What to Do if You’re Accused of Workers’ Compensation Fraud
Getting a notice that you’re accused of workers’ compensation fraud can feel like your whole world has crashed to the ground. Suddenly, something that felt routine, like your injury claim or your time off work, turns into a serious legal mess. Your mind races with questions:
Did I do something wrong? What happens next? Am I going to lose everything?
Make sure to take a breath. While this situation is serious, it does not automatically mean you’re guilty. How you respond in the next hours and days is what will shape the outcome with your state’s workers’ compensation board. Here are a few steps to take if you’re accused of workers’ compensation fraud.
Don’t Panic
Yes, this is easier said than done. However, panicking or reacting impulsively, such as posting your frustrations online, can make things worse. You want to pause, sit down, breathe, and give yourself a moment to think clearly. Remember, you need a level head to navigate this allegation.
Find Out the Exact Allegation
Workers’ comp fraud is not a one-size-fits-all issue. The accusation could be anything from “you exaggerated your injury” to “you were working while collecting benefits” or even “your paperwork isn’t accurate.”
You will want to ask for the full details in writing. When you know what you are facing, that is the first step toward defending yourself.
Don’t Ignore It
You might hope that it will just go away, but that never happens. Ignoring it usually backfires. Insurance companies, employers, and state agencies take these claims seriously.
When you brush off official letters or miss a scheduled meeting, that could end your benefits, or worse, lead to criminal charges. You want to respond right away, even if it is to acknowledge receipt while you get advice.
Call a Lawyer
When you have been accused of workers’ comp fraud, you could face civil and criminal charges.
This isn’t something to “just handle on your own.” You want to find a lawyer who is well-versed in workers’ compensation and has experience handling claims involving fraud. A good lawyer will explain your rights, communicate with investigators on your behalf, help collect evidence, and guide you through hearings.
Yes, lawyers cost money, but compared to fines, loss of benefits, or potential jail time, it is a worthwhile investment.
Collect Your Evidence
You want to start pulling together all the evidence that supports your original claim. This can be:
- Medical records
- Treatment notes
- Prescriptions
- Time-off records
- Emails
- Texts
- Statements from coworkers
You want to keep it organized, make copies, and absolutely do not alter or discard anything that could incriminate you, even if you are not guilty.
Be Honest
When talking to your lawyer, investigators, or doctors, stick to the truth. You should never exaggerate or contradict yourself. That can hurt your credibility more than the original allegation. Your honesty is your most potent weapon.
Cooperate but Be Careful
Yes, cooperate, but don’t overshare. Remember that anything you say can be used against you. Let your lawyer guide these conversations.
You want to show you are willing to work with the process, but do not hurt your case by speaking without guidance.
Show Up to Everything
You may have hearings, meetings, or check-ins with your insurance company; make sure to attend all of them. If you miss a single appointment, that can have serious consequences.
If something unexpected comes up and you are unable to attend, please call your attorney immediately to request rescheduling. When you are punctual and prepared, that shows you take this seriously.
What Is at Stake for a Worker’s Comp Fraud Accusation?
This is not just an annoyance. An accusation could result in financial loss, the loss of benefits, or even imprisonment. Some of the outcomes include:
- Repayment of benefits
- Fines
- Criminal charges
- Loss of future benefits
Knowing what you could face helps you and your lawyer decide on the best defense.
Consider Settlements or Mediation
Sometimes, you do not need to fight this out in court. Settlement or mediation can resolve issues more quickly and with less stress. Your lawyer can negotiate on your behalf. All that can save time, money, and emotional energy.
Get Help When You Are Accused of Workers’ Comp Fraud
Being accused of workers’ compensation fraud can be scary, but it is not the end of the world. With the right approach, you can protect your benefits and even clear your name.
Remember: an accusation is just an accusation. How you handle it determines what comes next.
If you’re looking for guidance on how to proceed with the next step, Work Injury Advisor has the workers’ comp resources for you. Any workers’ comp fraud accusation needs legal help, and we’re here to get you started in the right direction.
