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WORKERS’ COMP FRAUD: A TRAP FOR THE UNWARY

We’ve all seen the headline: “Worker Arrested for Comp Fraud.” But the story that goes unreported is that more often than not there was only one thing wrong with what the worker did: they didn’t give accurate information to the insurance company.

The two most common reasons an insurer will allege fraud are (1) failure to reveal a previous injury and (2) failure to inform the insurer about a return to work. In both cases, that’s usually because the worker is afraid that the information will hurt their case or reduce their benefits. And in both cases, the worker is usually completely wrong about that.

The Workers’ Compensation Law does not deny or reduce benefits because you had a previous injury or illness.  There is no rule that says you can only get hurt once at work.  So it’s important to answer the question about previous injuries on the claim form accurately, and to be honest with the doctors about any relevant past history.  It won’t hurt your case, and it will protect you against a fraud claim. The same is true about returning to work. If you go back to work making less money because of your disability, that won’t end your compensation benefits.  You’ll still have a claim for the loss of wages – and in some cases your benefit might actually go up if you go back to a lower-paying job.  Again, honesty is the best policy.

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