Employers nationwide, including here in California, may benefit by keeping a lookout for suspicious-looking workers’ compensation claims. Every injured worker claim affects the company’s insurance premiums, and if fraudulent claims go unnoticed, the impact on company profits can be significant. A business owner in another state recently won an appeal in a case that had previously been decided in favor of the worker.
According to court documents, the retail store’s workers were offered the option of collecting their paychecks at the store rather than having them deposited directly into their bank accounts. One worker whose regular shift was scheduled from 4 p.m. through 11 p.m. reportedly arrived at the store at 10 a.m. to collect his paycheck. Another worker claimed the man entered the store dressed in what looked like sleepwear while another person waited for him in the car.
He apparently cashed his check and stopped to buy a lottery ticket for a colleague who was operating a cash register. He then left the store. On his way out, he reportedly slipped and fell and suffered a knee injury that was later diagnosed as a medial meniscus tear. The worker sought workers’ compensation benefits for the injury while the employer claimed the injury was not suffered while he was on duty. A compensation judge ruled the injury compensable, and the worker was awarded more than $11,000.
On appeal, an appellate court ordered the reversal, finding that the worker was not appropriately dressed for work, nor was he reporting for duty as he was only scheduled to report for duty six hours later. It was determined that he was not performing work-related duties. He is now free to pursue civil litigation against the employer in the form of a personal injury claim. California company owners can benefit from the services of an experienced workers compensation attorney to protect their interests in challenging an invalid injured worker claim.
Source: workerscompensation.com, “Employee Who Came To Work Solely To Pick Up His Paycheck Was Not Covered For Comp When He Fell On Premises“, Dec. 16, 2015