3 Mistakes That Can Get You Accused of Workman’s Comp Fraud

Workman’s compensation fraud is serious. It is a crime, and it carries steep penalties.

Many people immediately think of workers who fake injuries when they think of workman’s compensation fraud. Or workers who claim disabilities well after healing has taken place.

And this form of fraud does, in fact, happen. So does a form of fraud perpetrated by employers, who fail to obtain or maintain adequate workman’s comp coverage. But there are simple mistakes that good, honest workers make when they are dealing with workman’s comp that can get them accused of fraud, even if all their actions were innocent.

#1) Failing to report changes in employment status.

“Misrepresenting your job status while collecting disability benefits” is one of the first definitions of workman’s comp fraud in the statute as written. Any change in work status must be reported both to your employer and to the insurance company.

This could mean taking on a new position with your old employer, doing some light duty “gig” work while you’re recovering, or taking on a new job. Do not assume either party knows you’ve made a change. 

You may be reluctant to do so, fearing the loss of benefits which are keeping you afloat. The new job or job status change may not cover all your bills. Just remember some coverage may still be available to you after you start any form of work again. You won’t be afloat if you get charged with fraud, either, so be sure to disclose everything.

#2) Failing to show a clear cut relationship between your job and your injury.

A lot of people represent an injury as having occurred on the job when it really happened somewhere else. 

Certainly, some injuries require a bit of argument to clarify the relationship. Repetitive stress injuries, which can be exacerbated both on and off the job, come immediately to mind.

But if you knowingly sustained an injury at the nightclub and then came to work the next morning to fake receiving the injury there, you could be caught and charged.

#3) Failing to disclose preexisting conditions. 

A lot of people are terrified to disclose preexisting conditions. They fear that they won’t get benefits at all, or that their benefits will be sharply reduced into uselessness.

But having a pre-existing condition doesn’t preclude you from receiving workman’s comp benefits if you were injured at work. The law in fact covers exacerbation of pre-existing conditions.

Failing to disclose means the insurance company won’t be able to calculate the damages accurately. It could result in you being overpaid, which could in turn result in big trouble.

See also: Does a Pre-Existing Condition Affect Workman’s Comp in New Jersey?

Not sure what to do?

The easiest way to avoid accusations of fraud would be to have an experienced workman’s comp lawyer by your side. Talone Law can guide you through every step of the process to make sure everything both is and appears to be above board.

We can also tell you what impact any one fact or factor is likely to have on your case, eliminating fear and giving you room to make a plan that works for you and your family.