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Los Angeles Employer Workers' Compensation Law Blog

When a claim becomes workers' compensation fraud

Experts agree that the rate of workers' compensation fraud continues to increase in California. The rise is seen in both contended claims and the amount of injuries that are filed. An employer that suspects an accident or injury has been claimed in an attempt to commit workers' compensation fraud may research the best possible method for investigating the situation.

A recent conference discussed the rising problem and how the actions of employers can be important when a worker files an injury claim. An employer can help prevent workers’ compensation fraud by asking questions and recording information immediately following an accident or injury. Unfortunately, not all business owners may be able to discuss a work injury before a claim is filed to help guide a victim and influence honesty.

Businesses allegedly suffered lack of insurance in California

An employer that has purchased workers' comp insurance from a false provider may be operating with a lack of insurance. In the event that an employee is injured while working, the lack of insurance may place a business in a very difficult financial situation. A California man was recently taken into police custody for allegedly selling fraudulent insurance to businesses.

The man was accused of providing both liability and workers' comp insurance to businesses, without having valid policies actually issued. The illegal practice of providing false insurance to an employer can place a business and its employees in a very difficult position in the event of an accident. He was charged for forgery including insurance and certificates, fraudulent conduct intended as theft and illegally transferring money.

California woman sentenced for false injured worker claim

Workers’ compensation fraud can be damaging to an employer financially and professionally. A California woman who worked for the county was recently sentenced for collecting benefits from a false injured worker claim she filed. A business owner who has suffered from a false injured worker claim may choose to seek repayment from the dishonest party and halt all medical benefits.

The situation began when the employee claimed to have severely injured her back while at work. While she remained on complete disability leave from her job, she purportedly requested home health care for assistance due to her extreme condition. As the woman continued to collect workers’ compensation benefits for her claimed damages, a team of investigators began to review her case.

Workers' compensation fraud at California bank

When an employer is taken advantage of through workers' compensation fraud, both the company and its insurer can suffer financial damages. Some professionals may choose to begin the process to reveal the theft and attempt to regain the monetary loss. A woman formerly employed at a local California bank has been accused of workers' compensation fraud after being involved in the robbery that purportedly caused the false mental injury.

The incident occurred when the accused woman helped organize a heist that included armed robbery of her place of employment. During the robbery of the bank that she helped to manage, the employee was staged as having been kidnapped by robbers. The worker claimed to have suffered from her experience and filed a workers’ comp claim for post traumatic stress disorder.

Arrest made for fraudulent workers' compensation claims

Fraudulent workers' compensation claims can damage a company financially and could affect insurance premiums if not discovered. A California employer that has discovered a false injury may start an investigation in an attempt to uncover the truth. A beauty contestant was recently arrested for making fraudulent workers' compensation claims when she was apparently seen competing in pageants following an injury.

The young woman claimed to have hurt her foot while working at a supermarket. The injury was serious enough that the woman stated she would be unable to return to work. She told her employer that the pain limited her ability to wear shoes or walk when weight was applied to the injured foot.

Employer defense and a worker seeking addition compensation

Home health care facilities in California are responsible for sending workers into the homes of their clients and may often require an employer defense in the event someone is hurt while on the job. An employer defense may work to protect a company from having to provide compensation benefits beyond necessity when an accident does occur. A higher court decision recently determined that an Alzheimer’s patient who had been sued by a home health care employee was not responsible for providing compensation for an injury.

The injury occurred when the trained worker was providing in-home care to an Alzheimer’s patient that included help with basic living. The care provider was washing dishes when the Alzheimer’s patient clumsily ran into her as she was cleaning a heavy knife. The impact caused a laceration on the wrist of the worker, which resulted in finger numbness and ongoing pain.

Workers' compensation defense and hired contractors

Workers' compensation defense may help to keep an employer from being taken advantage of and ensure that both the injured party and the company are protected. A California company that hires contractors to complete construction on its property may question its rights for workers' compensation defense in the event that a worker is hurt. A fire began recently at what used to be a California hotel while construction crews performed renovations on the premises.

The afternoon fire quickly reached three-alarm status and took over three hours for firefighters to put out. A total of eight contract workers suffered injury during the fire, though only seven of them were treated at a nearby medical facility for inhaling smoke. Health care providers believed the injuries to be minor.

Why medical information is important in work comp cases

Proper medical treatment is a cornerstone of the proper administration of California’s workers’ compensation system. Essentially, treating doctors must implement treatments that are scientifically proven to abate the injuries or illnesses that a worker suffers from as a result of an on-the-job injury or accident.

To that end, physicians must follow a set of guidelines approved by the workers’ compensation board regarding which treatments are appropriate for particular injuries, their frequency, and how long they should be given. In following these guidelines, the State of California has developed a medical treatment utilization schedule (MTUS) that applies to different body regions as treatment is contemplated. 

The financial benefits of a drug free workplace

Arguably, one of the best ways to manage workers’ compensation costs is to maintain a safe working environment. Part of this may include establishing a drug-free workplace policy. While it may seem obvious that workers should not be taking drugs while at work, it may be surprising how many workers come to the workplace while under the influence of drugs or alcohol. Also, the National Council on Alcoholism and Drug Dependence (NCADD) reports that drug abuse costs businesses more than $80 billion each year.

With that said, a proper drug free workplace policy will identify the drugs that employees must refrain from (i.e. methamphetamines, marijuana, cocaine) as well as a policy for testing and rehabilitation if there is a positive test or an incident related to drug use. 

The future of wearable technology and workers' comp

Wearable technology is the next big thing for retailers. From Samsung’s smart watch to Google’s Glass, the world of mobile technology has a great deal to offer consumers and employers alike. For employers, wearable technology can provide a number of opportunities to expound on safety measures and take further action to prevent injuries.

Additionally, wearable technologies are poised to give employers better opportunities to correctly assess injuries; which in turn, can help in diagnosing and assessing injuries, so that benefits can be correctly distributed. A number of our posts have focused on the troubles that come with employees who falsely claim injuries or fail to report that they have made it past injuries in order to continue receiving benefits. 

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