When you get injured at work, you can count on your employer to cover your medical care. You can also expect to get replacement wages while you’re out of work. In most cases, your claim will be approved and you’ll start to receive your benefits in a week or two. But what happens if your employer suspect that you weren’t really injured?
If you are accused of filing a fraudulent workers’ comp claim in Georgia, you’ll face some serious consequences. Of course, your employer will have to prove that you did indeed file a false claim. The problem is, it’s their word against theirs. This is why you need an experienced Moultrie workers’ compensation lawyer. He can help you prove that your claim was legitimate. He can also defend you against charges of filing a fraudulent claim.
What Qualifies as a Fraudulent Claim?
When it comes to a fraudulent workers’ compensation claim, there is no checklist that determines whether it’s legitimate or not. Your employer is going to look at the totality of the circumstances. If he has a suspicion that you’re faking your injuries, he isn’t going to pay your claim.
Here are some of the signs that companies look for when determining if a claim is fraudulent:
- The injury happened first thing on Monday morning – When you come back from a weekend and claim that you got hurt, it’s suspicious. The insurance company is going to think that you got hurt on your own time. Then you came into work and tried to fake a work injury so you’d be covered for your medical care. This doesn’t mean that all claims on a Monday are fake. It just means that they appear fishy.
- You have no witnesses to your accident – Most of the time, someone else is around when an employee gets hurt. This is because most of us don’t work independently. We all have coworkers and the chances of nobody being around is rare. If there are no witnesses to your injury, not only will it be hard to prove, but it will also look suspicious.
- You have a history of filing workers’ comp claims – You may have a history of filing false claims. You may even have a history of filing valid claims. Either way, no employer likes to see an employee filing multiple workers’ comp claims. They really have no choice but to be suspicious.
- You’re a new employee – If you haven’t been with the company that long, they’re going to be wary of your filing a workers’ comp claim. It seems coincidental that you start a new job and get hurt right away.
If your employer or their insurance company think your claim is suspicious, they are going to deny your claim. This means your Moultrie workers’ compensation lawyer will have to file an appeal on your behalf.
What are the Penalties for Filing a Fraudulent Claim?
If the court finds that your claim is indeed fraudulent, you’re going to face some serious consequences. These include:
- Fines of at least $1,000 and not more than $10,000
- Jail of up to one (1) year
- Assessed the costs of any fraud investigation
- Required to repay back any benefits already paid
With so much at stake, it’s surprising that so many employees commit insurance fraud.
Proving that you filed a fraudulent claim is difficult. Some employers would rather not take criminal action against you. They’d be happy to have the employee terminated and have to repay any benefits received. This is easier and less expensive for the employer. They know that the odds of actually receiving any money back from the employee is slim since you’d have to recover against their personal assets.
If your claim is deemed fraudulent, you won’t be covered for your medical care either. Of course, your lawyer will argue that your claim was valid. He will do his best to help you avoid any of these penalties.
Contact a Moultrie Workers’ Compensation Attorney
If you’re accused of filing a fraudulent workers’ compensation claim, you do want an attorney by your side. Call and speak with a Moultrie workers’ compensation attorney as soon as possible. There is a lot at stake. You don’t want to deal with this alone. You will be at a serious disadvantage.
Call and schedule your free initial consultation today. You can meet with an experienced workers’ comp attorney who’s handled many cases just like yours.