Fraud is abusive, but abuse is not necessarily fraudulent. An employer may not discourage an employee from filing a workers compensation claim. Reporting a work-related injury does not mean the employer accepts liability for that injury, it is merely a means of notifying the insurance company of an allegation that needs further investigation. Demonstrate abuse or misrepresentation and prove, beyond a reasonable doubt, intent to defraud the workers compensation system. Indicators of Claimant Fraud Injury reported on Monday that allegedly took place the week before.
Employee reports injury three or four months after it allegedly occurred.
Employee started employment shortly before the alleged incident. The injury was reported after the employee was terminated or laid off. The injury was reported immediately following notice of disciplinary action. There are no witnesses to the injury or witness accounts conflict with one another. The employee is unusually familiar with workers compensation claim handling procedures and laws.