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True Fraud in Workers' Compensation System

Posted by: Joseph Stanley
December 02, 2009
Topic: Workers' Compensation

It is not a surprise that there are people who are willing to take advantage of a system designed to benefit those who worked hard and were injured in the course of employment.  The costs associated with fraud on the Worker’s Compensation system cannot be ignored.  A recent crackdown effort by insurance companies has resulted in the arrest of 7 people who committed around $600,000.00 in fraud.  http://ifawebnews.com/2009/10/30/new-york-workers-compensation-arrests-add-up-to-600000-in-fraud/

Workers’ Compensation fraud can result in more than a denial of Workers’ Compensation benefits.  A Utica man was recently caught working as a handyman while collecting Workers’ Comp benefits and now faces up to four years in prison. http://ifawebnews.com/2009/08/12/utica-man-arrested-for-workers-compensation-fraud/.  Whatever amount of money he obtained as a result of his fraudulent behavior is not worth the loss of his integrity, nor the loss of liberty he now faces if convicted. 

His story is unfortunately a sad but common tale, as multiple other people have had their own headlines mere months before (http://ifawebnews.com/2009/07/07/carpenter-nailed-on-insurance-fraud-charges-in-new-york/; http://ifawebnews.com/2009/07/31/workers-comp-fraud-nets-jail-time-probation-for-new-york-man/ ).  When even the teachers to whom we entrust with the health and safety of our children have been known to betray the values that they purport to uphold, it is bound to impact public opinion and the credibility of the Worker’s Compensation system. http://ifawebnews.com/2009/10/08/new-york-teacher-arrested-for-insurance-fraud-for-camp-work/

The common thread here is abuse of the system by individual claimants, but what about abuse of the system by the Workers' Compensation insurance carriers?  When an employee is injured on the job, they should be able to receive the benefits to which they are entitled; yet what happens if those benefits are delayed or denied?  While knowing that an employee has been seriously injured, claims have been delayed or denied by carriers, causing delays in treatment and financial hardships on injured employees.  If insurance carriers knowingly use delaying tactics on legitimate claims, they should be considered as guilty of defrauding the system as any one of the individuals mentioned above.

In a perfect world, injured employees would not have to fight to receive Workers’ Compensation benefits.  Should you be injured on the job and denied benefits that are due to you, do not hesitate to hire an attorney so that you can obtain adequate medical treatment and the lost wages necessary to help your family until you can get back on your feet.