Los Angeles Workers Compensation Fraud Defense Attorney

Los Angeles Workers Compensation Fraud Defense Lawyer

Workers’ compensation fraud occurs when an employer wrongfully denies someone’s attempt to gain the benefits they rightfully deserve. Sometimes, employers are falsely accused of trying to cheat the system by denying injuries in a claim. If you are an employer who has been wrongly accused by an employee, you need to hire a skilled Los Angeles workers compensation fraud defense attorney.

At Bober, Peterson, and Koby, LLP, we have seen how workers’ compensation fraud accusations can impact an employer’s reputation. It is important to remember that being accused of a crime only marks the beginning of the case. You still have an opportunity to hire a lawyer and defend your rights. Allow us to guide you through each step of this process in order to protect the integrity of your business.

Why Are Employers Sometimes Incorrectly Accused of Workers Comp Fraud?

One of the most frequent causes for employers being incorrectly accused of workers’ compensation fraud is a simple misunderstanding of medical conditions. Some injuries, like soft tissue damage or chronic pain disorders, are not immediately apparent.

The lack of visible symptoms can lead an employer or insurer to question the legitimacy of a claim. Though it can appear like an employer is trying to get out of paying, the actions or non- actions of that employer may be the result of a genuine mistake or misunderstanding.

Errors in Documentation

To apply and be awarded workers’ compensation benefits, an employee needs to fill out a number of detailed forms to document what happened and what injuries are linked to the incident. When an employee makes a mistake in their documentation, for instance, missing a typo or deadline an employer may deny the request. If the employer denies the request, it could be misconstrued as an intentional act of trying to circumvent the system.

Surveillance Misrepresentations

Investing in surveillance is a powerful way for employers to protect their business from claims of fraudulent workers’ compensation denials. Security footage can provide compelling evidence of inconsistencies between a claimant’s reported injuries and their actual activities. However, interpreting this evidence requires careful legal analysis to avoid misrepresentations that could undermine a legitimate defense.

For example, while surveillance of an employee lifting a heavy load might appear to contradict medical restrictions, having an understanding of the full context is crucial. Hiring experienced legal counsel can ensure that evidence gathered through effective surveillance is both admissible and accurately interpreted. This can better defend your case against claims of fraud and ensure you are maintaining fairness.

Overzealous Fraud Investigations

Fraud investigations are essential to preserving the integrity of the workers’ compensation system. However, employers may face accusations of being overly aggressive in their investigative efforts, even when they are simply fulfilling their legal duty to protect the business and to prevent fraud.

For instance, an investigator might question a claimant’s activity log after discovering inconsistencies with their reported injuries. While such scrutiny is necessary, it can be misinterpreted as harassment or undue pressure. This mischaracterization can lead to disputes or legal challenges made against the employer. Legal representation ensures that investigative practices are defended as appropriate, lawful, and aimed solely at protecting the workers’ compensation system.

Relationships Between an Employer and Employee

Another major cause of wrongful accusations can be the result of a tense relationship between an employee and their employer. If there is already an existing history of mistrust in the relationship, an employee might claim that their employer was too quick to accuse them of fraud or failed to investigate the claim thoroughly. These situations typically stem from the interpersonal dynamics of this relationship rather than from any improper actions by the employer.

Keeping complete and thorough records of all workplace injury claims is the first step in protecting your business from any of these scenarios. Consulting with an experienced Los Angeles workers’ compensation fraud defense attorney early in the process can help ensure that your actions are well-documented and aligned with legal standards. This can help to strengthen your defense against any claims that the business is wrongfully retaliating against an employee.

FAQs

Q: What Are the Consequences of Being Accused of Workers’ Compensation Fraud?

A: Any accusation of workers’ compensation fraud can lead to a number of legal and financial consequences. For example, an employer may be charged criminally. If found guilty, the employer could potentially face a number of fines or even spend time in prison, depending on how severe that fraudulent activity proves to be. However, all employers have the right to hire a defense lawyer and present their side of the story in Court before a final decision is made.

Q: What Should an Employer Do If Accused of Workers’ Compensation Fraud?

A: If there is an accusation of workers’ compensation fraud, it’s important for an employer to remain calm and avoid making any statements without the presence of legal counsel. Be sure to gather every document that is related to the decisions made as an employer and bring this information to an initial consultation with the defense attorney. They will help you better understand your rights and what needs to happen next to build a compelling defense strategy.

Q: How Can I Protect Myself From Being Falsely Accused of Fraud?

A: To help reduce the chances of being incorrectly accused of employer fraud, an employer should keep detailed records of all employee’s injuries, medical visits, and all communications the employer has had with them. This can help avoid any scenario where an employee tries to make an invalid claim due to a lack of evidence to suggest otherwise.

Q: Can Employers Commit Workers’ Compensation Fraud Too?

A: Yes, it is possible for an employer to be the individual or entity who has committed workers’ compensation fraud as well. For example, they may misclassify an employee as an independent contractor to try and avoid providing legally mandated benefits. They could also underreport their payroll to try and reduce premiums or just simply deny someone’s legitimate claim. Accusations along these lines are sometimes misunderstood and warrant additional investigation.

Contact Bober, Peterson, and Koby, LLP Today

If you have recently been accused of denying an employee’s workers’ compensation claim that you believe was a fair or reasonable decision, connect with our fraud defense lawyers as soon as you can. We are happy to take the legal burdens off your plate and help ensure that no one tries to take advantage of your rights or charge you with allegations that do not meet the definition of a legitimate crime.