Worker’s compensation fraud is a big problem for insurance providers. Each year, millions of dollars are lost in fraudulent claims that have passed through the system successfully. Workers compensation fraud is a crime that is punishable by law and you if you are considering submitting a worker’s compensation claim, you should be sure you are complying with the rules associated with doing so. Before we get into more detail about worker’s compensation fraud, let’s define exactly what worker’s compensation is and who is eligible to receive it.

What is worker’s compensation insurance?

The New York State Workers’ Compensation Law was created to protect workers who are injured on the job or become ill as a result of their work. In New York State, businesses are required to obtain worker’s compensation insurance from an approved carrier and they must pay the premium. They are not able to pass any costs associated with having worker’s compensation insurance on to their employees.

When an employee is injured and submits a worker’s compensation claim, if approved, the insurance would provide wage replacement and medical benefits to the employee.

When does worker’s compensation fraud occur?

Worker’s compensation fraud occurs when an individual knowingly submits a claim and accepts funds that they are not eligible for. Worker’s compensation fraud occurs when you are:

• Filing a claim for an injury that did not occur on, or has no relation to the job.
• Lying about work status when questioned directly, such as at a deposition or a hearing, while receiving temporary disability benefits.
• Misrepresenting the severity of a claimed injury.*

*Source – http://www.wcb.ny.gov/content/main/fraud/WhatIsFraud.jsp

How to avoid committing worker’s compensation fraud

Worker’s compensation insurance is meant to protect you as an employee. The best way to avoid committing worker’s compensation fraud is to make sure you meet the eligibility requirements before submitting a claim. From there, you need to make sure you have the proper documentation in order to submit your claim and provide proof that your injury was work related. If you are unsure, contact our office to discuss your situation. We can talk with you about your eligibility and walk you through the process of submitting a claim to ensure that you are awarded the compensation you are entitled to.