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