How common and costly is workers comp fraud?

This question is much debated, and my quick Googling yielded nothing very definitive.

Predictably, some say it’s a huge problem; others that it is being exaggerated to promote antiworker reforms.

I’d submit that the truth is somewhere in between, but that anything that can be cost-effectively done to reduce fraud is certainly worth looking into.

In any event, I found a recent story about a Florida fraud crackdown that I thought was worth passing along. The article reports on a three-day sweep in Florida by the Bureau of Workers’ Compensation Fraud that resulted in 28 arrests for violations of workers’ compensation laws.

As is often the case, the article identifies what is undoubtedly one of the most extreme cases as its “poster child” of abuse:

Among those arrested was a claimant who alleged he was disabled following a 1993 on-the-job injury at Georgia Pacific Co. Jimmy Carr, 50, of Jacksonville, collected more than $800,000 in insurance benefits, stating that he had to use crutches, a cane, a buggy or a wheelchair, and had been able to walk only in his yard or house without using one of these devices. However, Carr was captured on surveillance video removing a basketball stand out of a truck and then shooting baskets.

Ah yes, the good old surveillance video.

Intrusive? You bet.

Illegal invasion of privacy? Not if properly conducted at time and place at which there is no reasonable expectation of privacy.

Worth doing in a really suspicious case? Quite possibly.

Be darn careful about accusing anyone of workers comp fraud, though, especially if coupled with termination of employment. If you can’t prove it, there will be a strong inference in a workers comp retaliation action that you acted improperly in response to a legitimate claim.

1 Comment

  1. Troy Rosasco

    George – you don’t mention the far bigger problem of EMPLOYER workers compensation fraud. How many employers hire undocumented workers, pay “off the books” or misclassify their employees to avoid paying proper comp premiums? When these workers get hurt, it boosts premiums for all honest employers. Employer fraud is rampant, but insurance companies won’t investigate their own customers. This is where the big fraud bucks are.

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