Signs of Worker's Compensation Fraud and Abuse Essay

Signs of Worker's Compensation Fraud and Abuse - Essay Example While the workers’ compensation system works in the best interest of employees, it is subject to abuse and/or fraudulent practices. Perpetrators of fraud, abuse, or both vary depending on the specific matter in question. This means that employees, employers, and legal experts among others can perpetrate workers’ compensation fraud and /or abuse for differentiated reasons, purposes, or motives (Green & Rowell, 2012). Fraud and/or abuse perpetrated by an employee entail the use of false information, practices, or procedures to obtain compensatory benefits that the employee is not entitled. Eligibility for such benefits is jeopardized, thus resulting in abuse or fraudulent activities that relate to worker’s compensation. When there is enough evidence that fraud and/or abuse in regard to workers’ compensation has occurred, it is important to establish the root cause, reason, purpose, or motive behind the activity. This would require that the perpetrator (the employee) be closely examined in order to ascertain the validity of the evidence available. Once this has been done, the response to worker’s compensation fraud and abuse should allow the perpetrator to explain why such a move was made (Rejda, 2011). This would allow the response team to establish the ground upon which fraud and abuse occurred. Responding to evidence of workers’ compensation fraud and abuse is strong when the baseline of such practices is understood (Green & Rowell, 2012). Once the evidence receives the aforementioned treatment, the next critical step seeks to determine contributory factors that provide loopholes in the system. This can take the form of determining the relationship between the stakeholders that verify and approve workers’ compensation. The idea here is to establish any cooperation and collaboration between fraudulent employees and parties in the compensation system.