What is Workers’ Compensation fraud?
Workers’ Compensation Fraud is a very serious offense. Insurance fraud is when a person collects money they are not entitled to, often by willfully deceiving an insurance company or misrepresenting their injury. Fraud can also occur if a person entirely fabricates their injury. An employee can commit fraud by misreporting facts about an injury, or not reporting new sources of income when he or she is receiving benefits from the Workers’ Compensation insurance company.
Insurance companies can commit Workers’ Compensation fraud as well. Occasionally, an insurance company or employer will issue a fake Workers’ Compensation policy, or an employer will indicate they have Workers’ Compensation insurance coverage when in reality they do not.
Committing acts of fraud can result in dismissal of your Workers’ Compensation claim with prejudice, a fine, or a jail/prison sentence. If you have any questions or concerns about your work injury, call our Workers’ Compensation lawyers today for a free case review.
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Avoid Committing Workers’ Compensation Fraud
Several steps can be taken to avoid committing Workers’ Compensation fraud. The easiest way to avoid fraud is to be honest with everyone you speak to regarding your Workers’ Compensation claim. Be honest with your doctor, your lawyer, your employer, and the insurance company. The insurance company will find out if you are not being honest. The second-best way to avoid fraud is to inform your attorney about any changes in status that you might have undergone since you filed your claim.
For instance, you should notify your attorney immediately if you change your name, address, or phone number. Similarly, you should report any new job or new source of income immediately to your attorney or the insurance company, especially if you are currently receiving Workers’ Compensation benefits. Also, if you receive a wage increase at any employer subsequent to the filing of your Workers’ Compensation claim, report it to the insurance company and your attorney immediately.
What is NOT Workers’ Compensation fraud?
There are also everyday occurrences that are not considered fraud. An insurance company’s denial of benefits is not considered fraud. An employee’s claim for denied benefits is also not considered fraud. Collecting unemployment when the Workers’ Compensation insurance company denies a claim for wage loss benefits is not fraud. Neither is using health insurance to obtain medical treatment when the Workers’ Compensation insurance company denies medical care.
How is Workers’ Compensation fraud reported?
Employers and Insurers will use many methods to discover fraud. Surveillance from a trained investigator over the course of several days or weeks is a common method of uncovering fraud. Insurance companies will also monitor social media websites, such as Facebook, YouTube or Twitter. Even online dating profiles are subject to search.
If an employer commits Workers’ Compensation fraud, an employee can still collect Workers’ Compensation benefits. The Special Compensation Fund is a fund created in the even that an employer unlawfully fails to buy Workers’ Compensation insurance coverage for its employees, and someone is hurt at work.
This is a state-administered fund. If the Special Compensation Fund or a compensation judge determines that Workers’ Compensation benefits should have been paid, the Special Compensation Fund can seek reimbursement from the employer.
Fraud can be reported anonymously by anyone, including employers, employees, friends, family and doctors. To report fraud, call the Fraud Tip Line at 1-888-372-8366. You can also submit a claim with the Minnesota Department of Commerce online.
