Preventing fraud keeps rates low and makes sure the right people are receiving benefits—and that's good for employers, workers, and all Oregonians.
SAIF's commitment to preventing fraud includes the largest anti-fraud program in Oregon and the experienced staff in our Investigations Program.
Employers who deliberately under-report their payroll, doctors who bill for phantom services, and workers who receive benefits not rightly theirs are all committing workers' compensation fraud. If fraud is proven, all related claims costs are removed from the claim and we seek repayment from the offending party.
To report a suspicious claim:
- Call our 24-hour anonymous Fraud Hotline at 800.282.8822
- Call our Investigations Program at 800.285.8525
- Email us at email@example.com
Help deter fraud at your workplace
- Establish an accident-prevention program
- Create a system for reporting injuries and accidents
- Conduct "in-house" investigations
- Create excellent communication with employees
- Support SAIF's early return-to-work programs
Signs of questionable claims
Remember, one or more of these signs could apply to a worker with a legitimate injury.
- Report of an injury after a scheduled break (such as weekend or days off)
- Delay in reporting an incident
- No witnesses to the injury, especially when there are normally other workers in the area
- Differing descriptions of the incident
- Difficulty contacting the injured worker at home
- Refusal of a reasonable diagnostic procedure
- Report is filed just before a layoff, project conclusion, end of seasonal work,
or similar circumstance
- Worker has recently obtained disability policies
- Frequent change of doctors or other medical providers
- Information indicates a worker is active while allegedly disabled from work
- Worker makes excessive demands
- Worker receives a release for work, followed by a change in doctors
- The disability is beyond that normally associated with the injury
The best way to help with the investigation process is by providing access to people or providing information quickly. Our investigator may need to obtain evidence from an accident scene or obtain documentary evidence such as employment, personnel, or contract records.
Learn more: Call our Investigations Program directly at 800.285.8525, or email us at firstname.lastname@example.org.