Employee Injured On The Job? How To Fight A Fraudulent Workers Compensation Claim

Posted on: 4 August 2019


When you own a business, you need to be concerned about workers compensation claims. If your employees are injured on the job, you want to make sure that they receive the compensation they're entitled to, which is why you have workers compensation insurance. However, as a business owner, you can't afford to have fraudulent workers compensation claims on your record. Here are four steps you need to take if you disagree with a workers compensation claim that's been filed against you.

Check the Video Footage

If one of your employees has filed for workers compensation benefits, but you question the honesty of the report, the first thing you need to do is check to evidence to corroborate the claim. If you have video surveillance at your establishment, take the time to go through the footage for the day in question. Once you find the footage, look for the following situations.


In some instances, employees may do something to intentionally cause their own accidents. This may include falling from elevated shelving, or purposefully slipping on a wet substance on the floor.


Negligence is another issue that you should look for. Negligence involves accidents caused by a failure to follow the necessary safety rules that are in place. For instance, this can occur when an employee receives an eye injury after failing to wear the required safety goggles during the operation of equipment.


Roughhousing can also lead to erroneous workers compensation claims. This can occur when a group of employees are participating in roughhousing or horseplay while on the job.

Look Into Medical Records

If your employee has filed for workers compensation benefits, but you believe that a pre-existing medical condition may have been involved, their medical records may hold the clues that you're looking for. While pre-existing medical conditions don't automatically let you off the hook for workers compensation benefits, they can play a significant role in reducing your liability for the incident.

Track the Statute of Limitations

If your employee submits an accident report and files for workers compensation benefits, you need to track the statute of limitations. There are specific time limits in place when employees can submit a claim. If your employee has missed the deadline, you'll need to notify your insurance carrier right away.

Identify Time the Injury Occurred

Finally, if your employee has filed a claim for workers compensation benefits, you need to identify the time that the injury occurred. Injuries that occur when the employee is off the clock, may not covered by workers compensation. For instance, if your employee suffered injuries by falling in the parking lot while leaving work, you may not be liable for the injuries, especially if they had already clocked out prior to the incident.

If you've been hit with a workers compensation claim, talk to a workers compensation defense attorney as soon as possible. There are ways to defend against fraudulent and erroneous claims.