If you suspect an employee has filed a fraudulent workplace injury claim in New Brunswick, you must still submit the Employer Report of Injury within 3 days. However, you can formally object to the claim by providing objective evidence, such as video footage or witness statements, directly to the WorkSafeNB investigations unit.
Protecting workers who suffer genuine injuries on the job is the core purpose of the provincial workers’ compensation system. Responsible employers in Saint John, Fredericton, and Bathurst gladly pay their premiums to ensure their team is safe and supported.
However, when an employee exaggerates an injury or completely fakes an accident, it severely hurts your business. Fraudulent claims drive up your company’s assessment premiums and damage team morale. While it is incredibly frustrating, employers must handle suspected fraud carefully, relying on objective evidence rather than angry accusations to navigate the WorkSafeNB system. 📍
Step-by-Step Process for Disputing a Claim in New Brunswick
You cannot simply ignore an injury report just because you think it is fake. Ignoring the paperwork will only result in fines for your business. Instead, follow a strategic legal path to raise your concerns.
Step 1: File the Mandatory Form 67 On Time
Under the Workers’ Compensation Act, you are legally required to file an Employer Report of Injury or Illness (Form 67) within 3 days of an accident being reported to you.
Do not refuse to submit this form. Filling it out does not mean you agree with the worker’s story. On the form, you will find a section asking if you have concerns or objections regarding the claim. Check the “Yes” box to flag the file for the adjudicator.
Step 2: Gather Objective Evidence
WorkSafeNB adjudicators cannot deny a claim based on a “gut feeling” or a personality clash. You must provide concrete evidence. 🔍
Collect any CCTV security footage of the incident area. Gather written, signed statements from coworkers who witnessed the event (or witnessed the lack of an event). Look for inconsistencies in the worker’s timeline or evidence that the injury actually occurred outside of working hours, such as on a weekend sports team.
Step 3: Communicate with the Adjudicator
Once you flag the claim, a WorkSafeNB adjudicator will contact you. Present your gathered evidence calmly and professionally.
If the evidence is compelling-such as social media photos of the “injured” worker engaging in heavy lifting while off work-the adjudicator can refer the file to the specialized WorkSafeNB Special Investigations Unit (SIU). These investigators have the authority to conduct surveillance and deep background checks.
Step 4: Formal Appeal (If Necessary)
If WorkSafeNB accepts the claim despite your initial objections, the fight is not over. As an employer, you have the legal right to appeal the decision. 💼
You must file an appeal with the Workers’ Compensation Appeals Tribunal (WCAT). At this stage, it is highly recommended to hire an experienced corporate lawyer or paralegal who specializes in labour law to present your evidence forcefully in front of the tribunal.
How Much Does it Cost in New Brunswick?
Fighting a fraudulent claim requires time and sometimes financial investment, but letting fraud go unchecked will permanently damage your premium rates.
| Action / Expense | Estimated Cost (CAD) | Description |
|---|---|---|
| Submitting Form 67 | Free ($0) | Filing the initial objection on the standard employer report costs nothing. |
| Private Investigator | $1,000 – $3,000 | Optional. Some large companies hire private investigators to gather surveillance before a hearing. |
| Lawyer Representation | $2,000 – $5,000+ | Optional. Hiring an employment law firm to represent your business at a WCAT appeal hearing. |
| Cost of Fraud | Higher Premiums | An accepted fraudulent claim can drastically increase your annual WorkSafeNB premiums for years. |
- Fines for Late Reporting: If you stubbornly refuse to submit Form 67 because you believe the claim is fake, WorkSafeNB can fine your business a significant penalty (often starting around $250 – $500 CAD) for delayed reporting.
- Criminal Charges: In severe cases of proven fraud, the WorkSafeNB Special Investigations Unit may push to have criminal charges of fraud laid against the employee by the RCMP or local police.
How Long Does the Process Take?
Addressing suspected fraud requires patience, as investigations must be thorough to withstand legal scrutiny.
You must submit the initial Form 67 within 3 days. Once the claim is flagged, a standard WorkSafeNB adjudication review might delay the worker’s benefits by 2 to 4 weeks while they gather medical reports and interview witnesses. If the case is escalated to the Special Investigations Unit or requires a formal hearing at the Workers’ Compensation Appeals Tribunal, the entire process can easily take 6 to 12 months to reach a final, binding conclusion.
Frequently Asked Questions (FAQ)
Can I fire an employee for filing a fake claim?
You must tread extremely carefully. Firing an employee simply because you suspect they are lying can lead to a severe wrongful dismissal lawsuit. You should only terminate their employment if WorkSafeNB officially confirms the fraud or if you have undeniable, ironclad proof, and you should always consult a lawyer first.
What if the worker goes to their own doctor?
Workers have the right to choose their initial treating physician. However, if their family doctor’s report is suspicious, WorkSafeNB has the authority to order the worker to undergo an Independent Medical Examination (IME) by a specialist of the government’s choosing.
Should I confront the employee myself?
No. Confronting the employee aggressively can be viewed as workplace harassment or an attempt to intimidate them into dropping a claim (which is highly illegal). Let the WorkSafeNB investigators handle the interrogation.
Does WorkSafeNB actually investigate these things?
Yes. WorkSafeNB has a dedicated Special Investigations Unit (SIU) that takes fraud very seriously. They use advanced surveillance, background checks, and witness interviews to uncover the truth.
Will my premiums go back down if the claim is proven false?
Yes. If you successfully appeal a claim and the WCAT or WorkSafeNB overturns the decision based on fraud, the claim costs will generally be removed from your employer account, which will correct your premium rates for the future.
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