California workers’ compensation and fraud

Please note that in the current business climate all employers and insurance companies are suspicious of all workers’ compensation claimants. They think everyone is trying to cheat them or commit fraud Therefore, they will often seek out information to try to prove you are not telling the truth, including secretly investigating or photographing you.

If you are found to have made false statements in order to collect workers’ compensation benefits, you can lose your right to collect any benefits and could even be forced to re-pay money paid by the insurance company to you or your doctor. This is true even if it is agreed that you have a work injury and all you have done is exaggerate the amount of your disability by claiming to be unable to do things which you are proven to have done. . It is a felony to lie to obtain workers’ compensation benefits.

We invite your Comments on this article.

We cannot prevent insurance companies and employers from exercising their paranoid fantasies. We can present your case in a way that prevents you from running into problems.

A few simple rules will keep you from getting into trouble. We recommend the following:

  1. Be honest.
  2. Keep your attorney informed.
  3. Never say “Never” or “Always.”

These three simple rules all boil down to the first rule which is to be honest. If you have had other injuries, be sure to tell your attorney. Try not to leave out any injury or part of body involved in any injury. Some simple examples are as follows:

  • If you sometimes pick up your children or grandchildren do not say that you “never” pick them up. If the defendants discover a photo or if they videotape you picking up your child the one time that you did, they will use it to prove that you were “lying.”
  • If you had an automobile injury where you hurt your neck and back do not try to pass it off as an injury to your neck only just to look good for your current workers’ compensation back injury. The insurance company will get the records from the doctor for your previous injury.
  • If you are working at all, be sure to tell you attorney. You will need to report earnings. If you are collecting temporary disability, you have been certified by your doctor to be unable to do any kind of work, or at least any kind of work which is available from your employer.
  • If you had any treatment with a chiropractor the chances are that he/she treated your whole spine; even if you remember only a neck injury, there will most likely be reference to your back as well in the records.

Keep these simple rules in mind. Be honest and keep your attorney informed and you will not have to worry about the insurance company gaining an advantage by making it look like you are dishonest or want to commit fraud.

This article is for general information, and not meant as specific legal advice. You should always see an attorney for specific legal questions.