Is My Employer Committing Workers' Comp Fraud?

Posted By Katz, Leidman, Freund & Herman || 9-Aug-2018

Fraud, it seems to permeate virtually every aspect of our financial lives, especially when it has to do with money or cash benefits. As a New York workers’ compensation firm, we can tell you that employers have been committing fraud for as long as they’ve been required by law to cover injured workers.

In fact, the fraudulent practices got so bad that in 1966, the Office of the Workers’ Compensation Fraud Inspector General (WCFIG) was established by statute. The agency’s job is to conduct and supervise investigations throughout New York that deal with potential fraud and other violations of the state’s workers’ compensation laws.

“Through its investigations, audits, and reports, WCFIG focuses on reducing costs to the workers’ compensation system by eliminating fraud and by acting to improve the efficiency and effectiveness of the workers’ compensation system,” according to the New York Workers’ Compensation Board.

Many of the WCFIG investigations result in:

  • Criminal arrests
  • Criminal prosecutions
  • Recoveries for overpayments
  • Other remedial actions (not necessarily criminal)

If someone reports possible workers’ compensation fraud, the WCFIG is going to investigate it. While the agency investigates reports of fraud committed by employees, healthcare providers, insurance carriers, and brokers, it also investigates reports of employers who wrongfully deny their employee’s claims for the purpose of lowering insurance costs and not having to pay valid claims.

Understanding Employer Fraud

There are different ways that employers can commit workers’ compensation fraud, but the two we’re interested in is how employers knowingly lie about facts for the purpose of denying or avoiding compensating employees who deserve coverage, or when an employer lies to an employee about their entitlement to benefits in an effort to discourage the employee from pursuing a valid claim.

Examples of employer fraud:

  • Intentionally misclassifying an employee as an independent contractor.
  • Lying about the nature of work performed by the employee.
  • Lying to the employee saying that he or she is not entitled to workers’ compensation benefits unless he or she has been employed for at least six months.

Do you believe that your employer is doing something wrong? Has your claim been wrongfully denied? To get down to the bottom of it, contact our firm to speak with a Long Island workers’ compensation attorney for free.