What Are the Consequences of Workers’ Compensation Fraud?

 Posted on December 28, 2021 in Workers' Compensation

Employees who experience work-related injuries are entitled to workers’ compensation benefits. These benefits, including coverage for medical treatment and partial compensation for income lost due to a temporary or permanent disability, are available regardless of who was at fault for an injury. If a person can show that they were injured in a workplace accident or otherwise suffered injuries or health issues that arose out of the work they performed, they will qualify for workers’ comp benefits. However, workers should also be aware of the potential for workers’ compensation fraud, including situations where employees or employers may be accused of committing fraud.

What Is Workers’ Compensation Fraud?

There are a variety of fraudulent activities related to workers’ compensation that may be committed by employers or employees. An employee may be accused of making a false workers’ comp claim in order to receive benefits. For example, if a person suffered a back injury after falling down while at home, they may contact their employer and falsely state that the injury occurred while lifting heavy objects at work. By doing so, they may hope to receive coverage for medical treatment, and they may plan to take time off work while recovering and receive temporary disability benefits.

Employers may commit multiple types of workers’ compensation fraud. In some cases, fraud will involve misclassifying workers as independent contractors rather than employees to avoid paying workers’ compensation benefits. Employers may also commit fraud by discouraging employees from making workers’ comp claims. For example, they may state that a particular type of work-related injury is not covered or that an employee does not qualify for benefits because they were at fault for a workplace accident.

Workers’ compensation fraud is a criminal offense. This crime is generally charged as a misdemeanor, and a person who is convicted may be sentenced to up to one year in prison. However, felony charges may apply depending on issues such as the amount of benefits that were fraudulently obtained or denied and a person’s previous criminal history. A felony conviction may result in a prison sentence of two, three, or five years. A person who is convicted may also be fined up to $150,000 or twice the value of any amounts that were fraudulently obtained, and they may also be required to pay restitution for benefits that were fraudulently obtained or denied.

Contact Our Gilroy Workers’ Compensation Lawyers

At Cramer + Martinez, we help injured workers take the correct steps to receive the proper workers’ comp benefits. We can make sure you follow the necessary procedures to ensure that you can avoid any claims of fraud. We can also help you determine how to address fraudulent activity by your employer and ensure that you receive the benefits you deserve. Contact our Hollister workers’ comp claim attorneys at 408-848-1113 to arrange a complimentary consultation.

Sources:

https://www.dir.ca.gov/dwc/faqs.html

http://www.insurance.ca.gov/0300-fraud/0100-fraud-division-overview/10-anti-fraud-prog/Workers-Comp.cfm

https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=INS&sectionNum=1871.4