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Workers Compensation Kit

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"Fraud & Abuse - Controlling fraud & abuse of the system"

Fraud, Abuse and Malingering: Some people take advantage of the system by staging accidents, faking injuries or pretending they are injured more seriously than they are.

  1. Be able to spot the red flags of fraud
  2. Hospital bill review
  3. Guide the investigators on your team
  4. Read and review surveillance reports, videotapes and photographs
  5. Have an anti-fraud program which includes a toll-free tip line

Forms & Documents

  • Letter to TPA Enclosing Report
  • Letter to Employee's Doctor
  • Letter Requesting Investigation