Workers' Compensation Fraud
LUBA puts a high priority on preventing workers’ compensation fraud, which costs the industry billions of dollars each year and affects everyone involved – insurers, policyholders and providers.
Fraud occurs when someone willfully makes a false statement or conceals information in order to receive workers' compensation benefits or prevents someone from receiving benefits to which they might be entitled. Employees commit fraud if they exaggerate a medical condition or work for cash while classified as disabled. Fraud also occurs if employers underreport their payrolls to receive lower premiums, or if health-care providers bill for services never performed.
There are numerous ways fraud can be committed. If you suspect someone is committing fraud, please let us know by completing the form below, and we’ll investigate.
Claimant Fraud
- Malingering or exaggeration of symptoms
- Working while allegedly disabled and not reporting income
- Claiming a job-related injury that never occurred
- Claiming a non-work related injury as a work-related injury
- Falsifying mileage reports
Employer Fraud
- Underreporting payroll or misclassifying employees for lower insurance premiums
- Deducting premium dollars from employee wages
- Employer knowingly fails to have necessary workers' compensation coverage
Medical or Health-Care Provider Fraud
- Providing unnecessary testing or treatment of injured workers to reap financial benefit
- Billing for services or treatment never performed
- Billing the workers' compensation insurer and the workers' health insurer for the same services
