How does recognizing fraud help manage your costs?

To protect injured workers’ benefits and keep employer premiums down, BWC is aggressively attacking fraud. The Special Investigations Department investigates allegations of fraud committed against the state insurance fund.

Many fraud cases start with tips and allegations made by concerned citizens, injured workers, employers and other witnesses who report activity that may be an abuse of the workers compensation system.

The Special Investigations Department seeks to identify and recover funds obtained illegally by injured workers, employers, health-care providers or attorneys in cases such as these:

• Individuals who collect BWC temporary total or permanent total compensation benefits while working;
• False information supplied to BWC for financial or other gain. This includes falsified or altered documents submitted by injured workers and misreported or under-reported payroll reports submitted by employers;
• Improper billing for medical services. This includes billing more than once for a particular service, billing by unlicensed personnel, and billing for services not rendered.

Click here to learn more about identifying fraud red flags.