Workers’ compensation fraud can be unintentional, but if the court does not believe your case, you will be punished regardless. The fines and penalties that go along with an any workers’ compensation violation, whether you made a mistake or committed fraud intentionally, can still be large, as well as damaging to one’s reputation and future career. If you have any questions about the legality of your workers’ compensation claim, whether or not you are eligible, or how to secure workers’ compensation benefits, do not hesitate to reach out to a skilled attorney for answers and professional assistance.
What Constitutes Workers’ Compensation Fraud?
Each state sets its own workers’ compensation rules and their own criminal justice statutes; however, the criminal charges are generally similar in each state. Workers’ compensation fraud is charged as either a misdemeanor or felony, depending on the amount of property (benefits) that were obtained or attempted to be obtained. The more property obtained, the more serious the charge will be. For example, in many states, if the amount of property was $500 or less, the individual is usually charged with a misdemeanor. If the amount was over $500, the individual would be charged with a felony. The more the amount, the higher the class of felony, which also means the more harsh the penalties are for conviction.
Workers’ compensation fraud can land an individual in prison if they commit fraud on a very large scale. The following are types of workers’ compensation fraud (committed by an individual, not an employer):
- The individual is receiving workers’ compensation benefits that they are not entitled to.
- The individual makes misleading statements or false claims with the intent of receiving workers’ compensation benefits.
- The individual destroys, falsifies, conceals, removes, or alters documents and/or records that are needed to determine the validity of a claim or to determine the condition of goods and services for a reimbursement claim.
- The individual enters an agreement of conspiracy to defraud the workers’ compensation commission or employer by making false claims.
Specific examples of workers’ compensation fraud could be 1) the employee did not get injured on the job, yet claimed that they did, 2) the injury was not as extensive or debilitating as the worker claimed, 3) there was no injury or illness at all, 4) returning to work after an injury or illness before letting the workers’ compensation commission know.
Even if you forget to inform the commission for a week or two, that could be considered workers’ compensation fraud.
Contact a Workers’ Compensation Attorney for Assistance
Having a workers’ compensation attorney advocating for you from the beginning of your injury can help avoid any issues or accusations of fraud. Your attorney can oversee the process to ensure that you receive the benefits that you are entitled to.
For all of your workers’ compensation benefits questions, whether you are concerned about fraud or not, contact Hickey & Turim today. Our seasoned workers’ compensation attorneys are eager to assist you.