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    Workers’ Compensation Fraud is Serious Business

    Fraud is not something the Pennsylvania Bureau of Workers’ Compensation takes lightly. In Pennsylvania, if someone is found to be guilty of fraud, they potentially face civil and criminal charges – and will be prosecuted to the fullest extent of the law. In Pennsylvania, insurance fraud is considered a felony. Anyone found to violate this law could serve up to seven years in prison and pay up to $15,000 in fines. Pennsylvania laws surrounding workers’ compensation fraud are so strict, it is a felony for employers to intentionally fail to carry workers’ compensation insurance to cover workers injured while on the job.


    Recently, a civilian employee from Chambersburg, PA found out just how serious these penalties were. In 2009, a civilian employee of the U.S. Army Corps of Engineers put in a claim for a work-related disability. From 2011 through 2014, this employee claimed benefits through the workers’ compensation program that totaled $143,475.41. Normally, there would be no issue with this scenario, but there was one small problem. It came to the attention of the Bureau of Workers’ Compensation that during the time the employee was out claiming benefits under the guise of not being able to work from his injury, the employee actually had a full-time job at a catering company. The employee never disclosed this employment to the Bureau.


    After an investigation by the United States Department of Labor’s Office of Inspector General’s Office of Labor Racketeering and Fraud Investigation, the employee was charged with five counts of fraudulently receiving benefits.


    Going From Bad to Worse


    This is the part where the employee’s story takes a turn for the worse. Because this employee was receiving benefits from a program administered by a federal government program, the sentence he receives will be according to the federal sentencing guidelines. In this situation, he is facing 10 years of imprisonment for each count of theft and five years on each count of fraud.


    Criminal Liability in Pennsylvania


    In Pennsylvania, the person claiming benefits is not the only person who can be found guilty of committing fraud in these situations. The law extends liability to anyone who provides bills for services that were never rendered or for more services than actually provided can be guilty of fraud. Any person that aids those who provide clients for doctors and attorneys, or anyone who accepts, request, offers, or gives any type of consideration for a referral for evaluation or consultation can be found guilty of committing fraud. In addition, anyone who underreports payroll or misclassifies payroll or job information can be found guilty of fraud.


    Pennsylvania take this issue very seriously, as they should. At one point, Pennsylvania was found to have the second highest incidence of workers’ compensation fraud, which cost $180 million a year. Workers’ compensation provides a “safety net” for workers who are injured on the job, which is why Pennsylvania is very diligent about cracking down on fraud.


    If you are in a situation where you need guidance with your workers’ compensation claim, it is in your best interest to contact a Philadelphia attorney for reliable and knowledgeable advice.

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