers who have been injured on the job. Thus, is it is the best interest of any company to have all employees involved in identifying and reporting fraudulent claims.

Education is the key to identifying fraudulent claims. Employers should publicize workers’ compensation policies and provide updated copies at least once a year. Employers should also make employees aware of their rights and make copies available in the employee handbook.

The following are ways to detect fraudulent workers’ compensation claims. Though it is not a comprehensive list, the following will help an employer to help identify red flags:

• The injured worker was not injured in the present of others

• There is no sound medical basis to support the disability; all physicians reports support a full recovery

• Employers should be cautious if the injury occurs late Friday afternoon or shortly after reporting to work on Monday

• If an employee is disgruntled or knows he or she is going to be laid off, he or she may commit fraud

• Employees working outside of normal job duties. For example if an administrative assistant is lifting heavy objects on a loading dock.

Part of the employer’s responsibility is to control potential workplace hazard and correct hazardous conditions or practices as they occur or are recognized. If an employer effectively identifies these or other red flags, he should begin and keep accurate documentation of the incident, investigate the accident adequately, and provide safety and health training annually.

Another means to detect and deter fraudulent claims is the use of on-site medial services including triage nurses. Companies can also contract and/or partner with local medical facilities. Contracting with a local facility helps a company to built healthy relationships with physicians who