There are 3 main types of fraud within the workers' compensation industry.
This is the type of fraud that most people think of when they think of workers' compensation fraud. An employee either fakes or exaggerates an injury.
Perhaps there really was an injury, but they indicate to the employer/doctor/insurance company that it was far more serious than it was so that they can stay off work or attempt to force a settlement with the insurance company. You see them walking in to the Dr.'s office on crutches
and then on a jet ski later that day.
Perhaps there really was an injury, but it occurred over the weekend and not while they were at work. These are both examples of fraud.
Medical Provider Fraud:
This occurs when medical providers deliberately over-treat a claimant or submit fraudulent bills to the insurance carrier.
Employers who attempt to escape/reduce the cost of the legal purchasing of workers' compensation for their employees are committing fraud as well. They can do this by the following methods:
Not purchasing workers' compensation, even though they know they are required by the State of Florida to do so.
Under reporting payrolls to reduce cost.
Knowingly misclassifying employees in the wrong class code to reduce cost.
Paying workers cash "under the table".
Trying to treat "employees" as "independent or sub" contractors.
While all types of fraud cost the system and ultimately all employers money, this is by far the largest financial impact to the fraud equation.