New York Drugstore Employee Cut Off Workers’ Comp Benefits Due To Fraud
An injured worker has the right to receive compensation if they are truly injured during the course of their job duties. However, workers could lose out on benefits if they lie, exaggerate, or stretch the truth.
A former drugstore employee in New York claimed he suffered a psychological injury at work, citing harassment and discrimination. He said his symptoms made him socially withdrawn and afraid to leave his home, and he stated he never returned to any form of employment.
Based on that claim, which he filed in 2018, the man began receiving workers’ compensation benefits. But the employer, Rite Aid, later investigated and discovered evidence that contradicted his account.
On social media, the claimant had posted photos of himself traveling to places like Florida and Pakistan. He was also seen participating in social events with friends and family.
More significantly, the claimant’s tax returns revealed that he was a co-owner of an ice cream franchise (and additional businesses) with his spouse and a sibling. The claimant had asserted that he played no real role in that business, claiming his spouse handled day-to-day responsibilities.
However, on both his tax returns and in his social media, the man was shown as actively participating in the business and even posting about it publicly. He was also a signatory on the business bank account.
A workers’ compensation judge agreed with the employer: his financial and social activity undercut his claim that he was completely disabled. The court also pointed out that the man never mentioned his business endeavors nor his extensive travel when he met with his psychiatrist. The claimant’s failure to disclose those activities was determined to be a material misrepresentation designed to secure workers’ compensation benefits. The Workers’ Compensation Board upheld the decision to cut off his benefits.
Under New York law, the board can deny or terminate benefits if a claimant knowingly misrepresents or lies in order to obtain compensation. In this case, the court ruled that his “failure to disclose” ownership, income, and active involvement with the ice cream business was a material misrepresentation.
How Injured Employees Can Avoid Fraud Allegations
- Be completely honest about symptoms and limitations.
- Describe what you feel, not what you think the insurer wants to hear.
- Do not hide side jobs or income.
- If you are unsure whether something counts as “work,” ask your doctor or lawyer.
- Do not push yourself to appear “fine” during exams.
- Make sure the doctor understands what tasks you can and cannot do.
- Use social media carefully.
- Avoid posting anything about your injury, work, hobbies, or physical activities.
- Attend all medical appointments, as missed appointments can be seen as lack of injury or cooperation.
- If your doctor says no lifting, bending, traveling, or prolonged standing, follow those instructions.
Contact Us for More Information About Workers’ Compensation Benefits
Workers’ compensation benefits are available for the injured. However, claimants will be investigated if their actions are suspicious.
A White Plains workers’ compensation lawyer from The Law Office of Michael Lawrence Varon can help you understand your rights to compensation. Fill out the online form or call (914) 228-1770 to schedule a consultation today.
Source:
workerscompensation.com/daily-headlines/did-ice-cream-shop-business-melt-drugstore-employees-claim-that-he-couldnt-work/
