Santa Ana Workers' Compensation Fraud Defense Attorney

The workers’ compensation system can be beneficial to both employers and employees. Workers’ compensation benefits can help injured employees get access to the compensation and services they need to recover, and carrying workers’ compensation insurance is one-way employers can offer these benefits to their employees without having to pay them out-of-pocket. In the state of California, workers’ compensation claims are filed by employees on a daily basis. However, not all of these claims are valid—some employees file fraudulent claims in order to get access to benefits they are not legally entitled to.

Filing Fraudulent Claims Is Punishable Under The Law

California Insurance Code 1871.4 states that it is unlawful to file a fraudulent workers’ compensation claim. Fraud may take many forms, but the end-game of the person filing a fraudulent claim is largely the same: to get money and other benefits that they are not qualified for. Persons who file fraudulent workers’ compensation claims could face penalties under both civil and criminal law, including thousands of dollars worth of fines.

Workers’ Compensation Fraud Examples

There are several types of fraud when it comes to workers compensation claims, including claims that are made under the following circumstances:

• An employee files a claim for workers’ compensation benefits when their injury took place off-the-clock and away from the workplace
• An employee files a claim for benefits and falsifies a nonexistent injury
• An employee exaggerates the severity or extent of their injury or enlists a medical professional to do so on their behalf
• An employee causes injury to themselves on purpose while at work and attempts to hold the employer liable for the injury

The Challenge Of Proving Fraudulent Claims

Proving that a given claim is fraudulent is not always easy, especially if an injury is not falsified outright. Workplaces that do not have extensive security camera coverage of the entire worksite will inevitably have pockets of space where injuries might occur and no one would have evidence beyond the injury itself as to how the injury took place. A qualified workers compensation fraud attorney can analyze your case and help you to prove fraudulent claims for what they are, or advise a reasonable path forward for otherwise handling the dispute.

Workers’ Compensation Fraud Attorneys in Santa Ana

At Sacks Law Group, APC, we help employers fight workers’ compensation fraud cases. If you are an employer and your employee has filed a claim you believe to be fraudulent, we urge you to contact us for a consultation. We can investigate the claim and its validity or lack thereof, and we can represent you and your business in court. We wrote the book on workers’ compensation defense, and we can put our skills and experience to work for you. Call today for a case evaluation with one of our workers’ compensation fraud defense specialists.