Workers’ Compensation Fraud: 4 Stories of Those Who Were Caught

Workers’ Compensation Fraud: 4 Stories of Those Who Were Caught

Denver Workers Compensation

Workers’ compensation fraud is a problem, due to propaganda, most think the fraud is perpetuated by the workers; however, employers also commit fraud by intentionally misclassify employees to widespread insurance schemes. These schemes cost the system money and detrimentally impact injured workers who rightfully deserve workers’ comp benefits.

Fortunately, most big money scams are eventually uncovered. Here are some stories of workers’ comp fraud over the years that made headlines when the perpetrators were caught.

Massive Medical Insurance Scam

An alleged California medical insurance scam racked up nearly $100,000 in false workers’ compensation medical claims. The fraudulent money-making scheme involved seven people, and was apparently spearheaded by a chiropractor. Several clinics treated injured workers and submitted inflated bills for exaggerated injuries and more. The businesses brought in more than $12 million in payments with their scam. Penalties for the charges they face can include up to 97 years in prison.  

 

FedEx Delivered Fraud in Multiple States

Well-known package-delivery company FedEx found themselves in hot water last year to the tune of $240 million! This proposed settlement was the result of a common scheme some employers use to avoid paying workers’ compensation and other employee-related costs and benefits. It involved fraudulently classifying employee as independent contractors, and dates back to litigation that began in 2005. The settlement was approved for $227,000 earlier this year. About 12,000 drivers in 19 states will receive payments of various amounts from the total.

 

Fake and Fraudulent Florida Construction Company

 

In this recent case, Leon Jimenez, the owner of a construction company, ran a widescale workers’ compensation scam. The company didn’t even perform any construction work. Instead, Jimenez was selling workers’ compensation certificates to subcontractors for profit. The subcontractors got their bogus certificates and the employees were left exposed to the risk of uncovered work injuries. Jimenez was arrested for workers’ compensation fraud, false documentation, grand theft, and various other charges that may carry up to 30 years in prison.

 

If you’ve been injured on the job and you believe that your employer or his insurer is behaving unfairly or illegally, contact an experienced workers’ compensation attorney like Kaplan Morrell to protect your rights.

SOURCES

 

https://www.thebalance.com/workers-compensation-fraud-examples-4101604

http://www.reuters.com/article/us-fedex-settlement-idUSKCN0Z229Q

http://www.theindianalawyer.com/judge-approves-227m-in-fedex-driver-suit-settlements/PARAMS/article/43610

http://www.businessinsurance.com/article/20170602/NEWS08/912313724/Construction-firm-owner-arrested-workers-comp-fraud-Chuy-Construction-Florida

http://www.desertsun.com/story/news/crime_courts/2016/06/06/seven-riverside-county-charged-98m-medical-fraud/85368290/

Worker’s Compensation Fraud 101

Worker’s Compensation Fraud 101

Denver Workers Compensation Workers Compensation Blog

 

Workers’ compensation entitles employees to certain financial assistance when they experience job-related injuries or health problems. However, some people take advantage of this system by falsifying the compensation claims for personal gain or for the benefit of another party.

While a Denver workers’ compensation lawyer can help you with your claim, it is still important for you to be able to recognize and identify possible false information in compensation claims to avoid being a victim of fraud.

Defining Workers’ Compensation Fraud

When an individual makes false statements or representation regarding important details in a worker’s compensation claim, he or she can be charged with workers’ compensation fraud. In Colorado, this is considered as a serious criminal offense that is punishable by up to 3 years of imprisonment, $100,000 in fines, community service and a permanent criminal record.

It’s important to note that compensation fraud does not only take place when the claimants fake and exaggerate their condition. Sometimes, the employer or a third party can misreport information in a claim. Whether the wrong information is a result of an honest mistake or is done intentionally, it could lead to workers or claimants being falsely accused of fraud, risking their chance of acquiring the benefits.

Common Types of Workers’ Compensation Fraud

The whole process of claiming workers’ compensation involves more than just the employer and the employee. It also includes health service providers, claim adjusters, and workers compensation lawyers. Compensation fraud can be committed by any of these parties.

Workers’ compensation fraud by applicant or claimant

This can include a worker exaggerating symptoms or an injury, making multiple claims possibly under multiple identities, claiming injuries that did not happen or were obtained outside of work, and failing to report secondary jobs and additional income.

Workers’ compensation fraud by the employer

It involves intentionally falsifying information to avoid compensating the employee for the injury, lying to prevent a worker from filing the claim, and misclassifying employees and under-reporting payroll for lower premiums.

Workers’ compensation fraud by the adjuster

This includes insurance adjusters tampering with paperwork to account for the denial of a claim or accepting payment in exchange for referrals to certain healthcare providers.

Workers’ compensation fraud by the provider

This can entail health care providers overbilling the services provided, billing for treatment or services that were never provided, or performing tests or treatment that are unnecessary to earn more money.

Workers’ compensation fraud by the attorney or lawyer

This can involve lawyers soliciting or helping an employee in filing false compensation claims. If you have an attorney that is filing false claims on your behalf, you need to find a new attorney to represent you and your case!

Related: Top 10 Workers Compensation Fraud Cases of 2014

Workers’ compensation fraud does not only cost companies huge amount of money; it could also result to legitimate claims being delayed or not being paid out properly. If you’ve been injured, you need to have a Denver workers compensation lawyer on your side. Our experienced lawyers, who have a comprehensive and thorough understanding of the workers’ compensation law, as well as the different issues and obstacles related to it, can help you file your claim properly. To learn more about workers compensation fraud and other workers compensation issues, consult with a Denver workers compensation attorney today for FREE.

Workers’ Compensation can be difficult, confusing, and very complex. Kaplan Morrell has helped thousands of injured workers since 1997 get the benefits they deserve. Contact our experienced workers’ compensation attorneys here or call us at 866-356-9898 for your free consultation.