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MTD worker's fraudulent workers' compensation claims discovered

A worker who has become disgruntled with his or her employer may seek opportunities to take advantage of his or her workplace and look for situations that could offer financial gain. A California business owner who suspects an employee of filing fraudulent workers' compensation claims for an injury incurred off premise may choose to pursue an investigation. Also, a person who fails to divulge information regarding pre-existing conditions when applying for benefits from a work injury could be accused of filing fraudulent workers' compensation claims.

A California Metropolitan Transit District bus driver recently pleaded guilty to the felony of filing a fraudulent workers' compensation claim for saying an injury happened at work when it did not and for intentionally concealing a pre-existing injury and collecting benefits. The California Department of Insurance completed the investigation that uncovered the employee's fraud and discovered what they believe is the underlying reason for seeking benefits. Co-workers of the man reported hearing the driver claim he had a desire for vengeance against the Metropolitan Transit District prior to his workers' comp submission.

The investigation found that the deposition for his workers' compensation claims contained fraudulent information pertaining to his previous back injury. Purportedly the man had visited his primary care physician concerning a gym injury that had harmed his back. Records indicate that on the third day following his doctor visit, he submitted a claim for a back injury he stated happened while working.

The driver received benefits totaling over $8,500 for disability and medical expenses, though compensation ceased when the potential fraud was detected. The California Metropolitan Transit District was able to successfully uncover an employee's attempt at financial gain through submitting fraudulent workers' compensation claims. An employer in California who desires to protect his or her company from fraud may choose to seek legal assistance.

Source: edhat.com, Man Pleads Guilty to Workers Comp Fraud, No author, Feb. 7, 2014

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