Workers’ compensation laws and benefits are in place in order to protect both employers and employees in the event that a person gets injured while working. In general, while employees are protected in that they legally have the right to workers’ comp benefits if they sustain a workplace injury even if they caused the injury themselves, employers are typically protected in that, if injured workers accept these benefits, the employers can’t later be sued for more damages.
Despite the fact that many people and companies comply with and receive the appropriate protection from workers’ compensation laws, some people and/or corporations may try to manipulate the system in order to fraudulently profit from it. When any party commits such workers’ compensation fraud:
- They will increase the financial stress on the already-burdened workers’ compensation system.
- They can be subject to criminal charges and penalties, the severity of which will generally depend on the amount of money fraudulently taken.
Here and in two upcoming parts of this blog, we will take a close look at the specific types of workers’ compensation fraud that can be committed by different parties, as well as the criminal penalties associated with criminal convictions for these fraud charges. If you have specific questions about a workers’ comp claim or would like help with a claim to avoid inadvertently committing workers’ compensation fraud, contact Brown & Brown.
Types of Workers’ Compensation Fraud
In general, workers’ compensation fraud can specifically include (but is not limited to):
- Claimant (employee) workers’ compensation fraud – This is typically committed by employees who are looking to fraudulently profit from the workers’ compensation system. This can include:
- Claiming injuries that didn’t occur at work
- Exaggerating the severity or nature of a work injury
- Working while injured and not reporting that income.
- Employer workers’ compensation fraud – When employers commit workers’ compensation fraud, they tend to do so in order to reduce the amount of money they have to pay out for these claims. Some specific examples of employer workers’ compensation fraud include:
- Failing to have workers’ compensation insurance coverage at all
- Failing to report an injured worker’s wages or salary accurately (usually by underreporting it to reduce their payouts)
- Classifying employees in lower levels of employment in order to undercut their benefits.
- Health care provider workers’ compensation fraud – This type of workers’ compensation fraud, which may not be so obvious to injured workers, may include:
- Over testing or treating an injured worker to try to increase their medical expenses/the medical billing associated with the case
- Billing insurers for services/treatments that the injured worker never received
- Double billing for services/treatments
- Attempting to pay off insurers to get them to recommend a specific medical facility for treatment.
Be sure to look for the upcoming second and third parts of this blog for a continued discussion of workers’ compensation fraud.
St. Louis Workers’ Compensation Lawyers at Brown & Brown Attorneys at Law
If you have suffered a workplace injury and are preparing to file a workers’ compensation claim – or if you are currently battling an insurer for workers’ comp benefits, contact Brown & Brown Attorneys at Law.
Since 1993, our St. Louis workers’ compensation lawyers have been passionate about serving our clients, and we are experienced at aggressively defending our clients’ rights in any legal setting. Our goal is to preserve and promote the rights and welfare of individuals and families who have suffered injuries and losses and/or who need help navigating through the complexities of the workers’ compensation system.