An important part of reducing workers’ comp claims costs is the employer’s willingness to use every tool in the work comp cost reduction toolbox. One tool, investigating suspicious claims, worked out very well for Wal-Mart when it discovered one of its “greeters” was not as unable to work as she claimed.
The “greeter” filed a work comp claim after a work-related injury claiming knee, neck and shoulder injuries. Following surgery, she continued to complain about pain and did not return to work until two years after her initial injury. After returning to light duty, the worker said her pain was so extensive she could not continue to work. In all, the claim covered a 4-year period.
The Investigation
In a deposition supporting her claim of being unable to work at all, the woman said she needed the support of a cane to move and found it difficult to stand, kneel and lift. The employer decided to investigate her claim.
Investigators videotaped the “injured” worker during a fishing expedition hauling in an anchor and casting a fishing rod – activities requiring her to twist and bend over the boat’s side and use her shoulder for casting. (Try to picture someone using a cane while fishing!)
Two felonious charges of workers’ comp fraud and perjury, with a possible prison term of up to 25 years, were brought against the woman. (workersxzcompxzkit)
Employers are encouraged to investigate suspicious claims to discourage fraudulent claims. Especially in cases where the injuries sustained do not match the physical requirements of the job position. A greeter is not necessarily required to “stand, kneel or lift” and a job modification is to provide a stool. In addition, when employees observe the company’s readiness to move toward work comp claim investigations, the temptation toward filing fraudulent claims is reduced.
(Extracted Torrington Register Citizen/Journal Inquirer, Feb 2010)
Author Robert Elliott, executive vice president, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers' Compensation costs, including airlines, health care, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. He can be contacted at: [email protected] or 860-553-6604.
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