Top Bainbridge Island, WA Workers' Compensation Fraud Lawyers Near You
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16000 Christensen Rd, #304b, Tukwila, WA 98188
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The Law Offices of Jason S. Newcombe has experience helping clients with their Workers' Compensation Fraud needs in Bainbridge Island, Washington.
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PO Box 50, Cle Elum, WA 98922
Contact Heritage Law Office in Bainbridge Island, Washington for experienced legal assistance in Workers' Compensation Fraud.
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1105 Tacoma Avenue South, Tacoma, WA 98402
A law firm in Bainbridge Island, Washington, Michael Austin Stewart, Attorney at Law experienced in helping clients with Workers' Compensation Fraud issues.
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PO Box 77041, Seattle, WA 98177
1001 Fourth Avenue, Suite 4400, Seattle, WA 98154
705 S. 9th St, Suite 204, Tacoma, WA 98405
108 S. Washington Street, Suite 406, Seattle, WA 98104
12835 Newcastle Way, Sute 301, Newcastle, WA 98056
720 3rd Ave, Suite 2015, Seattle, WA 98104
5611 76th St W, Suite A, Lakewood, WA 98499
999 Third Avenue, Suite 3900, Seattle, WA 98104-4040
400 Warren Avenue, Suite 415, Bremerton, WA 98337
604 West Meeker Street, Suite 206, Kent, WA 98032
215 NE 40th St, Ste C3, Seattle, WA 98105
986 ZYX Street, Suite 452, Lynnwood, WA 98036
2025 1st Avenue, Suite 1140, Seattle, WA 98121
1200 Westlake Avenue North, Suite 700, Seattle, WA 98109
1420 Fifth Avenue, Suite 2200, Seattle, WA 98101
32116 SE Red Fall City Rd, Fall City, WA 98024
1818 Westlake Ave. N., Suite 216, Seattle, WA 98109
2122 112th Ave NE, Suite A-200A, Bellevue, WA 98004
3250 Airport Way S, Suite 206, Seattle, WA 98134
19309 68th Ave S, Suite R-102, Kent, WA 98032-2112
520 Pike St, Suite 2350, Seattle, WA 98101
451 SW 10th St, Suite 215, Renton, WA 98057
Bainbridge Island Workers' Compensation Fraud Information
Lead Counsel independently verifies Workers' Compensation Fraud attorneys in Bainbridge Island and checks their standing with Washington bar associations.
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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 Washington?
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