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Workers’ Compensation Fraud

Filing a workers’ compensation claim involves a great deal of paperwork, several rules to be followed, and a number of requirements to be met, all to ensure that your claim is handled properly and that you receive the compensation you deserve after an on-the-job injury or accident. Because each person’s injury and medical history is different, and each injury or accident can vary between employees and workplace environments, it’s often difficult to regulate exactly how each claim should be handled and what should be provided in order to make a case.

Workers’ compensation claims are intended to provide care and monetary support for the injured employee without tricking the employer into paying more than he or she should. If an injured employee makes false claims or misrepresents the circumstances and extent of his or her injury in order to receive compensation, he or she may be facing charges for workers’ compensation fraud.

Colorado Statute for Workers’ Compensation Fraud

In Colorado, the state’s Revised Statutes (C.R.S 8-43-402 C.R.S.) classifies workers’ compensation fraud as a Class 5 felony, which has serious penalties if you are convicted. The criminal charges for this type of fraud are applicable if the person who filed the claim was committing fraud for his own personal gain or on behalf of another person.

The Colorado Department of Labor and Employment Division of Workers’ Compensation lists any of the following acts as workers’ compensation fraud:

  • Intentionally filing a false claim for workers’ compensation
  • Faking an injury or exaggerating an existing condition
  • Filing a workers’ compensation claim for an injury that was not sustained at work or during work-related activities
  • Filing multiple claims or using multiple identities to file claims for the same incident
  • Failing to provide information about other income or other employment

Employees who are charged with fraud may be denied compensation of any kind and could be fined or sentenced to jail, depending on the severity of the fraud.

Workers’ compensation fraud isn’t committed only by the person who suffered the injury. The provider of the compensation can be charged with fraud if the injuries and the related expenses are over-billed. Fraud can also be committed by the claims adjuster if he or she changes claim evidence to support a denial or changes details that would impact the claim. Additionally, an employer can be charged with workers’ compensation fraud if steps are taken to deny an employee the opportunity to file a claim.

Protect Yourself

Don’t let your workers’ compensation claim get complicated by legal requirements and potential fraud issues. In cases where an employer is covering costs for time off work, medical bills and other financial expenses, even a mistake in paperwork or forgetting to include pertinent information could cause problems with your claim and keep you from getting the financial support you need.

For more information on Colorado’s laws regarding workers’ compensation fraud, contact an attorney at Levine Law. Our Denver workers’ compensation law firm has experience representing employees who have been injured in work-related accidents and need to file claims. Call us today.

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