When Employees Fake Injuries
One of the most vexing problems we face as safety professionals is employees who fake injuries to collect workers' compensation. Here are some hints to help you handle this thorny problem.
Injury Fakers Do Genuine Harm
There is nothing petty about faking an injury to collect insurance. First of all, it's immoral - an ethical equivalent to shoplifting.
Faking injuries also does real harm. For one thing, it artificially inflates your injury rates, thereby jeopardizing the integrity of the statistics you use to measure the effectiveness of your safety program. This distortion can lead to mistakes and misjudgments that compromise the health and safety of everybody in the workplace.
Faking injuries to collect insurance also has an adverse effect on a company's financial performance. Though a single incident may be of little consequence, the cumulative effect of repeated fake injuries is higher workers' compensation premiums. This effect is felt not just within a single company but nationally across entire industries.
Back and Neck Injuries Particularly Susceptible
Injuries that have visible effects, such as contusions or lacerations, can't be faked. So when employees fake an injury, it's usually an internal one. Injuries to the muscles of the back and neck are among the most common forms of feigned injury.
Injury faking also tends to follow certain patterns. I've noticed a discernible spike in back and neck muscle injuries during the last few days of an intensive project, particularly by employees who are working on a temporary basis.
Why is it that after three or four months of nothing but obvious injuries, injury statistics in the wind-up period undergo a drastic change? Could it be that the last few months are finally taking their toll on back and neck muscles? Does it have something to do with the fact that during this period housekeeping tasks have increased and employees are bending over more often to pick up tools, boxes and trash?
Or, is this sudden increase in lumbar discomfort the symptom of the disease I call pink slip flu? I'm not suggesting that every temporary employee who reports a neck or back injury during this period is faking. But I am pointing out that the prospect of unemployment could make at least some temporary employees more apt to fake an injury. Only a fool would fail to recognize that the chance to collect workers' compensation during a lay-off constitutes temptation.
How to Protect Yourself
There's only so much a safety professional can do to prevent employees from faking injuries or to separate the fake claims from the legitimate ones. But you're not completely at the mercy of the cheaters. Here are some measures you can take to make it more difficult (and thus less likely) for an employee to put in a fraudulent claim:
- Keep detailed records.
- Make it a practice to include any eyewitness accounts for all of your accidents which result in medical care.
- Contact your insurance company for advice.
- Take pictures of the accident scene and any equipment involved such as hard hats, harnesses, etc.
- Review the history of any employee who gets involved in an accident even if there's no evidence of wrongdoing.
- Have everyone involved write out a firsthand account of what "did" and "didn't" happen.
Conclusion
Most of the employees who report an injury are experiencing real pain. But don't be naive. Recognize that, sadly, there are dishonest employees who will lie especially about on-the-job back or neck injury. So keep your eyes and ears open and take precautions to minimize the risk of getting burned.
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Good article - I sent this onto our people with my own comments:
Supervisors and Managers:
Please take a minute to read this article:
http://www.safetyxchange.org/financing-safety/when-employees-fake-injuries
Over the years, I have seen many injuries which are very suspicious in nature. When you complete the First Report of Injury, there is a very important question that asks: “Is there any reason to doubt the validity of the claim?” I feel that all too often, we routinely circle “No” to this question.
It is very important that those closest to the injury share their concerns even if you think the injury might be suspicious. This allows our insurance company to red flag the injury and do a follow up investigation.
Typical “red flags” for injuries include:
Disgruntled employee
Employee with poor work/attendance history
New employee
Employee who has had recent disciplinary action taken against them.
High number of injuries from this employee
Delay in reporting injury – on Monday morning employee says injury happened on Friday(?) or employee says nothing when he/she leaves work the day before but reports an injury the next day.
Employee isn’t eager to return to work
No witnesses to injury
Late Friday/early Monday injuries
Rumors from other employees that injury is not legitimate
Description of accident is vague, changes details with more questioning
As the article states, insurance fraud is a very real cost to all companies including the Pipestone System.
Please be vigilant in your investigation of injuries and if anything “doesn’t add up” let us know your concerns when the injury is reported or as soon as you sense something is “not right” about the injury. It is best to approach all injuries with a certain amount of skepticism that the injury is legitimate. This does not mean we treat our employees rudely or discourage reporting legitimate claims but that you make sure you are convinced the injury is legitimate.
If you have questions or thoughts on this (or when handling future injuries) please email or give me a call.
Thanks
Paul
Paul Ramsbey
Director of Safety, Maintenance and Ventilation
Pipestone System
P.O. Box 370
Pipestone, MN 56164
(507) 825-7930 Office
(507) 215-0494 Cell
(507) 825-2541 Fax