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Worker’s Compensation Fraud 101

 

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 303-780-7329 for your free consultation.