Why Would Your Employer Think Your Worker’s Compensation Claim Isn’t Legitimate?

Whenever an employee suffers a workplace injury, they’re required to file a workers comp claim. Once your employer receives the claim, they are going to do an investigation. If you’re a loyal worker who has been with the company for years, there’s a good chance your claim will be approved.

However, if you have only been with the company a short time, or have a history of disciplinary problems, it will be treated quite differently. In fact, you may need the help of a Miami workers compensation lawyer. If your employer doesn’t trust that your claim is legitimate, they aren’t going to approve your benefits.

Since COVID-19 hit, employers have become more strict about reviewing workers compensation claims. So many people have been in dire financial positions since then that they become desperate. If your employer thinks you fall into that category, they may assume that you filed a claim because you need the money.

If this happens to you, or you’re suspected of filing a fraudulent claim, you need help. We suggest that you contact one of our workers comp attorneys in Miami right away. They can help answer any questions or concerns you may have.

Here, we will describe some of the red flags that employers look for when an employee suffers a workplace injury. We will also explain some of the factors that can make your employer think that you’re exaggerating your injuries or trying to extend the time you are out of work.

Why Do People File Fraudulent or Exaggerated Workers Comp Claims?

As much as it may not make sense to most people, our Miami workers compensation lawyers do understand why people file fraudulent workers comp claims. They may be down on their luck and think they’d be better off at home receiving workers comp benefits. Or they may have suffered a workplace accident but their injuries weren’t all that serious.

People will do anything when they are desperate. While it may not make sense, given the fact that you would net more income if you stayed at work, it does make sense. While they collect workers compensation benefits, they simply work at another job under the table. This allows them to almost double their income by filing a fraudulent or exaggerated claim.

Your Employer Will Be Suspicious if There Were No Witnesses to Your Workplace Accident

One thing that will make your employer suspicious is if there were no witnesses to your workplace accident. It is rare that any employee is working in solitude. There would normally be another worker or manager around. At a minimum, one would think the incident would be caught on film.

So when the Human Resources department is told that nobody witnessed the accident, they are going to suspect something is up. They will talk to your coworkers and manager to see if there was a time that you were working alone. If there are cameras, they will look to see if you were where you said you were at the time of the accident.

a workplace injury with no witnesses will look suspicious

Most Human Resources Directors Become Suspicious if You Claim the Injury Happened on a Friday or Monday

Any Human Resources manager you talk to will tell you that they’re always suspicious when someone reports an injury on a Friday or Monday. When somebody claims that they were hurt during the last hour of their shift on a Friday, it will raise some eyebrows.

The same is true for somebody who says they were hurt first thing on a Monday. Your employer will assume that you were actually injured over the weekend. They’ll think you chose those specific times not because it’s when you were hurt – but because it would be harder to prove that your accident happened over the weekend on your own time.

Workers Comp Attorneys in Miami Know the Insurance Companies Will Look at Your History

When the insurance company receives your workers compensation claim, they are going to look at your past history. If you have a history of filing claims, they will presume that you make a habit out of doing this.

The way it looks is that you start at a new company and then, after a while, pretend you suffered a workplace injury. Once you exhaust your benefits, you leave and do it all over again. Your workers comp attorney in Miami will have to dig up your old medical records to prove that this isn’t the case.

If Your Claim Is Denied, You May Need to Call a Skilled Workers Comp Attorney in Miami

If your employer thinks your workers’ compensation claim is suspicious, they will conduct a thorough investigation. The insurance company will check to see if you have a history of filing these claims.

If they find anything to back up their suspicions, they will deny your claim. If that happens, you should reach out to one of our Miami workers’ compensation lawyers as soon as possible. They will review your claim and whatever other information you may have. If it appears to them that your claim should’ve been approved, they may be willing to represent you.

If, however, they think that there are too many signs that you may have exaggerated your injuries, they may not be able to help. The same is true if you admit that you filed a fake claim. No workers comp attorney in Miami would be willing to represent somebody who admitted that they filed a fraudulent claim.

If you think your workers comp claim should have been approved, contact our office directly. We offer all new clients a free, initial consultation. This allows us to review your and gives you the opportunity to ask any questions you may have.

Since the consultation is free and you pay nothing until you get compensation, you have nothing to lose by contacting us.

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