Workers’ compensation is a no-fault insurance program that helps individuals hurt at work maintain financial stability during their recovery. Workers’ compensation provides several benefits, including paying injured workers a portion of their lost wages and covering their medical expenses. Unfortunately, some individuals commit workers’ compensation fraud.
Workers’ compensation fraud is a significant offense that can cause legal and financial consequences. Understanding the definition of the term can help you avoid complications when filing for Minnesota workers’ compensation benefits.
What Is Workers’ Compensation Fraud in Minnesota?
The Minnesota Department of Labor and Industry oversees the state’s workers’ compensation program. Workers’ compensation is an insurance program that helps compensate workers injured at work, helping employees receive benefits and services until they can return to the workforce.
Minnesota law defines workers’ compensation fraud as when someone knowingly intends to receive workers’ compensation benefits by misrepresenting, misstating, or failing to disclose material facts about their situation or condition. Workers’ compensation fraud is a form of theft, the theft of money and benefits from an insurance provider.
What Are Some Examples of Workers’ Compensation Fraud?
Fraud can occur when an employee misreports or misstates facts about their injury or the cause of their injury, fails to report additional sources of income they generate while accepting workers’ compensation benefits, or when an employee fabricates an injury entirely. Some of the most common examples of workers’ compensation fraud include:
- Faking a work-related injury or illness
- Claiming a work-related injury or illness is more severe than it is
- Claiming a work-related injury occurred on the job when the injury occurred in another location
- Continuing to collect workers’ compensation benefits after an injury has healed
Proving Workers’ Compensation Fraud
Prosecutors must establish specific criteria to prove someone has committed workers’ compensation fraud in Minnesota. In most situations, workers’ compensation fraud cases involve:
- A false or misleading representation of a material fact
- The party knowingly provided false or misleading information
- The party intended to receive benefits based on their false representation
- The misrepresentation must have resulted in actual damages
The best way to avoid allegations of workers’ compensation fraud in Minnesota is to be completely honest and transparent when you start the workers’ compensation claim process. That means disclosing pre-existing conditions, being honest about your pain and discomfort, and reporting changes in your medical status promptly. Unfortunately, when you are coping with a painful or traumatic injury, it can be easy for details to slip your mind. You can protect yourself and recover the benefits you need by allowing an experienced workers’ compensation attorney to help you through the process.
Who Investigates Workers’ Compensation Fraud in Minnesota?
The Commerce Fraud Bureau, an extension of the Minnesota Department of Commerce, investigates potential workers’ compensation fraud cases in Minnesota. There are several ways to report workers’ compensation fraud, including submitting an online report, calling the Fraud Tip Line, and sending an email to the Division of Consumer Protection. Anyone can report a suspicious claim anonymously, including family, friends, associates, co-workers, or anyone who suspects that someone is receiving benefits without following the rules.
The Commerce Fraud Bureau is a law enforcement agency that investigates insurance fraud cases. These agents are highly experienced at investigating potential fraud cases and have the resources and tools to identify and substantiate workers’ compensation fraud issues. Surveillance and monitoring social media sites are two common tactics investigators use to substantiate workers’ compensation fraud.
Posting pictures of yourself having a great day at an amusement park riding a roller coaster may seem like an innocent gesture. However, this may demonstrate to an investigator that your injuries are less significant or severe than you claimed. It may seem far-fetched, but these things can impact a workers’ compensation claim.
Workers’ compensation fraud is a significant offense. Those who submit fraudulent workers’ compensation claims can face penalties such as dismissal of their workers’ compensation claim, fines, and imprisonment. The severity of the penalties a person may face depends on the value of the compensation and benefits they receive. Securing over $5,000 worth of compensation and benefits can result in fines of up to $20,000 and imprisonment of up to 10 years. Those convicted of fraud must also pay restitution.
Contact a Minnesota Workers’ Compensation Lawyer for Help
Protect yourself and recover the benefits you deserve by getting help from an experienced and resourceful Minnesota workers’ compensation benefits lawyer. At Robert Wilson & Associates, our workers’ compensation attorneys can help you manage the claims process, allowing you to focus on recovery and not paperwork.
Take the stress out of the workers’ compensation process. Call our office today at (612) 334-3444 or contact us online to speak with an attorney about your situation.
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