Workman’s compensation fraud is an all too often common occurrence throughout the United States, and no shortage of it in Illinois. RGH Investigations is faced with many surveillance cases that involve workman’s compensation, or worker’s comp. Oftentimes, workers hope to be paid for an injury that may not be all that serious…or injured at all. In this case, a private investigator is often needed to check the injured worker’s legitimacy to assure that they are truly unable to work and make sure they’re following doctor’s orders. If the worker doesn’t check one of these boxes, they are considered to be committing fraud, and the claims are withdrawn. In worse case scenarios, individuals may also face jail time or a financial penalty.
How to Spot Workman’s Compensation Fraud
Everyone has a right to feel safe at work, which is why workman’s comp exists. There are many occupations in the workplace that are high risk…or situations where a person can be at the wrong place at the right time. Nonetheless, any employee is eligible for workman’s comp insurance. If the worker is injured during work hours and can no longer work, the employee is entitled to monthly payments. Under Illinois law, if an employee makes a false claim, this is illegal and can be sent to prison, along with a large fine. The most common workman’s compensation fraud is when an employee claims injury that did not take place during the work hours, yet claim workman’s comp. They may also exaggerate the extent of the injury. We’ll be giving you a recent case in a moment.
However, let’s not forget that workman’s compensation fraud can go the other way…the employer. An employer may present false information, downplay, about job safety or claim the injured worker is an independent contractor. Because placing safety measures into practice can be costly, some companies choose to minimize safety standards placing more of the risk on the individual.
A Unique Fraud Case
Workman’s compensation fraud is common, but our story this month is unique. RGH Investigation received a case of workman’s compensation fraud, and we began with our surveillance service. A worker at a factory (Factory A) was reported as seriously injured and cannot work, but showing up to work at another factory (Factory B). We followed the worker to Factory B every day. We had a contact inside Factory B, who had a link to an employee who knew the injured worker. This employee immediately identified the injured worker using a name we were unfamiliar with. Curious, RGH Investigations identified that this injured worker was working at Factory B under a false name and Social Security Number. The person whose identity was being used by the injured worker was his associate. The two men looked very similar. It was easy for the injured worker to get away with fraud as no fingerprints or photos are required when working the job at Factory B. Long story short, this savvy worker was being paid worker’s comp from Factory A, and also being paid a salary at Factory B. It was clear the worker was able to continue working, and the claim to workman’s comp is considered fraudulent.
RGH Investigations notified both workplaces of the fraudulent activity. We also confronted the ‘injured’ worker about his activity, and instructed him to drop the workman’s comp case. We could turn this situation to the police, and the worker will likely face jail time. The worker’s attorney dropped the client and claim immediately.
Workman’s Comp Claims: Last Notes
RGH Investigations has a lot of experience dealing with surveillance and workman’s compensation fraud. If you or an employer suspect a case of workman’s compensation fraud, contact RGH today at 312-981-8770 to open a case today.
