Exaggerated workers’ compensation claims continue to cause trouble for businesses across the U.S., leading to higher costs and disruptions. Mike Lopez, a managing partner at Liberty Company Insurance Brokers and expert in workers’ compensation, has witnessed firsthand how these claims can hurt companies.
Lopez explains that some employees may overstate their injuries to get more benefits than they actually need. While most claims are real, even a small number of exaggerated ones can greatly affect a business’s finances.
Interestingly, Lopez points out that exaggeration isn’t always about fraud. Sometimes employees overplay their injuries because they feel unheard, don’t trust the system, or don’t have a clear plan to return to work. If not addressed, minor injuries can grow into bigger claims. He emphasizes how important good communication and a quick, caring response are in dealing with injured workers.
To spot exaggerated claims, Lopez suggests watching for warning signs like inconsistent stories, no witnesses, delays in reporting injuries, and frequent changes in doctors. He advises extra caution when claims come from employees who often file reports or seem unhappy with their job. Patterns, such as injuries happening late on Fridays or before holidays, might indicate someone is trying to get extra time off.
Prevention, Lopez says, starts with creating a safe workplace where employees feel they can report real injuries without fear. Training programs that teach about safety and reduce accidents play a big role too. Employers should keep open talks with injured workers, ask for second medical opinions when needed, and make sure all incidents are properly recorded.
Lopez stresses that being aware of these issues early on helps limit their cost and impact. Taking proactive steps can make a difference for businesses trying to handle workers’ compensation fairly and effectively.