Workers’ Compensation Fraud

Piles of CashWorkers’ compensation fraud happens when an individual intentionally makes a false claim or hides information in order to receive or prevent someone from receiving workers’ compensation benefits.

Earlier this month, a man from Attleboro plead guilty to fraudulently collecting over $53,000 in workers’ compensation benefits. He did this by collecting benefits while continuing to work – something the Massachusetts Attorney General and the Insurance Fraud Bureau call “double dipping.” The Insurance Fraud Bureau says that “double dipping” occurs quite often, and they are currently looking into over 80 different cases.

The Attleboro man was injured on a construction site and approved for temporary total disability benefits. Although state law requires those that receive workers’ compensation to disclose information on their current employment, current health, and some finances, the man did not report that he was receiving any income. Because of this, his compensation was not decreased to account for the money he was making in his new position.

Other Types of Fraud

Workers’ compensation fraud, however, can be more than simply one employee lying about his disability or working while partially disabled. It can also include employers who underreport their payrolls to receive lower premiums, employers who lie about injuries their workers have suffered, and healthcare providers charging for treatment they have never given.

In addition to being knowledgeable on the many different types of fraud that exist, it is useful to be aware of some of the ‘red-flags’ one should notice when looking for fraud. Here are a few:

If one is looking for fraud by employees, one should make note any injury that has no witness except for the employee himself/herself. Also, if the injury is not reported for a significant amount of time after it occurs, this may be a sign that an employee has not been truthful about the injury suffered. Fraud can also occur with employers. Here, employees should watch for the use of classification codes that are not consistent with the job functions associated with the job profile. Employees should also be on the lookout for small payrolls reported by large employers and any cancellations or revisions of workers’ compensation coverage.

How often does fraud occur?

Although workers’ compensation fraud is frequently covered in the media, studies show that only 1 to 2 percent of workers’ compensation claims are fraudulent. A PBS report argues that while estimates of the cost of workers’ compensation fraud vary from $1 billion to $5 billion per year depending on who is doing the estimate, the total amount of money this accounts for in yearly expenditures for workers’ compensation is very small. In other words, while workers’ compensation fraud is an issue, and the amount of money being scammed is no small amount, the money that individuals legitimately receive for injuries they suffer in the workplace dwarfs the amount of money illegitimately gained.

If you or someone you know has been a victim of workers’ compensation fraud, or if you would like to know about how workers’ compensation fraud may affect your life, contact John J. Sheehan today, or call us at 877-762-9510 today.

Photo Credit: aresauburn™ via Compfight cc

Real Stories From
Our Clients

Attorney Sheehan has been serving the needs of Boston-area residents since 1993. Our mission is to ensure complete client satisfaction and to obtain the maximum possible settlement or verdict for our clients.

Historias Reales de Nuestros Clientes

El abogado Sheehan ha atendido las necesidades de los residentes del área de Boston desde el 1993. Nuestra misión es garantizar la satisfacción de nuestros clientes y obtener el mejor acuerdo posible en sus casos.

"John Sheehan is a highly knoweldgable and all around amazing lawyer!" Si volvemos a necesitar un abogado para algo en el futuro, USTED será a quien llamemos.

I was injured at work in 2019 and John and his team made the process as simple as anyone could!! They took care of everything! The only thing I had to do is rest and go to doctor appointments! I would HIGHLY recommend anyone looking for an attorney to hire John Sheehan - if you would like a nice and easy process in a highly stressful situation and on top of it attorney Sheehan will get you the maximum of what your case is worth!

John Sheehan y su personal son muy amables, corteses, rápidos y explican todo a fondo. Hicieron un trabajo maravilloso para mi esposo y para mí y no podría recomendar un abogado más calificado. Hizo TODO lo que pudo por mi esposo y por mí a través de la compensación de trabajadores. He recomendado y continuaré recomendando a John a cualquiera de mis amistades que necesiten sus destrezas. Trabajo asombroso. John, Muchas gracias tanto de Al como de mí. No puedo agradecerte lo suficiente por hacer todo lo posible por nosotros. Cada vez que teníamos una pregunta, devolvía nuestras llamadas rápidamente. Esperamos no haberte vuelto loco. Si alguna vez necesitamos un abogado para algo, USTED será a quien llamemos. Muchas gracias de nuevo. ¡Gran trabajo! John, me gustaría darte las gracias aunque Judy ya lo hizo. Usted es el major y el personal de su oficina responden llamadas en seguida. Definitivamente lo recomendaremos a nuestros amigos si necesitan sus servicios. ¡Gracias nuevamente por un trabajo bien hecho!

- Jon P. (Google) Judy y Al Crowe