North Carolina DOJ Raises Alarm Over Workers' Compensation Fraud Scheme

The North Carolina Department of Justice, under the leadership of Attorney General Jeff Jackson, has issued a stark warning regarding a disturbing workers' compensation fraud scheme that targets injured workers across the state. This criminal activity involves fraudsters who impersonate government officials, judges, attorneys, and even employees from the North Carolina Industrial Commission, contacting claimants to demand payments for benefits that are legally owed to them. These scammers are exploiting a vulnerable segment of the population at a critical time in their lives, as individuals dealing with injuries focus on recovery and rehabilitation rather than being preyed upon by unscrupulous individuals.

In an official statement, Attorney General Jackson emphasized the importance of vigilance among the public: "People who are injured should be focused on recovery, not dealing with scams like this." The warning highlights how scammers often operate through various mediums such as phone calls, emails, and texts, falsely presenting themselves as officials from the North Carolina Industrial Commission — the agency responsible for overseeing the state's workers' compensation laws. The Commission is dedicated to protecting injured workers, and the fraudulent activities pose significant challenges not just for claimants but also for the integrity of the entire workers' compensation system.

As detailed by Philip Baddour, the Chair of the North Carolina Industrial Commission, the implications of such fraudulent schemes extend beyond individual cases. They threaten to undermine public trust in the workers' compensation system, which has already faced scrutiny and challenges in ensuring timely and fair compensation for claims. Baddour stated, "These scammers prey on people who are simply trying to access the benefits they are legally entitled to."

This warning from the Department of Justice necessitates immediate action from all stakeholders involved in the administration of workers' compensation. Agencies and contractors responsible for claims processing need to implement enhanced verification procedures and bolster their fraud detection measures. Organizations providing technology solutions for claims management stand to gain significant opportunities by developing robust systems aimed at fraud prevention and ensuring secure delivery of benefits. In light of these circumstances, the need for clear communication and education efforts to inform both workers and service providers about these scams has never been greater.

The North Carolina industrial landscape must adapt to increasing risks of fraud in this area. Behavioral changes among potential claimants could lead to reduced participation in legitimate claims processes, ultimately impacting recruitment and retention of reliable workforce talent. Legal and compliance teams must heighten their awareness of these evolving threats to ensure that they protect both the workers' interests and the administrative integrity of the system.

If you or someone you know is confronted with suspicious activity related to workers' compensation, the Industrial Commission’s message is clear: Do not engage with the scammers. Genuine communications from the Commission will never request payment for the release of benefits. Residents are encouraged to report any such fraudulent attempts immediately by utilizing the designated contact channels provided by the Commission, ensuring that actionable steps are taken to safeguard claimants.

• Procurement and compliance teams should be aware of increased fraud risks affecting workers' compensation claims processing and related services in North Carolina.
• Agencies and contractors involved in workers' compensation administration may need to enhance verification and fraud detection measures to safeguard program integrity.
• This alert underscores the importance of clear communication and education efforts to prevent fraudulent exploitation of government benefit programs.
• Organizations providing services or technology solutions for claims management should consider opportunities to support fraud prevention and secure benefit delivery in the state.
• Contact the North Carolina Industrial Commission immediately if approached by suspected scammers via fraudcomplaints@ic.nc.gov or call 888-891-4895.
• Monitor communication channels for legitimate notices from government agencies regarding benefits, and validate any requests for payment.