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Los Angeles Employer Workers' Compensation Law Blog

Surveillance can stop fraudulent workers' compensation claims

Most people tend to be honest most of the time in their personal lives and in their work. However, there are some people who decide to be less than truthful when it comes to workplace injuries in California and other states. Some workers may even decide to commit employee fraud when filing fraudulent workers' compensation claims. Such acts can be financially detrimental to employers.

On the other hand, there are various options for employers to proactively combat employee fraud. Doing so can help decrease the frequency of employee fraud as well as lessen the financial impact. One tool an employer has the right to utilize is surveillance. However, there are various tools for employers to choose from when implementing a surveillance plan aimed at stopping employee fraud.

Compliance with safety rules may not stop injured worker claim

California employers need to ensure that safety standards at the workplace are maintained. Not only can this help to reduce the chances of facing an injured worker claim, but it can also help avoid costly penalties levied by work safety authorities. This is particularly important in the construction industry because the chance of serious injuries are higher due to the nature of the work than in other types of work environments.

It appears that four construction contractors may have failed to adhere to safety standards and have recently been cited by the Occupational Health and Safety Administration (OSHA). The four construction contractors were working on converting an industrial building into residential apartments. Apparently, the contractors did not provide adequate fall protection for their workers at the construction site. OSHA inspectors visited the work site after receiving reports of possible fall hazards.

Walmart succesful in challenging injured worker claim

When a worker is injured on the job, he or she may be able to obtain benefits via workers' compensation insurance. This can be costly for an employer, although it is also possible for employers in California and other states to challenge an injured worker claim. Walmart successfully did this four years ago in one particular case. However, the Occupational Health and Safety Administration is now looking to make it more difficult for the company to apply the same employer defense strategy for similar cases in the future.

The incident happened four years ago when an employee was stocking during an overnight shift while working for Walmart. The woman began to notice pain in her arms, but she decided to continue working through the pain. By the time her lunch break came around, she was not able to even raise her arms. Her doctor indicated that the woman was suffering from tendinitis of the bicep that was caused by her employment at Walmart.

Fatal accident can result in injured worker claim

It is important for California employers to always adhere to work safety rules and regulations. This can help to avoid unnecessary accidents at the workplace which can result in serious injuries or even death. Work safety officials, along with local police, are investigating a recent workplace accident in a neighboring state to determine if any safety violations occurred. The accident may also result in an injured worker claim under that state's workers' compensation insurance program.

The accident happened one morning at a construction site and resulted in the death of a worker. The man was reportedly wearing his safety vest when he was run over by a construction loader. The construction worker was working on a new and unmapped street where housing construction was underway. The identity of the victim has yet to be released to the public, according to the latest reports.

Social media makes proving employee fraud easier

When a California worker is injured on the job, he or she may have the option of filing for benefits via workers' compensation insurance. Although most people are honest, there are some who may be looking to take advantage of the system and defraud employers. With the popularity of social media, it is now easier to detect employee fraud.

Before the advent of the Internet, employers only had limited and costly methods for investigating possible workers' compensation fraud committed by employees. Although employers may have suspected something strange going on with an injured worker's behavior while the worker was receiving benefits, it was often difficult to prove that something was amiss. Employers used to incur significant costs to hire private investigators in order to build an employee fraud case.

Contractor will need employer defense strategy after accident

Maintaining a safe workplace environment is of utmost importance for employers. Not only will this help avoid workplace injuries, it will also help to prevent legal problems from employee lawsuits in California or in any other state. One employer is now facing a lawsuit filed by a former employee who was hurt while on the job. The employer will now be looking to implement an effective employer defense strategy.

The incident happened in early December at a harbor where contractors had been working. The workers were employed by a contracting company. Apparently, the men were working on a floating platform at the harbor where the U.S. Navy keeps out-of-service vessels. Somehow, a huge buoy fell on the workmen, resulting in two of the workmen being killed.

Following new OSHA rules may not prevent injured worker claim

The Occupational Safety and Health Administration is in charge of implementing and enforcing work safety laws and regulations. The federal agency is also in charge of creating rules and regulations regarding reports of workplace injuries in California as well as every other state, regardless of whether there is an injured worker claim filed. Maintaining proper adherence to the new rules may help an employer avoid charges of work safety violations.

The new rules, which went into effect in the beginning of January, now require employers to report all fatalities resulting from a work accident within eight hours of the incident. All incidents that involve inpatient hospitalization, loss of an eye or amputations are required to be reported within 24 hours after knowledge of the accident. Even employers that are usually exempt from keeping routine OSHA records are required to comply with the new rules. Employers with 10 or fewer employees are usually exempt from routinely keeping records of injuries and illnesses.

Red flags for fraudulent workers' compensation claims

California company owners are sometimes victims of employees who falsely claim compensation for work-related injuries or illnesses that are not work-related or never occurred, or injuries that are exaggerated. In an attempt to reduce such incidents, it may be beneficial for employers to educate their workers about the adverse effect that fraudulent workers' compensation claims can have on each individual. Suspicion of fraudulent claims may result in all other claims to be perceived as false.

A fraud investigator recently pointed out that fraudulent workers' compensation claims can be a severe strain on business operations and may lead to an increase in the cost of insurance. He stated that there are ways to prevent such claims by keeping a lookout for specific red flags. These tell-tale warning signs of potential fraud include:

  • Injuries that allegedly occurred at the start of a Monday morning shift or late Friday and reported on Monday. In fact, any claim that is not reported timely without feasible explanation may cause suspicion.
  • Injuries that occur immediately after or before a change in employment, such as at the completion of a project, job termination or a strike.
  • When there is reason to suspect the worker's doctor who may have been involved with suspicious claims previously, or the worker's claim history that may have included fraudulent claims. Some workers may refuse medical examination or treatment as confirmation of the extent of the work injury.
  • When injuries were not witnessed by anybody or the worker's accident description is inconsistent with the nature of the injuries.
  • An injured or disabled worker who is not reachable at home or where he or she is recuperating may be active elsewhere. Workers who have a record of relocating or changing jobs regularly may also raise some suspicion.

Postal worker guilty of employee fraud after false injury claim

The Office of the Inspector General recently said that fraudulent medical-related claims in the U.S. Postal Service forms part of an increasing number of fraud cases in California and elsewhere. A worker was recently found guilty of making false statements in order to obtain benefits. This followed a case of a postal worker who committed employee fraud over a period of seven years.

It was reported that the worker had been under surveillance since 2010. The worker apparently failed to provide information about four car accidents in which she suffered injuries prior to claiming benefits for a work-related injury. She received almost $250,000 in benefits under the Federal Employees Compensation Act for what she claimed to have been a disabling workplace injury.

Monday is the most common day for an injured worker claim

No one likes Mondays, that is a given. However, there now may be a good reason for both California employers and employees to not like Mondays. According to a recent report, a Monday results in an injured worker claim more often than the other days of the week.

Apparently, workers are more likely to experience workplace injuries on Mondays when compared to the other days of the week. A recently released report revealed that approximately 167,000 workplace injuries happened on Mondays during 2013, which is more than any other day of the week. However, this is not a new trend. More workplace injuries have consistently occurred on Mondays during the past several years; however, this does not mean there is an explicit correlation between Mondays and the number of workplace injuries.

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