What Is Workers’ Compensation Fraud?

Workers’ compensation fraud happens more than employers could admit. If you work in Florida, your employer likely has workers’ compensation insurance. That means that when you sustain a work-related injury, you’re entitled to compensation from your employer. To that end, you will likely receive reimbursement for your medical bills and compensation for your lost wages. Usually, getting compensation requires that you file a work comp claim with the help of an experienced workers’ compensation attorney.

While many genuine injured Florida workers get injured, some employees try to defraud the system by faking their injuries. It’s called workers’ compensation fraud. That may sound like an intelligent thing to do, especially as some of them get away with it. Unfortunately, however, many of them get caught and face fraud charges.

So, to be on the safe side, you must learn about what work comp fraud entails. You must also speak with your work comp lawyer to identify the risks and penalties involved in work comp fraud. We’ve discussed some of them in this article.

What Does Work Compensation Fraud Mean?

Workers’ compensation fraud refers to any activity designed to facilitate undue benefits for anyone under a work comp claim. An employee, employer, or medical personnel are the usual offenders who perpetrate these fraudulent acts. In summary, to commit work comp fraud, an employee, employer, insurance adjuster, or health provider lies to receive undue compensation.

The most common ways culprits commit this fraud are by:

  • Faking a Work-Related Injury 

Sometimes, an employee can fake an injury to get workers’ compensation. They can do this by reporting a work accident that never happened. Another way of faking work-related injuries is attributing an injury that happened elsewhere to a work-related accident.

  • Exaggerating the Injuries 

Another typical example of work comp fraud is when workers exaggerate the extent of their injuries. By doing so, they’re likely to get more compensation than they truly deserve. By exaggerating their symptoms, these employees may get more time off work too.

  • Double Dipping 

Double-dipping under workers’ compensation comes about when an injured worker receives work comp benefits while earning a salary. This usually happens when the employee files a workers comp claim against one employer while working in another establishment.

  • Premium Fraud

When an employer commits work comp fraud, it’s called premium fraud. This type of fraud usually happens when employers misclassify their employees or their jobs. For example, an employer can misclassify injured employees by claiming they’re independent contractors to avoid paying compensation. They can also misclassify jobs to deduce their premiums. Worse still, some employers end up deducting work comp premiums from the affected employees’ wages.

  • Unjustified Medical Billings 

Healthcare providers commit work comp fraud through unjustified billings. This happens when they include costs for services that they never rendered in their medical bills. Other times, they may mandate unnecessary testing or medical services for the injured worker for financial reward.

How Do I Avoid Accusations of Workers’ Compensation Fraud?

The following are signs that a work comp claim may be fraudulent:

  • Missed medical appointments
  • No witnesses
  • An employee refusing medical treatment or attention
  • Financial challenges in the suspect’s home
  • Late reporting
  • Inconsistent injury reports
  • Post-termination claims
  • A furious and disgruntled employee

As an injured employee, you can avoid work comp fraud accusations by doing the following:

  • Documenting your injury details accurately and avoiding the urge to exaggerate symptoms. You can also document your doctors’ appointments, prognosis, bills, etc.
  • Getting credible witnesses to give recorded testimonies soon after the accident
  • Providing photo and video evidence of the accident scene

What Are the Consequences of Fraud in a Workers’ Compensation Claim? 

Many people think that work comp fraud doesn’t hurt anyone. However, the truth is that it hurts us all. It negatively affects Florida’s economy and can make the system deny legitimately injured workers their due compensation.

As such, Florida makes work comp fraud a felony, and convicted offenders are at risk of:

  • Prison Term
  • Fines
  • Restitution
  • Deportation

Contact Our Team at Miami Lawyers 360 Immediately!

Sometimes, your employer may erroneously classify your work comp claim as fraudulent even when you’re eligible for compensation. You need a qualified Miami workers’ compensation lawyer to help you defend your claim at such points. Our attorneys at Miami Lawyers 360 are always available to offer you the necessary legal assistance.

We’ll assess your claim and advise you on the best legal solutions to validate your claims and get fair compensation. We are also available to answer whatever questions you may have about Florida’s work comp laws and fraud. Get top-notch legal help now; contact us this minute.

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