Workers’ Comp Fraud: What It Is and How It Affects Your Claim
Workers’ compensation is designed to protect employees who suffer work-related injuries or illnesses. Unfortunately, some employees and employers take advantage of the system, leading to fraud. Workers’ compensation fraud happens when an employee fabricates or exaggerates an injury to receive workers’ comp benefits they are not entitled to. Similarly, employers and their insurance companies may engage in deceptive practices to not pay out legitimate workers’ comp claims. Understanding how workers’ comp fraud happens is essential to help you recognize the warning signs and protect your rights when injured on the job.
What Is Workers’ Compensation Fraud?
Workers’ compensation fraud is any action of deception, including false, incomplete, or misleading statements intended to obtain or deny workers’ compensation benefits unlawfully. It can happen when an employee lies about their injury, an employer misclassifies workers to avoid coverage, or an insurance company denies legitimate claims.
Types of Workers’ Compensation Fraud
Workers’ comp fraud can emanate from both employees and employers. While fraud can happen in so many ways, most common workers’ comp fraud falls under the following categories:
- False claims: This occurs when an employee fakes an injury that never happened
- Exaggerated injuries: This happens when an employee suffers a minor injury but claims that it’s severe to collect more benefits
- Non-work-related injuries: This happens when an employee gets injured outside of work but tries to pass the injury off as a workplace accident
- Double Dipping: This happens when an employee collects workers’ comp while secretly working another job.
- Employee misclassification: Sometimes employers label workers as independent contractors to avoid paying benefits
- Underreporting payroll: By reporting lower wages, the employer pays lower insurance premiums, resulting in less coverage for employees when need arises
- Failing to provide coverage: Sometimes, companies fail to purchase workers’ compensation insurance, which is illegal.
- Unfair claim denials: This is where insurance companies reject valid claims for unjustifiably
- Lowball settlements: This occurs when an insurer approves a claim but offers a significantly lower payout than the employee deserves or needs to recover fully.
How To Protect Yourself From Workers Comp Fraud
To avoid raising suspicion after suffering a work-related injury, be sure to do the following:
- Report your injuries immediately
- Ensure witnesses (if any) document the incident to avoid disputes
- Stick to a consistent and truthful account of what happened
- Seek medical treatment promptly to link your injury to your job
- Be available for communication with your employer and the insurance company
As an employee, remember that you have the right to fair compensation if you are injured on the job. If you suspect your employer is withholding benefits, delaying your claim, or underreporting your wages, don’t ignore it. At the same time, don’t be tempted to exaggerate or fabricate a claim, as this can lead to fines, criminal charges, and difficulty obtaining benefits in the future.
Instead, the best way to avoid workers comp fraud and secure the benefits you’re entitled to is to work with a workers’ compensation attorney. A lawyer can help you navigate the claims process, fight against wrongful denials, and ensure you get the medical care and financial support you need.
Contact a Vermont Workers’ Comp Lawyer Today
If you’ve been injured at work and are struggling to receive the compensation you deserve, don’t resort to fraud. Instead, contact an experienced Vermont workers’ comp lawyer at Sluka Law PLC at 802-457-1000 today to discuss your case.
