Fraud and Forms


When we think of fraud, we think of someone stealing. For example, what if an injured worker has told everyone including the judge and the insurance company that he hasn’t done any work while at the same time lying, cashing workers’ compensation checks and working all along?

Easy answer here. It appears that the worker has committed fraud. In all likelihood, the judge will use this as a basis to stop further payments. We workers’ compensation lawyers call this the death penalty. What this means is that if the insurance company can prove a worker was taking workers’ compensation checks under the assumption of an inability to work while lying about it while working, the judge can stop the compensation payments permanently. Of course any possible criminal charges may be referred to the district attorney as the Workers’ Compensation Board does not decide criminal matters. And, any testimony taken in the workers’ compensation case may possibly be used in further proceedings.

But, what if the workers simply receives one of the blizzard of forms sent by the insurance company and buried in one of the forms is a question about any work done during any point in time since the accident? What if the worker worked one day and forgot? Does this mean the worker has committed fraud?

Well, the short answer is that this is for the judge to decide. And the insurance company will work hard to make it look as if the worker lied rather than made a mistake. Because, if the judge believes the worker intended to deceive in order to receive benefits, the judge will punish the worker with a negative legal decision.

This means that every form the insurance company sends must be carefully scrutinized. Many attorneys will tell their clients don’t sign anything sent by the insurance company. We believe that no blanket rules should apply and sometimes certain forms need to be signed. But, sometimes those forms will lead to an effort by the insurance company to have your benefits suspended. If they can convince a judge that you really didn’t make a mistake on the form or really didn’t remember something from a long time ago, the carrier can try to convince the judge you lied and try to have your case terminated.

Another example of something you might not remember is whether you hurt the same part of your body before. Sure, if you broke your right wrist last year and broke it again in your work accident, you will remember. But, what if you had an old high school injury that you thought was healed and the insurance company finds out and tries to convince the judge that you lied? Again, the judge decides whether you made a mistake or you meant to deceive.

Contact New York Workers’ Comp Lawyer – Robert A. Koenigsberg

Finally, the best way to understand this is to call a New York Workers’ Compensation lawyer to discuss. I have discussed these concerns with dozens of my clients over the last 25 years. Pick up the phone and let me know if I can help. Call (212) 964-9292 or fill out an online contact form to schedule a consultation.