Let's face it, most people don't take a job to stage an accident, fake an injury and then file a fraudulent Workers' Compensation claim. Typically, employees who commit fraud are first time offenders. So, what then, motivates employees to commit fraud? There are a number of reasons why someone might commit fraud including opportunity, pressure and in these economic times, one can speculate that fraud is born from need.
However, it's important to note that employees found to be pursuing a fraudulent Worker’s Compensation claim will be guilty of a crime in the fourth degree. Penalties include repayment of funds with interest, up to 18 months in jail, a maximum fine of $10,000, as well as possible civil action.
Given our economic climate and the increase in Workers' Compensation claims, employers and insurers are especially cautious during their evaluation of claims. They will look for signs to determine whether or not your claim is valid. If you know your claim is valid, you'll want to avoid making mistakes on your claim petition or at your hearing so as to not raise any red flags and risk having your claim denied. Before you file a claim, it's best to consult with a New Jersey Workers’ Compensation lawyer.
10 Signs of Workers’ Compensation Fraud
The following list contains the warning signs for Workers' Compensation fraud:
- There are no witnesses to the injury;
- Witnesses' statements conflict or are exactly identical to the employee’s;
- The accident occurred before or after a vacation, the weekend, or just prior to retirement, a strike, layoffs, termination, or the closing or relocation of the company;
- The injury may be associated with a pre-existing condition;
- The injury was not reported when it happened. For instance, if the injury occurred on Friday, but was not reported until Monday, it could be argued the accident happened over the weekend;
- The medical assessment is not consistent with the incident report;
- The claimant refuses diagnostic and rehabilitative treatment;
- The employee has a prior history of Workers’ Compensation claims;
- The employee has an additional part-time job that is labor-intensive, or engages in physical hobbies like sports, home improvement, or weight lifting; and
- The employee is difficult to contact, is never home or available to talk when they are allegedly disabled.
Get Legal Help to Avoid Having Your Workers’ Compensation Claim Denied
For more than 20 years, the Law Offices of Manfred F. Ricciardelli Jr. have fought employers and insurance carriers in New Jersey for fair compensation for employees who are injured on the job. With a background working as an in-house lawyer for a major insurance company in the Workers’ Compensation department, Mr. Ricciardelli knows what companies look for in order to challenge your claim. For a free consultation, call 973-285-1100 today.