The Dire Consequences of Workers Compensation Scams

Every type of workplace—from warehouses to retail floors and office spaces—includes a specific set of risks. With so many moving parts, accidents happen. Workers' compensation insurance exists to mitigate the financial fallout in case an employee is injured or takes ill on the job.



 Regardless of the accident's cause, workers' compensation covers these expenses for workers injured on the job:
  • Cost of medical care
  • Cost of post-injury rehabilitation
  • Lost wages due to post-injury downtime
  • Death benefits for dependents (if applicable)
In exchange, employees waive the right to sue their employer following an accident. The idea is that the insurance policy handles the payout, safeguarding the finances of all parties involved. Currently, every state besides Texas requires this coverage for companies surpassing certain thresholds. The National Federation of Independent Business gives a rundown of state-by-state requirements here.

It sounds pretty straightforward, right? Unfortunately, workers compensation fraud is rampant—and not just from unscrupulous employers. Many fraud rings involve a mixture of business owners and healthcare professionals, like the $40 million operation busted in California.
But sometimes individuals themselves attempt to scam the workers' compensation system. And the consequences of getting caught are steep. A recent case in Montana involving a former U.S. Postal Service worker shows just what's at stake. The former employee claimed total disability from 2006 to 2016 following a work-related back injury and subsequent surgery. Thus, she collected workers' compensation benefits for lost wages, medical costs, and more during that period.

However, the U.S. Postal Service Office of Inspector General began to suspect the former employee was not totally disabled. As the Great Falls Tribune reports, this organization collected evidence showing that she was engaging in physically strenuous activities. These included ''feeding horses, lifting hay bales, jogging in the morning, removing stumps from fallen trees, and other physical activities.''

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