What Is Employee Workers’ Compensation Fraud? (Part 2)

December 13, 2013

In an earlier post, we talked about ways employers work around state workers’ compensation regulations to pay less money on insurance premiums. When an employee commits insurance fraud, the aim is to obtain money not rightfully due for the injury suffered. Insurance fraud costs everyone money. Also, employees who defraud the workers’ compensation system make it harder for legitimately injured employees to receive needed benefits.

In Pennsylvania, 12 percent of criminal fraud referrals in 2012 were associated with workers’ compensation, according to the Pennsylvania Insurance Fraud Prevention Authority (IFPA).

Types of fraud committed by Pennsylvania workers include:

*        Making a claim for an injury or illness that does not exist

*        Overstating the severity of an injury

*        Suffering an injury outside of work and claiming it as a work-related injury

*        Making a medical disability claim, receiving benefits and then taking a different job

*        Knowingly making statements on workers’ compensation forms that misrepresent an injury

While most workers’ compensation fraud cases in Pennsylvania involve employers, workers who commit fraud face serious consequences. Along with fines and penalties, an individual may incur criminal charges, up to seven years in prison and a permanent criminal record.

Employees who suspect that employers or other workers are committing fraud should steer clear. Many people would not commit a crime without the opportunity to do so. If considering workers’ compensation fraud, do not do it. At the very least, a criminal record can destroy your chances for good employment in the future.

Workers’ compensation is for employees who work — and who are injured. Use the system when you need it, and contact a lawyer if you have questions about your benefits along the way.

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