No employer wants to see a worker suffer an injury on the job. Everything comes to a halt while you tend to the employee, and if the injury is serious, you and your crew may find it difficult to get your minds back on the tasks of the day. As frustrating and time-consuming as it may be, you may be more than willing to set in motion the wheels of the workers’ compensation process for an employee who legitimately suffers an injury in the course of his or her duties.
On the other hand, it is possible that nearly everyone who hires workers also deals with those who dishonestly claim to be injured so they can obtain workers’ compensation benefits. These claims can be a drain on your budget, not to mention the stress it puts on the rest of your staff when they must cover for an employee who is supposedly too injured to work. If you suspect your employee’s injury claim is not valid, do you know how to deal with it?
Is the injury fake?
If you have been in business long, you may already know how to recognize when a claim of a workplace injury is false. Some of those red flags include the following:
- The employee hires an attorney right away.
- The injured employee has only been on the job a few days.
- The employee has a history of missed days or wasting time on the job.
- You know the employee is struggling financially.
- No other employee witnessed the alleged accident.
- The supposed injury occurred on a Friday or at the start of a Monday shift.
While any of these may be coincidences, they may give you cause to examine the incident more closely. You have the right to ask your other workers for their opinion of the accident or to review surveillance footage of the area where the accident supposedly occurred.
When the adjuster meets with you
You will likely be the first person the insurance adjuster confers with, so you may want to have as much information as possible for that first meeting. You may even wish to meet early with an Iowa attorney with experience defending businesses during workers’ comp disputes because such an ally will have resources to assist you. The more support you have for your suspicion, the more likely the insurer will consider denying the claim for benefits.
Even if your insurer accepts your employee’s claim, you may want to follow through with a dispute in court. On the other hand, a denial may bring a lawsuit from your employee. In either case, you would do well to have the advocacy of an attorney.
