Understanding Workers’ Compensation Fraud
If you get injured at work, you can file a workers’ compensation claim under New York law. Such a claim allows you to receive compensation for your injuries while you are unable to work.
However, workers’ compensation claims need to be accurate. You must be honest about how the accident occurred. Any type of dishonesty can be serious, even leading to criminal charges.
Workers’ compensation fraud is a felony in New York. That means lying or giving false information to get benefits or insurance coverage can result in a felony.
A person commits workers’ compensation fraud if they knowingly try to deceive an insurance company by giving false information or leaving out important facts when applying for workers’ compensation insurance or filing a claim for benefits.
Common examples of fraud include:
- Faking an injury: Claiming to be hurt at work when no injury actually happened.
- Exaggerating injuries: Saying an injury is more serious than it really is to collect larger benefits.
- Working while collecting benefits: Receiving disability payments while secretly working another job.
- Claiming a non-work injury happened at work: For example, hurting your back at home but reporting it as a workplace accident.
- Using fake medical documents: Submitting altered doctor’s notes or medical bills.
A person convicted of this crime can be charged with a Class E felony. They may also lose their right to benefits and be ordered to repay money they wrongfully received. In some cases, prosecutors can file workers’ compensation fraud charges along with other criminal charges if the same actions violate other laws.
False Statements by Employers or Insurance Companies
Employers, insurance carriers, or anyone acting on their behalf can also face felony charges if they knowingly give false information while handling or investigating a workers’ compensation claim in order to avoid paying benefits.
Employer fraud includes:
- Underreporting payroll: Listing fewer employees or lower wages to reduce insurance premiums.
- Misclassifying employees: Calling dangerous jobs “office work” to pay lower workers’ compensation insurance rates.
- Failing to carry workers’ compensation insurance: Operating without required coverage.
- Pressuring employees not to report injuries: Threatening workers or offering cash to avoid official claims.
- Lying during claim investigations: Giving false information to deny a legitimate worker’s claim.
Insurance Fraud
It is also illegal to lie or provide false information to obtain, keep, or renew workers’ compensation insurance coverage, or to avoid the legal requirement to carry insurance. This is also considered a Class E felony, and the insurance company may seek repayment of any money lost because of the fraud.
Contact Us for More Information About Workers’ Compensation Benefits
If you have been injured at work, it is important to know how to correctly file a claim. Inaccurate information can be viewed as fraud, which can be a serious criminal matter.
If you have been involved in a workplace accident, get the help you need from a White Plains workers’ compensation lawyer from The Law Office of Michael Lawrence Varon. Let us help you file an accurate claim. To schedule a consultation, call (914) 228-1770 or fill out the online form.
Source:
workerscompensation.com/daily-headlines/what-is-fraud-under-new-york-workers-compensation-law/
