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Top 5 Workers’ Compensation Frauds You Must Know

Workers' Compensation Fraud | Gaylord & Nantais Law Firm

Workers’ Compensation fraud is a severe problem; unfortunately, many people take advantage of it by making false claims. In this article, we’re going to profile five of the most common types of workers’ compensation frauds that you may not be aware of – false medical records, falsification of an accident report, forgery or alteration of an employer’s payroll records, and fraudulent workman’s compensation statement. We’ll also share some tips on avoiding these scams so that you don’t fall victim to them.

What Is Workers’ Compensation Frauds?

Workers’ compensation fraud occurs when someone deliberately misrepresents himself or herself to receive benefits they are not entitled to. This can take many forms, such as filing a false claim or exaggerating an injury.

Workers’ compensation fraud is a severe problem in the United States. According to the National Insurance Crime Bureau, workers’ compensation fraud costs California taxpayers an estimated $1 billion yearly. This money could be used to improve working conditions or provide better benefits for employees.

People desperate often commit workers’ compensation fraud for money. They may be out of work and facing financial hardship. In some cases, people commit fraud because they are injured and unable to work. This can be difficult for the person committing the fraud, as they may genuinely need the benefits they are trying to claim.

You can do a few things to help prevent workers’ compensation fraud. If you are an employer, you should have a clear and concise policy regarding workers’ compensation benefits. It would be best if you also educated your employees on the consequences of committing fraud. If you are an employee, you should know your rights and responsibilities regarding workers’ compensation benefits.

5 Workers’ Compensation Frauds You Must Know About

  1. Fraudulent Workman’s Compensation Statement: This is when an employee lies about their injuries to receive workers’ compensation benefits. This is a severe offence and can result in jail time.
  1. Exaggerated Injury: This is when an employee exaggerates their injuries to receive more workers’ compensation benefits. This is also a severe offence and can result in losing your claim.
  1. Falsifying Time Sheets: This is when an employee fakes their time sheets to receive more workers’ compensation benefits. This is also a severe offence and can result in losing your job
  1. Faking an Injury: An employee pretends to be injured to receive workers’ compensation benefits. This is also a severe offence and can result in a fine.
  1. Not Reporting Pre-Existing Injury: This is when an employee doesn’t provide information about their previous injury. This is problematic if the prior injury is not work-related.

How to Prevent Workers’ Compensation Frauds?

There are a variety of measures that companies can take to eliminate the possibility of workers’ compensation fraud. Having a workers’ compensation policy that is both straightforward and detailed is one of the most critical things that can be done. Employees should be aware of the procedure and what is expected of them if they are injured on the job.

Another way to prevent workers’ compensation frauds is to perform regular audits of the claims that have been filed. This can help to identify any fraudulent claims. Additionally, businesses should require employees to provide documentation when filing a claim. This documentation should include medical records and bills.

Legal Consequences for Employee Theft

You may face several legal consequences if caught committing workers’ compensation fraud. These can include fines, jail time, and the loss of your job.

Worker’s Compensation Fraud is sometimes regarded as a criminal. If found guilty, you might spend up to five years behind bars. In addition, you might have to pay a $10,000 fine. You can also be obliged to pay back the money you stole if you are discovered stealing workers’ compensation benefits.

If you are caught stealing workers’ compensation benefits, you may also be required to repay your stolen money. Sometimes, these maybe double the amount you initially took. Workers’ Compensation is a serious offence with severe repercussions. Come see us at Gaylord and Nantais Workers’ Compensation Lawyer if you are interested in learning more about workers’ compensation or fraud in general. Call us now at (562) 561-2669 to book your free consultation


Picture of Thomas M. Nantais

Thomas M. Nantais

Thomas M. Nantais is the Partner of Gaylord & Nantais, a legal firm specializing in workers’ compensation, in the state of California. This firm deals in getting hearing loss compensation and work related injuries compensation for those who have worked in the state of California. With his sincere efforts, Thomas is committed to meet the highest standards of the legal industry, and aims to provide the clients with an honest and aggressive representation.

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