Human Resources News & Insights

Workers’ comp fraud: Better watch those falling sprinkler heads

Luckily, they’re pretty rare. But some employees will go to astonishing lengths to fake on-the-job injuries in order to collect workers’ comp.  

Take the case of Sheyla Veronica White, who worked at Cinque Terre Energy Partners in Florida. White filed a workers’ comp claim for an on-the-job injury she said she sustained when a sprinkler component fell from the ceiling, bounced off her desk and hit her in the head. Cinque Terre promptly filed the claim.

But the insurance company was suspicious. And there happened to be a surveillance tape.

What the tape showed: A small piece of a sprinkler head did, indeed, fall onto the woman’s desk. But it didn’t hit her.

She picked it up and examined it … looked around the office to see if anyone was looking … and smacked herself in the head with the metal part. (You can watch the video here.)

White was arrested and transported to the Broward County Jail. She faces two counts of workers’ compensation fraud, and faces up to five years in prison if convicted.

Red flags to look for

The employer’s insurance company was the one that decided to investigate the claim because this particular individual had a previous criminal history at a former employer, Jennifer Azara wrote in a recent issue of our affiliated newsletter CFO and Controller Alert.

That’s one of the top red flags for workers comp fraud, according to workers’ comp insurance specialists MEMIC, Azara added.

The others MEMIC thinks you should be familiar with:

  • The person is a job jumper. Of course these folks don’t tend to be your first choice to hire anyway, but sometimes it gets explained away convincingly enough that you bring them on.
  • They have a child support lien. Payroll’s your best ally here. At times folks whose wages are being garnished will turn to less-than-scrupulous ways to get off paying.
  • You get exaggerated details about the incident or symptoms. No one needs to start playing amateur P.I., but check with the manager who took the incident report and the person’s direct supervisor (if they’re different). A quick search on a site like WebMD can help you see if something strains reality.
  • There’s co-worker skepticism. This might be your most critical red flag. The people that work most closely with that individual will have the best idea of when something’s fishy. So keep an ear out and encourage other managers to as well.

 

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