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What is Workers’ Compensation Fraud?

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What is Workers’ Compensation Fraud?

Workers Compensation Lawyers | Philadelphia

Workers’ compensation claims are made to ensure that injured employees get the compensation they deserve. However, there are those who would try to take advantage of the system by making fraudulent claims. Workers’ compensation fraud can take many different forms. In either case, workers’ compensation fraud is a serious crime that can have significant consequences. Our workers compensation lawyers in Philadelphia explain the various types of workers’ compensation fraud and how you can avoid filing a fraudulent claim.

Filing a Claim for an Injury That Did Not Occur at Work

One type of workers’ compensation fraud is when an employee files a claim for an injury that they did not actually sustain on the job. This can be difficult to prove, as it often comes down to the word of the employee against that of the employer. However, if there is evidence that the employee was not actually injured at work, the claim will be denied.

Filing a Claim for a Pre-Existing Condition

Another type of workers’ compensation fraud is when an employee files a claim for an injury that they had before starting their job. This is also difficult to prove, as it can be hard to know whether or not the employee was actually injured at work or if they are just trying to get compensation for a pre-existing condition. However, if the employer can prove that the employee had the injury before starting their job, the claim will be denied.

Faking an Injury

It may sound unlikely, but there have actually been cases of workers’ compensation fraud where employees fake an injury in order to get workers’ compensation benefits. This is a serious crime, as the employee is essentially committing insurance fraud. If an employee is caught faking an injury, they will likely be fired and may face criminal charges. Possible penalties could include large fines or even jail time.

Inflating the Severity of an Injury

Another type of workers’ compensation fraud is when an employee inflates the severity of their injury in order to get more money from their workers’ compensation claim. Examples of this type of fraud could include an employee claiming that they have a more serious injury than they actually do or claiming that they need more time off of work than they actually do. If an employer suspects that an employee is inflating the severity of their injury, they may request an independent medical examination.

Working While Receiving Benefits

Another form of workers’ compensation fraud is when an employee returns to work, but does not report their income to the workers’ compensation insurance company. This is considered fraud because the employee is essentially cheating the system by not reporting their income and continuing to receive benefits.

Contact A Workers Compensation Lawyer in Philadelphia Today

If you were injured on the job, you may be entitled to workers’ compensation benefits. However, it is important to make sure that you are not committing workers’ compensation fraud. If you have any questions about whether or not your claim is valid, or if you need help filing a claim, our workers compensation lawyers in Philadelphia can help. Contact Rosen Justice Injury Lawyers today to schedule a free consultation.

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