Dishonest Claim Reporting During a Downsizing

Thursday, February 7, 2002 | 0

In our last article, we examined issues with employee psychology and external forces that can affect workplace safety when a company is downsizing. In short, remaining employees inherit new duties that they are unfamiliar with and sustain injuries because no one has shown them how to safely perform the work and employees know how to perform the work but sustain an injuries because they are overworked and/or in poor physical condition to take on the increased workload.

Other reasons claims rise can be because workers, facing an impending layoff, will pursue a claim, legitimate or otherwise, that they previously did not either bother to mention or did not actively pursue. They do so because they believe that it will insulate them from the turmoil associated with the downsizing or any potential future downsizings. It also affords them a convenient 'respite' from an evolving workplace.

While workers who face layoffs could have a financial incentive to suddenly suffer an injury, not all claims are false. According to experts, workers facing a layoff are more likely to file claims when they feel they've been "wronged."

Issues that raise "red flags" indicative of claims which warrant more attention during a downsizing include:

* Vague accident details.
* Lack of witnesses.
* Minor accidents resulting in major injuries.
* Injuries occurring late Friday or very early on Monday.
* Delayed reporting.

There are certain other areas of concern that require follow up in a work accident investigation:

Be aware of claimants who actively participate in sports, hobbies, or other jobs. Management should have regular conversations with workers, casually asking about their weekend plans, or activities that were engaged in. Obviously, take note of those who planned strenuous activities, such as skiing, and who "suddenly" get injured on Monday.

Everyone in the company should understand that your company requires prompt reporting of all incidents, from near-misses to full-blown accidents. This discourages workers from the temptation of inflating the severity of an incident to collect workers' comp payments. Another good idea is to workers sign a "no-accident-this-week" form before they leave for the weekend that will discourage workers who "forget" to report Friday injuries until Monday.

Employers should keep a list of different light-duty assignments for injured employees who want to return to work. But if a worker refuses all available assignments, then you should be suspicious. If this happens, get the worker to explain their reasons for refusing assignments, and then have them sign a statement for your records.

In the next article of this series, we'll examine some "Best practices" during layoffs.

This article sponsored by HealthCareProducers.com, where one stop health and workers' compensation insurance is just a click away.