Questionable workers' compensation claims increasing

Workplace injuries can severely disrupt employee time and attendance, and according to a Sept. 24 report by the National Insurance Crime Bureau, questionable workers' compensation reports are on the rise. The report covers workers' compensation questionable claims referrals submitted from Jan. 1, 2011, through June 30, 2013. While the total number of workers filing for compensation has been decreasing over the past several years, the number of questionable claims has been steadily increasing over same period.

California has the largest number of claims filed over all, but when ranked by claims per 100,000 residents, Maine takes the top spot for the first half of 2013. However, Los Angeles still ranks as the city with the highest number of questionable claims both in 2012 and the first half of 2013.

Medical claims made up the large majority of all claims filed in the first half of 2013, with indemnity taking the second spot. The top questionable claims were described by NICB members as claimant fraud, prior injury and malingering, in which the claimant maintains that an injury is ongoing when they have actually recovered.

For the second half of 2013, the number of workers' compensation claims filed overall is expected to decrease yet again, and the number of questionable claims reported is expected to increase, the report says.


Related Headlines