Unfortunately, as with any system involving large amounts of money, there are “bad apples” who will try to game the system. According to the National Insurance Crime Bureau (NICB), workers’ compensation fraud amounts to a $7.2 billion per year loss across the United States, and it is the fastest growing segment of insurance fraud.
Investigating Workers’ Compensation Fraud
Some cases of workers’ compensation fraud are more obvious than others because they often make splashy headlines. Classic examples include the man claiming a debilitating back injury who is seen playing football at the park or the supposedly injured woman collecting workers’ compensation payments who continues to work a second job. There was even one woman (fittingly named Cathy Cashwell) caught on the Price Is Right TV show spinning the big wheel despite her claims that she could not “stand, run, reach, or grasp.”
These examples are classified as claimant fraud, which include but are not limited to two main types:
A claimant collecting medical and income benefits when they are not actually injured; and
A claimant receiving income benefits to make up for lost wages while maintaining employment somewhere without disclosing it.