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Workers Compensation Fraud

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Our Work Injury Law Firm Explains Workers’ Compensation Fraud

As with all insurance programs, the workers’ compensation insurance system is susceptible to fraud, Intentional misrepresentation or omission of fact in order to obtain benefits.  This normally consists of misrepresentations of material facts (i.e. lies) but can also occur through misrepresentation by omission or by deliberately concealing the whole truth. In the insurance context, fraud can result in massive losses for insurance companies, which they then pass on to the public in the form of higher premiums. Speak with an attorney at a work injury law firm right away to ensure your claim is legitimate and help you avoid mistakes. Our practice has offices in New York City and throughout Long Island. 

Some of the most common forms of workers’ compensation fraud include:

Employee Workers’ Compensation Fraud in New York

Fabrication or Exaggeration of Symptoms

One of the most egregious forms of workers’ compensation fraud occurs when a claimant simply makes up an injury or grossly exaggerates his or her symptoms in order to receive higher benefit amounts. Also, engaging in activities inconsistent with a claim for disability.

Claiming a Non-Work-Related Injury as a Work-Related Injury

The workers’ compensation program compensates claimants only for injuries or illnesses that they sustained on the job. This type of workers’ compensation fraud occurs where a claimant alleges that his or her injury occurred at work but actually occurred outside of work, making it ineligible for workers’ compensation benefits.

Working While Collecting Benefits without Reporting Income

While workers’ compensation recipients are not strictly prohibited from working while they receive benefits, it is generally discouraged, and the recipient must report his or her income to the state workers’ compensation board. Failure to do so may be considered fraud.

Employer Workers’ Compensation Fraud Claims Handled by Our Work Injury Law Firm

Misclassifying Employees

Occasionally, employers will try to avoid having to carry workers’ compensation insurance (and thus lowering their cost of doing business) by classifying their employees as independent contractors. While misclassifying employees can often be the result of an honest mistake, it can also indicate fraud.

Under Reporting Payroll

A good example of this is when employers pay employees ½ on the books and off the books but do not report the full income.

Deducting Workers’ Compensation Insurance Premiums from Employees’ Wage

Under both federal and state law, the cost of workers’ compensation insurance is to be borne by the employer; employers may not take deductions out of their employees’ wages to pay for workers’ compensation premiums. Employers who do so are engaged in workers’ compensation fraud.

Lying about Workplace Safety

Workers’ compensation premiums generally are based on the risk of injury or illness to employees. As such, employers have an incentive to exaggerate or even lie about the safety of their workplaces in order to obtain lower workers’ compensation premiums.

Not Carrying Workers’ Compensation Insurance

Almost all employers in New York are required by law to provide workers’ compensation coverage for their employees. However, many unscrupulous employers simply do not purchase worker’s compensation insurance. While they may think that they can get away with doing so, their non-compliance will quickly become evident in the event that one of their employees is injured on the job. Failure to carry Workers’ Compensation insurance is a misdemeanor.

Contact the Work Injury Law Firm of Turley, Redmond, Rosasco & Rosasco

If you have been injured on the job, you may be entitled to workers’ compensation benefits. To get started with your claim, please contact the work injury law firm of Turley, Redmond, Rosasco & Rosasco by using our online form or calling us at 877-693-2529 (New York City), 516-745-5666 (Garden City), 631-582-3700 (Ronkonkoma), or 631-399-0400 (Shirley/Riverhead).

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