False allegations of workers compensation fraud are quite common. There are some people who would like you to believe that every time someone files a workers compensation claim they’re committing some form of fraud.
Workers compensation companies get to deny claims they believe to be fraudulent, so they’re more than a little incentivized to make fraud allegations. The person so accused faces not only the prospect of absorbing all of their medical bills and lost wages themselves, but the possibility of jail time. Under Section 34:15 – 57.4 of the New Jersey Revised Statute, fraud is a felony.
Workers compensation fraud is not limited to workers. Employers also commit their own forms of workers compensation fraud, including by failing to carry workers compensation insurance in the first place and by misclassification of employees. Nevertheless, this post specifically addresses allegations of worker fraud.
Types of Fraud
If a worker does commit fraud there are generally four ways that it happens.
- Misrepresenting their job status while continuing to collect benefits.
- Filing claims for injuries that did not occur on the job.
- Misrepresenting a physical condition for benefits.
- Misrepresenting preexisting conditions or previous trauma or treatments.
In an era where more workers work remotely we might expect to see more denials based on certain types of fraud. For example, we might see more instances of denials on the basis that the worker’s injury did not occur on the job.
Handling Fraud Allegations
As your New Jersey workers compensation attorneys we can help you handle fraud allegations.
We do this by gathering as much evidence as possible, including videos, witness statements, and medical records. We may turn to an expert or second opinion where necessary. It is, of course, vital that you comply with all doctor’s instructions and that you avoid activities which might tend to undermine your claim. It is also wise to assume that you will be under surveillance for any major workers compensation claims, as employers will be on the look out for ways to deny or cancel any long-term, major, or catastrophic benefits.
Of course, we encourage all of our clients to be as honest as possible throughout the workers compensation claim process.
If you filed your initial claim without us and made a mistake, we can help you correct that mistake. We can also advise you as to whether correcting the claim or providing evidence is enough to move forward, or as to whether you might need to seek help from a criminal defense attorney.