Was the injury real or fake? Was the cause avoidable? More importantly here is what you should do.
Whilst the vast bulk of claims are genuine, there are a small percentage of fraudulent workers’ compensation claims that cost the Australian economy millions of dollars each year.
What to do
The following behaviours may indicate an employee has falsified and oversated their injury.
Firstly, make sure you document what happened, when & where, immediately, if don’t have a form email me I will send you a form at no cost or obligation.
Do not send them to a local doctor's office. Take control, stay on side with them and take them to a work place investigation practice, go with them into the appointment always be there to talk about reduced duties and alternative work. Don’t even begin to talk about worker’s compensation, stay focussed on treatment and having your worker back in the business immediately. Be positive about good and fast outcomes.
When a claim might be false
- The alleged injury occurred on a Monday morning. Your worker may have sustained an injury over the weekend playing sport, it’s spring maybe they were working in the garden or something happened when they weren’t working.
- The employee is vague and keeps changing their story about what happened it leaves you with the feeling that something doesn’t add up.
- Is there an eyewitness who gives an account which matches that of the injured worker exactly? Make sure you interview the worker and the witness separately. Insurance statistics say it is rare for anyone to actually see an accident. Usually witnesses are looking elsewhere, being in the vicinity doesn’t mean they witnessed what happened.
- When a person is injured they often state that they are not injured. A part of a machine hits a worker and he cries out in pain, a witness asks, ‘Are you okay?’ The injured person replies, ‘yes, I think so,’ rather than, ‘I just hurt my arm.’
- No witnesses to the injury or it's aftermath. This should raise a flag especially if the employee normally works with others, and the injury occurred during in a moment when the employee was alone.
- If there is a delay in reporting the injury, days or even longer even though the injured person is aware of the correct reporting procedure. Why the delay?
- What is the worker’s state of mind.? Are they unhappy, do they have workplace behavioural issues. A worker who is dissatisfied with his or her job may be more likely to submit a claim and exaggerate the extent of injury.
Maintain communication, make sure you are on good terms with them, pay them for their time off, if it becomes a claim you will recover the wages paid. You don’t want be in a situation where the worker is difficult to reach and slow to respond to calls, texts or emails. Your employee should be willing to undertake tests and treatment, make sure you ask smart questions such as was there any evidence of pre-existing conditions, old injuries, or the existence of a degenerative condition?
Most workers will go through their working careers without ever making a claim or incurring an injury. There should be no reluctance on the part of the injured person to submit to an investigation to clarify the circumstances of the injury. It is not about blame it should be about cause and prevention.