Top Arnold, MD Workers' Compensation Fraud Lawyers Near You
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Baltimore Premier Criminal Defense Firm, Handling both Federal and State Cases for over 33 years, including Internet Sex Crimes.
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Maryland's Premier Criminal Lawyer & Law Firm....Super Lawyer Nominated 2013-Present
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1435 Sulphur Spring Road, 1st Floor, Baltimore, MD 21227
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Get assistance for your Workers' Compensation Fraud issue in the Arnold, Maryland area. Law Offices of Charles L. Waechter can help.
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210 W Pennsylvania Ave, Suite 100-F, Baltimore, MD 21204
Gary S. Bernstein, P.A. can help you find legal solutions for your Workers' Compensation Fraud issue. The practice serves the Arnold, Maryland area.
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111 S Calvert St, Suite 2000, Baltimore, MD 21202
10015 Old Columbia Road, Suite B-215, Columbia, MD 21046
6914 Holabird Avenue, Suite A, Baltimore, MD 21222-1747
300 E Lombard St, Suite 900, Baltimore, MD 21202
1001 N. Calvert Street, Baltimore, MD 21202
100 International Dr, Suite 700, Baltimore, MD 21202
7226 Lee DeForest Drive, Suite 101, Columbia, MD 21046
250 W Pratt St, Suite 2200, Baltimore, MD 21201
100 Light Street, 26th Floor, Baltimore, MD 21202
614 Edmonson Ave., Catonsville, MD 21228
307 West Pennsylvania Avenue, Towson, MD 21204
303 W Pennsylvania Ave, Towson, MD 21204
6510 Falls Road, Baltimore, MD 21209
12 N Court St., Suite 2, Westminster, MD 21157
6 E Biddle Street, Baltimore, MD 21202-2766
6851 Oak Hill Lane, Suite 305, Columbia, MD 21045
8 E Mulberry Street, Baltimore, MD 21202-2105
7310 Ritchie Hwy., Suite 609, Glen Burnie, MD 21061
201 N Charles Street, Suite 2301, Baltimore, MD 21201
201 N. Charles Street, Suite 400, Baltimore, MD 21201-4111
7310 Ritchie Hwy, Suite 1007, Glen Burnie, MD 21061
7 Central Ave, Suite B, Glen Burnie, MD 21061
201 N. Charles Street, Suite 1900, Baltimore, MD 21201
Arnold Workers' Compensation Fraud Information
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What Is Workers’ Compensation?
Workers’ compensation provides benefits for workers who are injured on the job or suffer a work-related illness. Most employers are required to provide workers’ comp insurance for employees. When an employee is injured in the workplace, a workers’ comp claim provides medical coverage and partial wage replacement while the employee is unable to work.
The workers’ compensation process is generally a no-fault system. The employee is supposed to be covered for any work-related accident or occupational diseases. The worker does not have to show the employer was negligent. In return, the employer is protected from most personal injury lawsuits related to the accident and the compensation claims are limited to wage benefits, medical care, and disability benefits.
If employers or workers comp insurance carriers suspect the employee is committing fraud, they may investigate the claim to deny coverage or report the employee for fraud. If criminal fraud is suspected, law enforcement agencies may work with the insurance provider and employer to investigate the worker and could prosecute the worker for criminal charges.
What Qualifies as Workers’ Comp Fraud in Maryland?
Workers’ comp fraud involves fraud or misrepresentation in a workplace injury claim. Fraud may involve the worker trying to claim benefits for a non-covered injury or claim benefits when they are still able to work. Some examples of workers’ comp fraud include:
- Claiming a non-workplace injury happened on the job
- Claiming to be disabled when the worker can still perform their job functions
- Intentionally causing an accident or injury to get benefits
- Working another job under the table while receiving benefits
- Advising other workers on how to fraudulently claim workers’ comp benefits
- Filing multiple claims for the same injury
Fraud in workers’ comp claims can also involve health care providers. Doctors, medical service providers, and chiropractors may work together to defraud the workers’ comp system. Workers’ compensation insurance fraud rings may recruit workers to claim workplace injuries, with a medical provider making a false diagnosis of an injury, and doctors fraudulently treating the injured employees or billing for medical procedures that were never provided.
What Investigators Look For in Workers’ Comp Fraud
Some insurance providers or employers look for “red flags” that may indicate possible fraud. This may be a clue to further investigate the claim, talk to other employees, or use a private investigator to monitor the injured worker. Some possible red flags of workers’ compensation fraud may include:
- No witnesses to the accident
- Employee refusing treatment or examination
- Worker is difficult to contact after filing a claim for workers’ comp
- Injury occurred right before or after a planned vacation
- Injury occurred shortly before the employee was to leave the job
- Employee reported the injury after a poor performance review or workplace incident
- Treatment is inconsistent with the alleged injury
- Extent of injury and accident time frame do not match up
Is Workers’ Comp Fraud a Felony?
Workers’ compensation fraud can be charged as a misdemeanor or a felony, depending on the situation. As a misdemeanor, a conviction for fraud could result in up to a year in county jail and a fine. If fraud is charged as a felony, penalties can include more than a year in prison, fines, and restitution.
Some incidents of workers’ comp fraud can include additional criminal charges. The defendant may face related charges for:
- Identity theft
- Insurance fraud
- Health care fraud
Investigating Workers’ Comp Fraud
Insurance companies and the employer may investigate employees even without indications of claimant fraud. The insurance company and employer have a financial interest in denying workplace injury claims. As a result, they may wrongly deny a legitimate claim for an injured worker. Many employees do not go through the process to appeal the denial, and end up going without the benefits they deserve.
Do Private Investigators Follow Workers After a Claim?
A private investigator may follow the worker with video surveillance. Investigators may also talk to co-workers or neighbors about the worker’s activities. Social media accounts may also be reviewed for evidence that could hurt the worker’s claim. Some of the things investigators look for when an employee makes a workers’ comp claim include:
- Participating in sports or leisure activities
- Doing yard work, home improvement projects, or heavy lifting
- Going on vacation after making a claim
- Social media post showing the cause of the injury that is unrelated to work
- Medical bills for appointments the worker never attended