Workers Compensation Fraud Defined

Workers’ compensation is a welcomed benefit for people who sustain injuries on the job. It can be a source of survival while those injuries take time to heal. However, there is a larger overall effect on the system when fraudulent claims are filed. This can be done by both employees and businesses. Insurance companies have also been guilty of workers’ compensation fraud and here is a closer look at how it all happens.

Employees and fraudulent claims

One of the most common forms of workers’ compensation fraud occurs when an employee concocts an illness or injury that have no legitimacy. The goal is typically to get paid while not having to work. Back injuries are commonly used in fraudulent claims. Even if the claim is legitimate, you should expect to be scrutinized.

Employees do not have to completely make up an injury for it to be fraudulent. They can also fabricate the extent of the injury. The goal here is generally to make a minor injury seem to be major so that compensation will be disbursed without having to work.

One more way of committing workers’ compensation fraud is to acquire an injury or illness outside of work and make the claim that it was acquired while on the job. This is more difficult to stage when it is a severe injury. And a recurring illness or injury may also be a source for a fraudulent claim.

Fraudulent employer claims

Companies are required to purchase workers’ compensation insurance. Over the course of a year, premiums are paid to cover this insurance. Premiums could rise if there are workers’ compensation claims being paid out. However, employers could falsify the extent of their safety conditions in an effort to lower their premiums. Companies also commit fraud by listing some employees as independent contractors as this will lower the number of employees, thus reducing their premiums.

Some employers may omit workers compensation insurance and still make the claim that it exists. This could result in fines and penalties if the rouse is discovered. There have even been instances when employers teamed up with employees to commit workers’ compensation fraud in hopes of taking advantage of the insurance company.

If you are taken advantage of by a company in any way when it comes to workers’ compensation in South Carolina, contact a personal injury lawyer at John Price Law Firm. Proudly serving clients from North Myrtle Beach to Hilton Head Island and all across the palmetto state.