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Los Angeles Employer Workers' Compensation Law Blog

Protecting the bottom line against workers' compensation fraud

If a California employer suspects a worker of attempting to defraud the system with regard to a work-related injury or illness, there are several options available to address the situation. Workers' compensation fraud is a problem that can impact productivity and profitability in the workplace. An employer's bottom line may be at risk for various reasons, including being forced to pay increased insurance premiums as a result of such incidents.

Employers often take steps to prevent employee fraud, such as monitoring workers on the job, keeping thorough and careful records and immediately seeking witnesses to any reported accident or injury. In spite of employer efforts, many businesses still face issues involving false injury claims or other misrepresented situations where workers are collecting compensation benefits to which they are not entitled. In fact, Sacks & Zolonz, LLP has successfully represented many business owners confronting these circumstances.

Man accused of workers' compensation fraud

Falsifying documents to claim benefits after a workplace injury is illegal. Many California employers have faced challenges regarding workers' compensation fraud. A recent incident in another state involves a man who is suspected of collecting benefits while earning income at two separate places of employment.

The 47-year-old man was arraigned on a recent Friday. He faced the court with one first-degree count of theft against him. After pleading not guilty, a judge filling in on a temporary basis released him on the stipulation that he sign a written statement saying he promised to appear in court for all upcoming proceedings.

Ways to fight workers' compensation fraud in California

Most California employers are used to handling various types of challenges concerning employee relations. One issue that may be especially difficult to address, however, is workers' compensation fraud. Knowing where to turn for guidance in such situations may help employers obtain swifter solutions to their problems.

Committing unemployment benefits fraud or other acts of compensation-related deceit is punishable by law. Such fraudulent acts may carry severe penalties that include time in prison and substantial monetary fines. Since employers' bottom line interests are at risk through possible increased premiums, they have every right to aggressively fight against suspected employee fraud in court.

Employee fraud continues to be problematic in California

It is unlawful to collect benefits through a workers' compensation claim if one is not entitled to them. Such employee fraud continues to plague many California employers. Schemes often involve false injury reports or exaggeration of the severity of injuries suffered in on-the-job accidents. 

There have also been situations where recovered injured workers have returned to their workplace duties while continuing to collect unemployment benefits without first reporting their incoming wages. If such fraud is determined, severe penalties may be incurred that include denial of benefits. A worker who has committed fraud may also face mandated restitution in the form of paying back any amount considered an overpayment due to non-entitlement.

Uninsured employers and workers' compensation in California

California employers face many types of challenges regarding employer/employee relations in the workplace. When a worker is injured, the situation may be complicated. However, if an employer has purchased required workers' compensation insurance, there shouldn't be much of a problem so long as the appropriate reports and claims are filed. Uninsured employers, however, may face significant problems that are best addressed alongside experienced guidance.

Workers' compensation provides benefits that can help injured workers pay for medical treatment and replace lost wages regarding missed time from work while recuperating. Some employers fail to obtain insurance and find themselves facing precarious circumstances when employees seek to file injured worker claims. In such situations, uninsured employers are typically held personally responsible for paying all expenses related to the incident.

Woman guilty of false injured worker claim

It is illegal to feign injury, then file a fraudulent compensation claim to collect benefits meant to help pay medical bills and replace lost wages. Many California employers face employee fraud in the workplace. An employer in other state recently confronted an employee about a false injured worker claim.

A woman reportedly collected more than $27,000 in workers' compensation benefits. She is said to have committed fraud after feigning injury. The woman allegedly went so far as to use a cane she did not need in an effort to add merit to her claim.

Staying abreast of injured worker claim laws in California

Workers and employers are bound by state and federal employment laws. One area of of governance pertains to the filing of an injured worker claim. Such matters can become complicated, especially when California employers suspect  a workers' claims as fraudulent.

Employers are under obligation to make every reasonable effort to prevent workplace accidents from occurring in the first place. From diligent inspection of the physical work space to appropriate employee training and equipment maintenance, employers must strive to keep work areas free from obstacles or situations that have potential to cause injury. If an employee is injured, however, the  employer must make sure the injury is properly reported.

Employee fraud problematic in many California businesses

False workplace injury claims continue to cause many employers problems in California and throughout the nation. According to the National Insurance Crime Bureau as many as $7 billion worth of workplace injury claims turn out to be false each year. This type of employee fraud is a significant concern for many employers who are obligated to carry workers' compensation insurance to provide benefits to help pay medical bills and replace lost wages for employees injured on the job.

Some say that at least one out of every four workers' comp insurance claims filed in the United States are fraudulent. This type of illegal activity in the workplace can adversely affect bottom line interests, especially for small business owners who may be unequipped to properly investigate a situation. Repeated workplace injury claims may cost an employer when he or she is made to bear the burden of increased premiums further down the line.

Employee fraud leads to prison for woman who pleaded guilty

There have been a number of situations in California where workers claim to be unable to work due to injury and are then caught working somewhere else while receiving benefits from their former employers.  In such situations, it is often crucial to fight against the potential negative effects of employee fraud. One woman in another state recently pleaded guilty after filing a fraudulent claim, then earning income while simultaneously collecting injury benefits.

The woman apparently became eligible for wage-replacement benefits after being injured on the job back in 2010. She was reportedly working at a cafe when a robber intruded, and she became injured while running away. Health care providers confirmed that the woman was unable to return to the workplace because of her injuries.

California employers advised to be on guard for employee fraud

Not all workers are honest when it comes to reporting injuries that allegedly occurred on the job. Many California employers have suffered negative impact from false injury claims filed to collect workers' compensation benefits. A recent situation in another state involved a woman who has been charged with employee fraud after collecting almost $70,000 in benefits through a suspected fraudulent claim.

The woman is said to have claimed that she was injured when helping a customer up from the floor at the supermarket where she was employed at the time. She said her injuries affected her wrist and finger. The incident occurred approximately 10 years ago, and the women apparently did not return to work as a baker and cake decorator at the store since the supposed injury took place.

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