Workers Compensation Fraud

Thank you for the signed retainer with our firm to handle your Workers’ Compensation Medical Provider Applications. The Workers’ Compensation Court allows us to recover for authorized and emergency treatment on behalf of your patients through the Workers’ Compensation Court. In our experience, most of these cases have been resolved amicably with the insurance carrier. However, there are various issues that we encounter as a part of our representation of Medical Providers in Workers’ Compensation Court.

Worker's Compensation is a service that provides reimbursement for lost wages to employees who have sustained injuries from work or work-related tasks. It is also one of the services that is most often the victim of fraud. Each of the three types of fraud, claimant, employer, and provider, is defined by the same characteristics, outlined by the Ohio Board of Workers Compensation:

On Monday, 11-16-2015 she recalled the claimant had punched in early for work that morning and did not say anything to her until shortly later around mid-morning when the claimant came into her office. She said the claimant was brief with her when she requested to file a Workers’ Compensation claim for her alleged right wrist injury coupled with pain to her right fingers. She claimed that her injury was work-related, and her injury occurred on 11-12-2015.

Zamudio, Human Resources Administrator and acting custodian of personnel records of the Domino Realty Management Company who allowed access, and copies in support of any relevant information pertaining to any injuries, had located a “Work/School Status Report” under the name of the “Talbert Medical Group.” The document had placed the claimant off from work from 2-5-01 through 2-5-01 for pain to the claimants left knee, and yet, according to Ms. Zamudio, the document did not state that a work related injury occurred as there were no other documentation in support of an injury. Furthermore, the witnesses had not cited any job related incidents where the claimants left knee from 2001 had been injured were the alleged 2001 left knee had been irritated or exacerbated in any

We found that both witnesses claimed that there was no correlation to suggest that any of these alleged injuries specified by the claimant’s attorneys and by the claimant himself occurred or where the claimant suffered a stroke. Also, both witnesses were unaware if the claimant was experiencing any non-industrial stressors or if there were any outside non-work related factors that would suggest the claimant was suffering from any psychological problems and/or issues because of his employment.

On Thursday, 10/22/2015 the claimant stated he reported for work pain-free and was not suffering from any pain or discomfort from four other work related injuries that he reported as claims and received judgments. The claimant was unable to account for the real dates of his past work-related injuries that occurred between 2010 and 1/2013. The claimants past industrial-related injuries ranged from a left wrist injury, head injury and two separate right wrist injuries which he says did not include any injury to any other body parts.

A Court is likely to find that Michael Bluth is entitled to recover under Texas Worker’s Compensation laws, because though he was traveling home at the time of his injury, it is likely that he was in the course and scope of his employment at the time of the accident. Course and scope of employment means any activity or character that has to do with and “originates in” the work, business trade, or profession of the employer and that is performed by an employee while engaged in or about the furtherance of the affairs or business of the employer. Tex. Lab. Code Ann. § 401.011 (12). An injury “sustained in the course of employment” is compensable only if the injury (1) relates to or originates in, and (2) occurs in the furtherance of the employer’s

1. Janet works as a branch manager for a large banking firm. Her job requires her to travel by personal vehicle to different branch offices several times each week. Janet has lower back problems from a result of a skiing accident many years ago, which is further aggravated by long periods of sitting while driving. Janet was returning from the branch office to the home office on Thursday afternoon when another driver struck her car from behind. A physician examined Janet and determined that the accident aggravated her pre-existing back injury. The physician ordered Janet to remain off work for at least two weeks.

If you are injured while on the clock but due to the negligence of a third-party, a professional and experienced law team can help you receive the maximum legal compensation for your pain and suffering. The responsible party is held accountable for your experience while workers' comp covers the medical expenses and your lost wages.

We explained our objective and our approach to obtaining their story of the facts that would aid to establish facts about the Claimant’s employment to decide the facts surrounding an alleged injury.

Unfortunately, being injured at work is something many people face on a daily basis. Sometimes accidents are caused when an employee works in a dangerous environment. Other times, the employee is careless or is not provided with the right safety equipment. Regardless of the cause of the accident it is important that the employee has the tools they need to heal and get back to work as quickly as possible.

The claimant had stated before she started at Yamaha Motor Inc. she did not report her injuries to the Human Resources Department or her supervisor when hired on 9-5-12. She stated if she did, it might have compromised her chances in gaining employment with theYamaha Motors Corporation

If you are injured on the job or while performing job-related tasks, you must report the injury immediately to your Supervisor. If medical assistance is required, you will be referred to a health care professional for treatment. If your injury results in time off from work, you may be eligible to receive Workers’ Compensation payments in accordance with Pennsylvania regulations.

Timing: Under New Jersey's workers' comp laws, you must report your injury in a timely manner. The sooner you file an accident report with your employer, the better. Waiting to file only hurts your claim, and many claims are denied because workers simply missed the deadline.

Here’s a scenario; Omar, an Uber driver was working one night for Uber as a driver. When he reached the destination for his passengers, they refused to leave his car. From there a fight broke out and Omar was hit in the face with an unidentified shiny object. Omar’s jaw was broken in two places and had a week’s stay in the hospital (Huet, 2015). Many would expect Uber to cover Omar’s hospital expenses and give him some sort of compensation but, no such thing happened. In most cases, a company’s Human Resource department would ensure that the employee received care and all other issues and