Treated Like a Criminal Over a Work Injury?

by ShelbyW on May 4, 2013

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The workers’ compensation system is one of many protections that the American worker enjoys. These insurance benefits make sure that a worker who is injured on the job, regardless of who was at fault, is able to pay for their medical bills and be reimbursed for their lost time from work. Unfortunately, many con artists see this as a chance for “free money.” This is so big of an issue that it affects the way the entire system works. Sadly, it even has negative effects on those who are legitimately injured in the course of their jobs.

The Problem of Workers’ Comp Fraud

There are several methods that people use to get undeserved money from the workers’ compensation system. Some workers will actually get injured while not at work but then pretend as if they sustained the injury on the job. Additionally, some individuals will embellish the seriousness of or flat out fake an injury. There are several other types of workers’ comp fraud as well, but they all result in the same issues.

The National Insurance Crime Bureau released statistics that showed that workers’ compensation fraud makes up 25 percent of all insurance fraud each year. This is a $7.2 billion loss to workers’ comp insurers throughout the country. The organization also stated that workers’ compensation fraud had become the fastest growing type of insurance fraud in the country. Because of this, it’s not difficult to imagine how fraud affects the overall workers’ comp insurance world.

How Fraud affects Legitimate Claims

It’s a sad fact that insurance companies are cheated out of billions of dollars every year due to workers’ compensation fraud. This means that they must be more vigilant in their dispensing of benefits. This often equates to longer periods of time between approvals, increased scrutiny of injuries and even the use of private investigators in an effort to catch fraudsters. All of the methods that insurers use to try to prevent fraud result in difficulty for those with legitimate injuries.

In reality, an injured worker is often treated as “guilty until proven innocent.” This is an unfortunate result of those who try to game the system. It’s important to note, however, that a difficulty receiving benefits may not always be for these understandable reasons. Because of this, as stated on, “Hiring a workers’ compensation lawyer to handle one’s claim is often the most critical step in ensuring that all necessary and deserved workers’ comp benefits are received.”

Consequences of Dishonesty on Both Sides

The repercussions of workers’ comp fraud are severe regardless of the locale where it occurs. Punishments will vary by state, but they often result in a felony charge which, in some places, can result in a 30 year prison sentence. Additionally, the convicted will have to pay restitution for the funds that they received and even pay fines which can land in the $30,000 range. Individuals, however, aren’t the only ones that can be dishonest when it comes to workers’ comp insurance.

Though it’s the fraudsters who steal from workers’ comp who are often noticed, the insurance companies can also be dishonest. Some insurers will deny legitimate claims or purposefully delay payments in an effort to save money. This is known as bad faith insurance. Anyone who thinks that their workers’ comp insurer is doing this will need to seek legal help from an attorney. Not only will they likely recover the compensation they deserved, but they’re also liable to recover punitive damages due to the company’s dishonest tactics.

Workers’ compensation fraud is a serious crime that will lead to serious consequences. Unfortunately, some of these consequences befall workers who are legitimately injured. Due to the relatively high rate of workers’ compensation fraud, there’s a good chance that an injured worker could find it a bit difficult to recover benefits. Unfortunately, some insurers simply make it difficult for workers to recover deserved benefits in an effort to save money. In these cases, getting legal help is usually one’s only recourse.

Legal researcher Shelby Warden shares this information to raise awareness of worker rights. The law offices of Price Benowitz, LLP at are committed to helping employees receive the benefits to which they are entitled following an eligible accidental personal injury or occupational disease.

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