Felony, Fines and Jail – The Story of Workers Comp Fraud (ENGLISH)On October 15, 2019 by Raul Dinwiddie
Fake an injury on the job, and cash in, all
while getting time off. Tonight a Peace Officer, who gave
into temptation is speaking out. Seventeens Trisha Wash is
joining us in the News room with more on this story. Yeah, I was trying to make easy money, you
know. I thought I was going to get a big chunk of money and
not work anymore. Fraud costs everyone. Because when there is
fraudulent cases against an insurance company then they are raising
their rates. A felony mistake will cost you more that you
will ever imagine. The term “fraud” covers knowingly
false statements to do any of the following; to obtain workers’ compensation
benefits not rightfully due, to cause denial of worker’s
compensation benefits that are rightfully due. Even knowingly assisting anybody
to do any of these things can be
fraud. I couldn’t resist anymore, I had to go out
there and play..I did it all my life. I went out there the last month,
just before I was suppose to go back to work and I got caught on tape. They showed up, they asked my boss where I
was at. And, asked to bring me up front. They took me outside and arrested
me. Worker’s Compensation Fraud is a felony in
California. A single count of workers compensation insurance fraud under 1871.4,
can land you in prison for five years. The fine is up to $150,000 dollars. Or, double
the amount of the fraud. So, if a person would commit a fraud worth a $100,000 dollars they
would be fined $200,000 dollars in addition to being sent to prison for five years. To understand workers’ compensation
fraud we first need to know what workers’ compensation insurance is.
90 some years ago if you were hurt at work, you had to sue your
employers to get them to pay for your medical bills. This was very
expensive for employees, who usually were awarded a tiny
settlement … if anything at all. That’s why the workers’
compensation insurance system was created. Now, if you are injured
at work, coverage is provided for all of the medical bills and a part
of your salary, regardless of who is at fault.
This system was intended to get, prompt relief to employees in all
legitimate workplace injury cases. I lost my house, my cars. you know,
people just looking at me different. No respect anymore.. I lost a lot.
They booked me, they told me what I did wrong. I already knew what I did
wrong. It don’t do any good to do this. Your life turns up side down. The money from this system, comes from
insurance premiums paid by all California employers.
As an employee, you pay nothing for the coverage. Your employer does not deduct the cost of
workers comp insurance from your paycheck. You have
the right to understand what workers compensation
is, how to use it when needed, and the benefits it can
provide. There are a number of factors that
make it difficult to do business in California, including the cost of
workers’ compensation insurance. Some of the factors driving up
rates include, spiraling medical costs, legal fees, market
instability and, of course, a big factor is fraud.
The workers’ comp system was designed to compensate legitimately
injured employees — it was not designed with fraud in mind. But
that’s all changing fast . State-wide prosecutions for
workers’ comp insurance fraud are on the rise, and will continue to
rise until people get the message: Workers’ comp insurance fraud is a
serious felony offense that is harming this state.
Workers compensation insurance rates are going up dramatically. In some ways
bankrupting companies. That is why fighting fraud is so important. Hey, man how you doing?
I haven’t seen you around work in a long time. Hey, Ricky what’s happening man.
I hurt myself on the job some time ago and filed
for workers compensation. Decided to take my
time about coming back to the job. Know what I’m
saying? You mean you collected off the system? And,
come to play ball with us out here? Yeah, dude so what?
Man, I got family that were laid off because workers comp
costs did their company in. Under california law, every
employed person who is injured while performing job duties is
entitled to Workers’ compensation benefits. Hi, I’m Daryl Carter, welcome to the supply
department. When you are newly hired, your
employer is obliged by law to notify you of these rights.
Temporary disability, which is partial reimbursement for lost
wages, is paid to an injured employee during the time he or she
is recovering from the illness or injury.
Injured employees are also entitled to all medical treatment
needed to cure or relieve the effects of the injury, and this can
include doctor’s visits, chiropractic treatment,
hospitalization, physical therapy, etc.
Injured employees who are determined to be medically unable
to return to their usual occupation are entitled to job retraining.
For a more detailed and extensive list of workers’ comp benefits,
talk with your employer. How is your hand?
Not too much pain now… If you are injured on the job the
first thing you need to do is to notify your employer of an injury
immediately. Your employer will then provide you with a claim form
within one day. Complete this form and return it as soon as possible. This
is very important. As an employee you can receive the necessary benefits more
quickly if you complete the paperwork on time.
If anyone you know tells you that you can get ‘easy money’ from
filing a worker’s comp claim: Watch out!
Be cautious of doctors, chiropractors or attorneys who try
to tell you what to say, or what is wrong with you. If they need to
tell you what is wrong with you then maybe you are not really
injured. Watch out for supposedly
‘free’ treatments or diagnosis. You may be getting involved in a
without knowing. And don’t lie to get more benefits.
That is just as much a fraud as lying about the injury in the first
place. The best advice I can give is: Just
tell the truth. You can’t drive a tow truck and have a
felony on your record. I’ve been trying to get jobs at distribution centers, warehouses,
different jobs and they turn me down cause of
the workers comp fraud. A lot of jobs are that
way.. If you have a felony, you can’t do it. The number one thing you need to
remember when it comes to filing a workers’ compensation claim is to
simply tell the truth. If you were legitimately injured at
work you likely have benefits coming to you.
If you try to cheat the system, you are taking a chance on a felony
arrest record, big fines and possible jail time. It’s not worth
it. Don’t get sucked in to others’
fraudulent claims. Lying to assist someone else with a fraud can get
you charged with fraud . Be leery of advertisements that
offer one thing, but when you try to take advantage of the offer,
they offer something different. Often these ads lead
you to companies looking to file phony workers’ compensation
claims. And if you witness, or even suspect
a fraud is occurring know that you are the one being ripped off.
You can help fight workers’ comp fraud . If you have information
about a suspected case of fraud call the State Fund Anti-Fraud
hotline at, (888) Stop Fraud, [Graphic: (888) 786-7372]. You can choose to remain anonymous.
And you are helping to fight fraud for yourself and all other working
Californians by preventing damage to the system that was put in place
to help you when you and your family need help.
Thanks for watching and work safely.