What Are the Consequences Of Filing A Fraudulent Workers’ Compensation Claim?
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Workers’ compensation fraud is a serious problem in the United States. Every year, insurance companies lose billions of dollars to fraudulent claims. Consequently, premiums paid by honest workers go up, and the availability of benefits decreases.
Filing a fraudulent workers’ compensation claim is a felony in most states. If you are convicted of workers’ compensation fraud, you could face significant penalties, including jail time and hefty fines.
This blog will discuss the consequences of filing a fraudulent workers’ compensation claim. We will also provide some tips on how to avoid becoming a victim of fraud.
What is workers’ compensation fraud?
Workers’ compensation fraud occurs when someone deliberately lies or withholds information to receive benefits they are not entitled to. For example, an employee might claim that they were injured at work, when in fact the injury occurred outside of work. Or, an employee might exaggerate the severity of their injury to receive higher benefits.
Employees, employers, or even doctors can file fraudulent workers’ compensation claims. In some cases, organized crime rings are involved in workers’ compensation fraud.
Some Examples of Workers’ Compensation Fraud
Here are some common examples of workers’ compensation fraud:
An employee lies about the nature or severity of their injury to receive benefits.
An employer knowingly withholds information about a dangerous work environment or fails to provide safety equipment, leading to an employee’s injury.
A doctor knowingly provides false information about an employee’s injury to help them receive benefits.
An organized crime ring stages accidents and injuries to collect workers’ compensation benefits.
How are workers’ compensation investigated?
Insurance companies have fraud units that investigate suspicious claims. When a claim is flagged for investigation, the insurance company will often hire a private investigator to gather evidence.
Investigators may look at surveillance footage, interview witnesses, or comb through social media posts. In some cases, they may even set up surveillance of injured workers to see if they are truly disabled.
If fraud is suspected, the case will be referred to the district attorney’s office. The district attorney will then decide whether to file criminal charges.
The consequences of workers’ compensation fraud
Workers’ compensation fraud is a serious crime. If you are convicted of fraud, you could face significant penalties, including jail time and hefty fines.
Jail time. Depending on the state, workers’ compensation fraud is usually a felony. If you are convicted of a felony, you could face up to 5 years in prison.
Fines. In addition to jail time, you could also be fined up to $50,000 for workers’ compensation fraud.
Restitution. You may be required to pay back the workers’ compensation benefits you received fraudulently, plus interest and any legal fees incurred by the insurance company.
Loss of benefits. If you are convicted of workers’ compensation fraud, you will likely lose your eligibility for future benefits.
Probation. In some cases, you may be placed on probation and required to complete community service.
A conviction for workers’ compensation fraud can also result in a loss of your professional license if you have one. For example, if you are a doctor or lawyer, you could lose your license to practice.
A conviction on your record can also make it difficult to find a job, get housing, or obtain a loan.
So how can you avoid becoming a victim of workers’ compensation fraud?
Here are some tips:
Make sure you are honest when reporting your injury.
Do not exaggerate the severity of your injury.
If you are not sure whether or not you are eligible for benefits, speak to an attorney.
Be cautious of any doctor who is pressuring you to file a workers’ compensation claim.
Do not sign any documents that you do not understand.
If you have been injured at work, you may be entitled to workers’ compensation benefits. However, filing a fraudulent workers’ compensation claim is a serious crime that can result in significant penalties. If you have been accused of workers’ compensation fraud, it is important to contact an experienced attorney as soon as possible. Contact Oracle Law Firm At (888) 547-1778 , we have extensive experience handling workers’ compensation fraud cases, and we can help you understand your rights and options.