Workers Compensation Fraud


This kind of fraud arises when you deliberately make a phony version of a material fact facilitating your acquisition of falsified benefits or to refute workers'compensation benefits. Additionally, these misrepresentations may be conducted to avoid responsibilities under the law. Also, when an employer misrepresents the amount of payroll or classification of its employees, the workers, compensation fraud occurs. It is also a crime to fail in the maintenance of the required workers' compensation insurance coverage.

All of you who work and live in Los Angeles, California are liable to pay the price of fraud in the loss of jobs and profits. The fraud also results in lower benefits and wages while simultaneously increases higher costs of insurance premiums and services. Whenever you discover the existence of such frauds, make sure that you deal with them and sort the issues out to entirety with the help of legal professionals.

Examples of Fraud

There are many ways through which a worker may engage in the Workers Comp Fraud. A worker may commit fraud through:

  • Misrepresentation of their job status while they collect temporary disability benefits
  • Filing a claim for an injury that never occurred or that which has no relation to their job
  • Misrepresentation of previous treatment or trauma
  • Deliberate misrepresentation of their physical conditions to attain Workers Comp benefits

There are many ways through which an employer may engage in the Workers Comp Fraud. An employer may commit fraud through:

  • Misrepresentation of their amount of payroll or improper classification of their employees
  • Failure to acquire workers' compensation insurance coverage. This failure is an infringement of the Los Angeles labor laws and is punished by a jail term not exceeding 18 months and a fine not exceeding $11,000. Also, the crime is punishable with further considerable civil penalties.

There are many ways through which a health care provider may engage in the Workers Comp Fraud. A health care provider may commit fraud through:

  • Assisting individuals to engage in fraudulent schemes, participate in double billing or deliberately to bill for services that have not been provided or are unwarranted.

In Los Angeles, CA the workers' compensation insurance is a no-fault system. In this jurisdiction, you need not, as an employee, prove an injury was somebody else's fault to get full compensation for an on-the-job injury. In some instances with the help of a legal expert, you can recover a portion of your lost wages that result from these kinds of injuries. Workers Comp Fraud claims are enticing targets for criminals who take advantage of the loopholes in the systems for their personal gains.

The Workers Comp Fraud occurs in a variety of simple and complex schemes. Almost all of the cases require lengthy and difficult investigations since your employees in case you are the employer, will exaggerate and even fabricate injuries. Moreover, white-collar criminals, for instance, doctors and lawyers, will entice, pay and conspire with other individuals to defraud the system. They achieve their objectives through the creation of false or exaggerated claims.

Whenever such frauds take place, your insurance company will take up the cost and pass it on to the taxpayers, policyholders, and the general public. Therefore, to avert incurring extra costs, you should take it upon yourself to fight these kinds of crime through all the legal channels available. The legal team at Law Offices of Jeff Voll is the premier workers comp fraud criminal defense law firm in Los Angeles, CA. We are experienced and knowledgeable to successfully fight off this type of compensation fraud.

Are you facing workers comp fraud charges in Los Angeles? Engagement in workers' comp fraud in California as an employee, an employer, or a healthcare provider is classified as a serious offense. When it comes to these kinds of cases, hiring the services of a criminal defense attorney is an imperative first step and there is no better attorney to hire in these pivotal situations than Jeff Voll.

The Workers' Compensation Fraud Program was incepted in the year 1991 to curb the rampant incidents of fraud that were on the rise in Los Angeles.

After the establishment of the program, the legislature made the workers' compensation fraud a felony. The insurer is required to report any suspected case of fraud. Furthermore, to make sure that these frauds are dealt with in entirety, the legislature established a funding mechanism to enforce the prosecution activities efficiently.

A Fraud Assessment Commission was established to assist further in the determination of the level of severity of the compensation fraud.

Workers Compensation Scams

As an employee, the workers compensation insurance will shield you if injuries occur when you are working. This compensation caters for medical bills, salaries lost and other expenses while you heal from the work-related injury. Though a majority of employers and employees are honest, a small number engage in the workers comp fraud and cause great damages. This kind of crime results in the theft of tens of billions of dollars in unpaid premiums and false claims annually.

These scams result in higher premiums payments. Also, they deplete business earnings and may cost you your pay or even job though you are honest. These large costs of fraud are passed onto you, and hence you end up paying increased prices at the cash registers. Therefore, you should always report such cases since they end up affect you even if indirectly in the long term.

Warning Signs for Employees

There are many signs that raise suspicion and trigger an investigation. When none on its own is a necessary cause of the alarm, some require scrutiny. Some of the main suspicious cases are Monday morning reports of injuries, accidents right after employment change, suspicious medical providers after an accident, and lack of witnesses to support the cause of the injury. Also, conflicting descriptions, late reporting, and a history of suspicious claims should cause alarm to your compensation case as an employee.

Warning Signs for Businesses

Whenever the business address is a mail drop located elsewhere from the business, and an unusual ratio of clerical to non-clerical staff for the type of business may raise suspicion. Moreover, an excessive number of certificates of insurance issuance on small policies may raise questions.

If you may be a victim of circumstances and are faced with the workers comp fraud accusations. Contact the Law Offices of Jeff Voll for legal assistance. We specialize in these kinds of cases and through our experience we will fight for your defense and your freedom.

To find out more information about these topics, please call us direct at 323-467-6400.

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