How to spot workers’ compensation fraud
As a supervisor, handling workers’ compensation claims is probably not your responsibility. However, injury claims affect your department (productivity, morale, retraining) and the company’s bottom line (claims are not cheap).
Most reported injuries are legitimate, but some workers may exaggerate their injuries, fabricate them entirely, or claim that injuries which happened at home are work-related.
Spotting workers’ compensation fraud isn’t easy, but supervisors are in a good position to notice things that don’t seem right.
Red flags
The following red flags can alert you to possible fraud:
- The injured employee cannot identify any witnesses to the accident.
- The injury was not reported promptly.
- Documents submitted by the employee have a lot of cross-outs or other corrections.
- The injury was reported on Monday morning, which could be a weekend injury that the employee claims is covered by workers’ compensation.
- The accident occurs in an area where the employee does not normally work.
- You hear through the grapevine that the employee is working somewhere else while on workers’ comp.
- The employee has a record of suspicious claims.
- You observe the worker engaging in activities that are inconsistent with the injury.
- The injured worker is difficult to reach at home.
- The accident report is inconsistent with the diagnosis, like a repetitive motion injury that allegedly resulted from a fall or impact.
- The injury occurs shortly after disciplinary action.
- The type of injury is unusual for a particular job.
None of these red flags alone prove that an employee is attempting fraud. However, if you notice several warning signs, report your suspicions to your safety or workers’ comp manager for investigation.

















































