Workers compensation fraud is the misrepresentation of workplace injuries for personal benefit, and it can be committed by employees, employers, or insurance companies. When an employee commits workers' compensation fraud, it is generally an effort to obtain undeserved payments or benefits. When it is committed by an employer or workers compensation insurer, it is generally an effort to avoid paying benefits to injured employees who need and deserve them.
Common types of workers compensation fraud include:
In Oklahoma, workers compensation fraud is investigated by the Workers Compensation and Insurance Fraud Unit of the Oklahoma Attorney General's Office. According to the Attorney General's website, the unit "investigates and prosecutes fraud on the part of claimants, doctors, attorneys and insurance companies" and "provides education and training about workers’ compensation fraud."
Workers compensation fraud can make it difficult for deserving employees who suffer workplace injuries to get the benefits and compensation to which they are entitled. When an employer or insurer commits fraud to avoid paying benefits, injured employees are deprived of the salary and medical benefits needed to protect their families and their health during recovery. When employees make false claims, it casts all applicants under a cloud of suspicion and can make it more challenging for employees with legitimate claims to get needed compensation.
Workers comp lawyers in Oklahoma represent injured workers who are having difficulty obtaining the benefits they deserve. When a claim is in dispute, a skillful attorney can help gather the evidence necessary to prove that an employee's injury is work-related and eligible for workers' compensation benefits. At Phillips and Associates, find an attorney dedicated to protecting your workers comp rights and committed to fighting to get you the help you need for the fullest recovery and protection of your livelihood if your workplace injury prevents you from returning to full-time employment.
- Premium fraud, in which an employer attempts to lower the company's workers comp insurance premiums by designating workers as employees of low-risk units. Employers may also attempt to undermine an employee's pay grade.
- Benefits fraud is generally committed by employees who lie about an injury or exaggerate an injury in order to obtain undeserved benefits, or who maintain full-time employment while collecting benefits for injuries they claim have incapacitated them for work
- Workers compensation insurance providers may fake documents or otherwise misrepresent injuries in order to deny benefits they owe.