Authorities charged three California workers with insurance fraud for claiming that workplace injuries were preventing them from returning to work. This includes a roofer, housekeeper and lab worker. While all three claimed debilitating injuries, there are allegations that all three engaged in physical activity going beyond their restrictions. At the same time, all three claimed thousands of dollars in benefits from insurers.
There were observations of all three workers engaging in activity inconsistent with the injuries they reported. In the case of the housekeeper, she was shopping and caring for a small child after claiming she could not walk or drive. In the cases of the two other workers, they were earning income since the claimed injuries occurred. One of the workers claimed to be terrified of ladders while also too injured to work. However, videotaped evidence showed him spending two hours climbing up and down from a roof.
Attorneys representing employers and insurers in such matters work to prevent individuals from using fraudulent conduct to take advantage of an otherwise necessary process to help injured workers. This also allows allocations of resources to be directed towards injured workers in need of actual help.
We’ve set up the workers compensation system to make certain injured workers receive compensation while recuperating. Fraud committed by workers helps defeat this purpose. “When an injured worker lies about the extent of their injury or their physical abilities as they recover, they are adding unnecessary costs that potentially cheat every worker and every employer in California,” stated a deputy district attorney.
Source: WorkersCompensation.com, “Three CA Claimants Charged With Workers’ Compensation Insurance Fraud,” April 10, 2015