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CIC offers news and updates to employers about the latest laws, trends and risks related to hiring, fraud, and drugs or violence in the workplace.

workers compensation fraud

Are you completely exhausted from attempting to stay on top of Workers' Compensation fraud or FMLA abuse?

If you have a suspicion that you have a problem with one of your employees, CIC has experienced Investigators that can assist you. Successful surveillance conducted by a professional investigator can be a powerful instrument in your fight against abuse and fraud, and you should consider hiring one.

Problems with Workers' Compensation and FMLA Fraud

Workers' Compensation fraud is still alive and well in the state of Ohio. It is expected to cost Ohio businesses an average of $84,000 each instance, according to the Bureau of Labor Statistics. Workers' Compensation fraud charges can be classified as either misdemeanors or felonies, depending on the severity of the offense and the amount of money involved.

Workers' Compensation fraud can only be successfully combated by effective investigation and surveillance. In a Workers' Compensation lawsuit, having an expert investigator on your side can be quite beneficial. CIC's team of skilled and certified investigators employs still images, videos, and GPS monitoring to provide you with high-quality surveillance evidence that may be used to support accusations of fraud.

Do you have a Workers' Compensation claim that is causing financial hardship for your company? Even if the suspicion of fraud is not conclusive, CIC's surveillance team can frequently give sufficient evidence to allow a claim to be discontinued – or to negotiate a lesser settlement amount. As a result, you may be able to lower your insurance prices.

Workers' Compensation Fraud Case

An individual submitted a workers' compensation claim with his employer after suffering a left shoulder injury on the job. The company followed all of the required procedures and provided the employee with adequate time to rehabilitate after the incident. The employee claimed that he was unable to work as a result of his injury and he repeatedly prolonged his leave. CIC was contacted by the employer, and we were able to perform surveillance.

We discovered that the individual was fairly active, but on one specific day, we were able to gather enough evidence to demonstrate that his shoulder ailment was not impeding his activities.

FLMA Abuse

While workers' compensation fraud has long been a source of concern for employers, exploitation of the Family and Medical Leave Act (FMLA) should not be overlooked. Yes, it does occur, and it occurs more frequently than we think. It is also in this situation that an expert Investigator can be your key to breaking through the case.

How many of your employees are aware that there are deception companies out there that will assist them in perpetrating this fraud by answering phone calls and vouching for a bogus illness or doctor's appointment for a little fee? Like the Diploma Mills and Reference Services that have grown into profitable enterprises, this latest approach of fooling employers is gaining appeal among job seekers and employees alike.

It has been reported that employees have taken use of the Family and Medical Leave Act (FMLA) in order to avoid their work obligations in some cases. When an employee requests FMLA leave on a regular basis, employers must look for patterns in the requests and try to identify whether the requests are valid or whether there is a pattern of abuse taking place in the workplace.

CIC can assist you if you suspect abuse or if abuse is brought to your attention. Our team has effectively documented individuals engaging in activities that are incompatible with the reasons for their FMLA absence as stated to their employers by the employees themselves.

FMLA Interference Lawsuits

The use and misuse of FMLA leave is a serious source of concern for employers, not to mention the record-keeping requirements associated with the program. According to some estimates, ten percent of the United States workforce is taking advantage of this right, with an average leave period of fourteen days per year. Although it is true that companies lose money when this leave program is abused, there is another side to this that is rarely mentioned: the FMLA interference cases that are filed against them.

We've seen cases filed against employers as a result of managers making personal, disparaging comments to employees who were requesting FMLA time off from work. Comments along the lines of...

  • "We pay your insurance, and we expect you to be here," says the employer."
  • "I believe it is impolite of you to take time off when we are already short-staffed."
  • "I'm fed up with FMLA requests in general, so I'm going to make it a point to look into that particular leave request."

If a court finds that an employee has been forced into not applying for their earned leave, the claim of FMLA interference will be regarded seriously by the employer and the courts.

As a result of this narrative, you should train your managers on how to manage your leaves of absence in accordance with your company policy and the law — as well as how to communicate effectively while avoiding personal comments that could harm the entire organization.

Workers' Compensation Fraud Investigation and Surveillance

CIC can be of assistance. From hiring to firing and all in between, we've helped customers navigate the complexities of human resource management. "To supply our clients with reliable information that will enable them to make more informed decisions." That is our objective.

Workplace performance challenges that go beyond knowledge, skills, and abilities can develop from time to time. Unfortunately, businesses must deal with difficulties such as excessive absences from work from time to time. These issues not only affect individual employees, but they can also have a negative impact on the overall operation of your company. The most severe cases of fraudulent claims result in organizations being forced out of business entirely. We aim to assist you in keeping your business functioning smoothly.

Employers may rely on our team of qualified and licensed Surveillance Specialists to offer them with high-quality video surveillance evidence that can be used to battle false claims. As is always the case, we approach these issues with honesty and integrity, and we endeavor to provide our clients with peace of mind.

For more information about our Investigative and Surveillance services or to discuss a matter involving Workers' Compensation fraud, set up a time to speak with us.

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For more information about this article, or Professional Surveillance, please contact us at 1.800.573.2201 / 419.874.2201.

Our Expertise ... Your Peace of Mind.

Do you have an urgent issue to discuss with an Investigator? Please contact us by phone at 1.800.573.2201.