What Are the Consequences of Filing a Fraudulent Workers’ Compensation Claim?
Workers’ compensation is a no-fault system. Because of this, fraudulent workers’ compensation claims can be an enticing target. It is estimated that insurance companies lose billions of dollars to false workers’ compensation claims. Consequently, the availability of workers’ compensation benefits decreases, and this negatively impacts workers who file honest workers’ compensation claims.
Employees need to know that filing a fraudulent workers’ compensation claim is illegal. You should only submit a workers’ compensation claim if you are actually eligible for workers’ compensation benefits. Filing a fraudulent workers’ compensation claim could result in you facing criminal consequences. You could also face non-criminal consequences. Below, we discuss what constitutes a deceitful workers’ compensation claim and the consequences of filing a fraudulent workers’ compensation claim.
What Constitutes a Fraudulent Workers’ Compensation Claim?
Workers’ compensation fraud arises when an employee lies or withholds information to receive workers’ compensation benefits they are not entitled to. Some injured employees exaggerate their injuries. Other employees fabricate injuries or claim that they were injured while on the job when, in reality, their injury occurred outside of work.
Because employees are not required to prove fault to recover workers’ compensation benefits, the workers’ compensation system is vulnerable to fraudulent claims. Many people know that proving negligence in a personal injury claim can be challenging.
Workers’ compensation insurers know that people take advantage of the no-fault system and have fraud units in place that investigate suspicious claims. Insurance companies use several methods to investigate workers’ compensation claims, including interviewing witnesses, combing through social media posts, and setting up surveillance. If you are considering filing a workers’ compensation claim yet you are not entitled to benefits, keep in mind that the chances of you being caught are high.
What Are the Consequences of Filing a Fraudulent Workers’ Compensation Claim?
As mentioned earlier, filing a fraudulent workers’ compensation claim can result in both criminal and non-criminal consequences. Filing a false workers’ compensation claim can result in misdemeanor or felony charges. A misdemeanor is punishable by up to 12 months in jail, whereas a felony is punishable by up to 5 years in jail (depending on the state).
Filing a fraudulent workers’ compensation claim can result in you paying huge fines. Additionally, you may be required to pay restitution, which entails paying back all the benefits you received fraudulently, plus interest and any legal fees the insurance company incurred.
If you are found guilty of filing a fraudulent workers’ compensation claim, it could result in you losing your professional license (if you have one). Being convicted of fraud can make it hard for you to get employment in the future. It can also make it hard for you to find housing or obtain a loan.
How Can You Avoid Filing a Fraudulent Workers’ Compensation Claim?
If you are an employee who has recently suffered an injury, the following are some tips to help you avoid filing a fraudulent workers’ compensation claim;
- If you are unsure whether you are eligible for workers’ compensation benefits, talk to a lawyer
- Make an honest report of your injury
- Don’t exaggerate the severity of your injury
- Don’t sign documents you don’t understand
Contact a Vermont Workers’ Compensation Attorney
Our Vermont workers’ compensation attorney can help you determine if you are eligible for workers’ compensation benefits so you can avoid filing a fraudulent claim. If you qualify for benefits, we can help you file your claim and fight for the compensation you deserve. Contact us today.
Source:
pbs.org/wgbh/pages/frontline/shows/workplace/etc/fraud.html#:~:text=workers%27%20compensation%20fraud%20is%20quite%20common.%20The%20industry%20estimates%20it%20adds%20up%20to%20%245%20billion%20a%20year
