Shepherd S L, LaFleur B J
Medical Information Systems and Operations Research Department, Naval Health Research Center, San Diego, CA 92186-5122, USA.
J Occup Environ Med. 1996 Jul;38(7):681-8. doi: 10.1097/00043764-199607000-00010.
Insurance-industry researchers have shown an increase on Mondays of lost-time sprain and strains said to be work-related, but thought to be fraudulent claims for off-the-job weekend injuries. We examined this issue among civilian employees of the Department of the Navy, using data from claims for injuries occurring between 1989 and 1994. We found that the rate of Monday sprains and strains significantly exceeded the expected rate and that such claims were significantly more likely to be made by claimants who were craftsmen and mechanics, who reported an injury to the back or trunk, who were supervisors, or who did not have college degrees. We estimate that 22% of claims for Monday-occurring sprains and strains are possibly fraudulent and that their cost to the Department of the Navy during the 6 years studied was $38 million. For the entire federal government, cost for such claims during this period may have exceeded $250 million.
保险行业研究人员发现，据说是与工作相关的误工性扭伤和拉伤在周一有所增加，但被认为是对周末非工作期间受伤的欺诈性索赔。我们利用1989年至1994年间受伤索赔的数据，对海军部文职雇员中的这一问题进行了研究。我们发现，周一扭伤和拉伤的发生率显著超过预期发生率，而且此类索赔更有可能由以下索赔人提出：工匠和机械师、报告背部或躯干受伤的人、主管或没有大学学历的人。我们估计，周一发生的扭伤和拉伤索赔中，有22%可能是欺诈性的，在研究的6年期间，这些索赔给海军部造成的成本为3800万美元。对于整个联邦政府来说，这一时期此类索赔的成本可能超过2.5亿美元。
