Employers in California are required to provide workers’ compensation insurance coverage for their workers. Instead of accepting coverage as a benefit, some workers choose to misrepresent their injuries and file fraudulent workers’ compensation claims. Tactics may include false declarations of the manner in which injuries occurred or exaggerations about the severity of the workplace injuries.
A worker in another state was recently convicted of charges of workers’ compensation fraud, following an investigation by the Illinois Department of Insurance Workers’ Compensation Fraud Unit. According to court documents, the filed reports of injuries the woman claimed to have suffered at several workplaces were fraudulent. Investigators determined that her medical condition was misrepresented, and her descriptions of her symptoms provided to her employers, doctors, and insurance companies were exaggerated. It was stated that her actions were an attempt to be awarded benefits for temporary total disability.
It was also established that 19 claims for workers’ compensation benefits had been filed by this worker against several employers since 1987. This investigation involved three of the companies that were defrauded by this worker. She pleaded guilty to felony charges of workers’ compensation fraud, and her sentence included probation for two years, and a restitution payment of $14,737.86, along with fines, costs, and fees.
California employers who want to protect their businesses against fraudulent workers’ compensation claims may recognize the importance of being educated on tactics workers may use to fraudulently obtain benefits that will ultimately affect the insurance premiums they, as employers, have to pay. Retaining the services of an experienced employee fraud attorney may be beneficial. Such a professional can educate employers on how to recognize fraudulent claims and assist with actions to hold employees responsible for such illegal acts.
Source: workerscompensation.com, “Illinois Claimant Convicted of Workers’ Compensation Fraud”, 16, Aug. 11, 2015
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