From the standpoint of an employer, ideally, it would be best to never have to payout on a workers compensation benefit claim. Unfortunately, this employer-based mindset often sets up injured and sick workers up for a level of scrutiny for which the results may not be fair.
To avoid a suspicion or accusation of f-r-a-u-d regarding a workmans comp claim, a worker should be mindful of the following factors:
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If no one witnessed the injury or accident, this may cause the worker's compensation carrier to have suspicions regarding the claim. For this reason, a worker will certainly want to present a list of witnesses to the accident.
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If the employee's story regarding the accident changes, this may cause suspicion as well. For this reason, a worker filing a workers compensation claim should be very clear in their own mind regarding the details of a work accident or injury.
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Finally, if there is an unusually protacted length of time between the occurrence of the work injury or work accident and the time that it is reported as a compensable workers compensation claim, a carrier may suspect that the claim is not wholly legitimate. For this reason, among others, a work accident or injury should be reported promptly and immediately to one's employer, typically to someone in a supervisory capacity.
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