Top Upper Darby, PA Workers' Compensation Fraud Lawyers Near You
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934 E. High Street, Suite 2, Pottstown, PA 19464
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Bellwoar Kelly, LLP has experience helping clients with their Workers' Compensation Fraud needs in Upper Darby, Pennsylvania.
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328 West Broad Street, Old Borough Hall, 2nd Floor, Quakertown, PA 18951
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Applebaum & Associates has experience helping clients with their Workers' Compensation Fraud needs in Upper Darby, Pennsylvania.
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600 W Germantown Pike, Plymouth Meeting, PA 19462
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Ciccarelli Law Offices has experience helping clients with their Workers' Compensation Fraud needs in Upper Darby, Pennsylvania.
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215 North Olive Street, Suite 201, Media, PA 19063
Get assistance for your Workers' Compensation Fraud issue in the Upper Darby, Pennsylvania area. Nistico & Roberts can help.
1219 Spruce Street, Philadelphia, PA 19107
Get assistance for your Workers' Compensation Fraud issue in the Upper Darby, Pennsylvania area. van der Veen, Hartshorn, Levin & Lindheim can help.
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3245 Ridge Pike, Norristown, PA 19403
Conway Schadler, LLC, a reputable Workers' Compensation Fraud firm representing clients in the Upper Darby, Pennsylvania area.
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516 DeKalb Street, Norristown, PA 19401
1500 JFK Blvd., 2 Penn Center Suite 1240, Philadelphia, PA 19102
100 S Broad St, Suite 1910, Philadelphia, PA 19110
1901 Callowhill St, Philadelphia, PA 19130
10 North Main Street, 2nd Floor, Doylestown, PA 18901
2003 S Easton Rd, Suite 304, Doylestown, PA 18901
Station Square Three Suite 105, Paoli, PA 19301
2800 Kelly Rd, Suite 200, Warrington, PA 18976
737 Second Street Pike, Southampton, PA 18966
1500 Walnut St, Suite 1510, Philadelphia, PA 19102
1700 Market Street, Suite 1418, Philadelphia, PA 19103-3907
1760 Market Street, Suite 600, Philadelphia, PA 19103
230 S. Broad Street, Suite 900, Philadelphia, PA 19102
1515 Market Street, Suite 1200, Philadelphia, PA 19102
1650 Market Street, Suite 3669, Philadelphia, PA 19103
100 South Broad Street, Suite 1910, Philadelphia, PA 19110
600 West Germantown Pike, Suite 400, Plymouth Meeting, PA 19462
21 West Third Street, Media, PA 19063
2005 Market St, 29th Floor, Philadelphia, PA 19103
Upper Darby Workers' Compensation Fraud Information
Lead Counsel independently verifies Workers' Compensation Fraud attorneys in Upper Darby and checks their standing with Pennsylvania bar associations.
Our Verification Process and Criteria
Ample Experience
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Pledge to follow the highest quality client service and ethical standards.
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 Pennsylvania?
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