Workers Compensation Fraud – Get the facts


We continue to find it interesting, and alarming that so many people in the community continue to question the “genuine” status of injured workers. The media obviously has a large role to play by reinforcing the stereotype of injured workers as fraudulent malingerers, even though research has proven over and over again that injured workers (employee) fraud accounts for less than 1% of all workcover fraud.

If  you’re unfortunate enough to be injured or made ill on the job – you are now considered a fraudster or a criminal until proven otherwise.

If anyone would actually enforce the law, I think we would all be shocked at the level of fraud committed by workcover insurance carriers, medical service providers and employers in the workers compensation system.

Workers Compensation Fraud? You’re Looking the Wrong Way

By Rowan | The Injured Workers Support Network (NSW)

Business entities, not workers top the list of Americas “Most Wanted”.

The last statistics for workers compensation fraud in NSW were in 2011 (updated). these said that 0.01% of fraud is committed by injured workers. Unfortunately 0.2% was committed by employers. Both figures are surprisingly small but being two years away, some may say out of date.

America gives the word a top ten list of workers compensation fraud cases each year. this is there list:

  1.  (California) Medical Equipment Company Overbills $36 Million (3/17/14)
  2. (California) 15 Medical Professionals Indicted in $25 Million Scheme – Small Child Dies (6/24/14)
  3. (California) Lowe’s Settled Independent Contractor Misclassification Case for $6.5 Million (7/3/14)
  4. (California) Paving Company Cheats System of $4 Million (6/19/14)
  5. (Florida) False Insurance Certificates Check Cashing Scheme Defrauds Insurance Company of $1 Million (11/18/14)
  6. (Texas) Man to Pay $806,000 for Underreporting Payroll to Workers’ Comp Carrier (3/11/14)
  7. (Arizona) Paul Johnson Drywall Inc. Agreed to Pay $600,000 in Back Wages, Damages and Penalties to 445 Employees (5/19/14)
  8. (Washington) Summit Drywall, Inc. Ordered to Pay $550,000 in Unpaid Wages and Damages to 384 Workers (2/20/14)
  9. (Georgia) Nurse Gets 5 Years in Prison for $450,000 Bogus Workers’ Comp Claims (8/26/14)
  10. (California) Drywall Company Owners Arraigned on $420,000 in Fraud Charges (12/11/14)
Lets put that another way:
monetary cost
Employer fraud $74,876,000.00
Employee fraud $450,000.00

(information from North Carolina workers compensation journal)

I would be interested in seeing what the latest NSW and Australian Figures are but the governments just are not letting these things be published for some reason.

Next time someone tells you about the “Problems with workers compensation laws” you can simply call false on it. the problem (if one really exists) with workers compensation fraud lies with businesses- not their workers.


We would also be very interested in the latest VICTORIAN and other Australian states’ workers compensation fraud figures. Interestingly, as Rowan pointed out, our governments and workcover authorities don’t publish these figures… which says a lot indeed!