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What if my employee files a faulty workers’ compensation claim?

As an employer, you want to make sure that your workforce remains healthy and fully functional. One of your primary tools to achieve this is workers’ compensation coverage for your employees, but that doesn’t mean that every workers’ compensation claim actually necessitates a payout. Depending on many factors in an employee’s claim, you may have reasonable grounds to avoid paying the claim in full or in part.

While it is important for employees to remain healthy, some claims are simply an abuse of the system. If, for instance, an employee files a claim for an injury that not actually work related, you have reasonable grounds to contest the claim. In some cases, the employee may actually bear the responsibility for his or her injury, either out of direct action, or because he or she does not properly pursue treatment to address the issue.

If, for instance, an employee suffers an injury on the job that you believe he or she actually inflicted on him or herself, a workers compensation claim may not prove appropriate. Workers’ compensation insurance is not a buffet of benefits that magically materialize — it offers important protections to both employers and employees, and works best when both parties use the benefits properly.

Similarly, if an employee claims an injury but then does not seek appropriate treatment to actually improve the issue, you may have grounds to contest the claim. It is not fair for an employee to claim that you, as the employer, bear responsibility for an injury he or she does not properly treat.

Should you face this dilemma, don’t hesitate to reach out to an experienced attorney who can help you assess the strengths of your position and weaknesses in the claim itself. Be sure to use all the legal counsel you need to protect your rights as an employer and encourage efficiency and proper engagement in the workplace.

Source: Findlaw, “Common Workers’ Compensation Defenses,” accessed Oct. 27, 2017

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