If you are an employer that has had several claims, it's likely that you have seen multiple cases of what you might consider fraud. Some reasons employees do this include:
- To get an off the job injury covered under workers compensation. Workers with no medical coverage are prime for this and also workers comp has no deductible.
- To obtain a lump sum settlement. We have seen some employees with over 10 workers comp claims all involving settlements and all involving the same attorney.
- To obtain pills - Opioid abuse is at an all time high and Oklahoma is one of the worst states for this. Many work comp doctors will prescribe a complete battery of pain killers which the injured employee may either sell on the black market or take themselves.
I break this down into complete fraud, in which the employee fabricates the entire injury, or modified fraud in which the employee gets legitimately injured and is then swayed by an attorney, friend, or coworker to modify their symptoms to obtain one or more of the above.
The Oklahoma Option makes attorney involvement much harder for the average attorney who is used to dealing with the workers comp system because most claims will routinely be referred to Federal Court due to ERISA (Employee Retirement Income Security Act), which regulates these types of workers comp plans. This can actually benefit the employer.
The Oklahoma Option also greatly reduces the time for reporting a claim because employers can choose reporting requirements under this type of benefit plan. This will curtail the past practice of reporting claims months or often years after the claim allegedly happened.