Oakland

Workers' Compensation Fraud Lawyer

Workers’ compensation was intended to be a simple system to help workers injured on the job so they could get back to work quickly. However, the system grew complicated, and claims in Oakland are now often drawn out and defended with vehemence by insurance companies who want to keep their costs as low as possible. To avoid paying fraudulent claims, insurance investigators may make allegations of workers’ compensation fraud in cases where those allegations are not warranted.

Unfortunately, the penalties for any form of insurance fraud in California can be quite severe. Therefore, if you are facing charges of fraud in connection with workers’ compensation insurance, it is a good idea to talk to an Oakland workers’ compensation fraud lawyer who can explain the charges. Let our criminal defense attorneys at The Nieves Law Firm evaluate your options for defense so that you can work toward the best possible disposition of your case.

Understanding This Offense

Concerned that workers’ compensation fraud is estimated to cost the state billions each year, California lawmakers enacted a scheme to prosecute and prevent fraud.

Among other things, the legislation mandates posting personal information of anyone convicted of workers’ compensation fraud online. In addition, the stronger laws made workers’ compensation fraud a felony offense, although it is often referred to as a “wobbler” because in some cases courts have the discretion to treat the offense as either a felony or misdemeanor.

The term of imprisonment for a first offense can be as high as five years and fines can be levied in the amount of up to $150,000 or twice the amount obtained by fraudulent means, whichever is greater.

Actions That Constitute Workers’ Compensation Fraud in Oakland

Insurance fraud, including workers’ compensation insurance fraud, is governed by different sets of statutes in California, including Section 1871 of the Insurance Code and Section 550 of the Penal Code. Both sets of statutes prohibit individuals from knowingly presenting fraudulent or false claims to receive payment for a loss or injury. They also prohibit acts such as assisting others in insurance fraud, submitting multiple claims for the same injury, and making false statements to prevent others from filing or receiving workers’ compensation benefits.

Some examples of actions that would constitute workers’ compensation fraud include:

• Submitting a claim for reimbursement for a fake medical expense, such as medical equipment never purchased or purchased at a lower rate
• Claiming an inability to work due to a disability from an injury when in actuality the injury was minor and the injured worker is caught working at another job or participating in strenuous physical activity while receiving disability benefits
• Making a false statement about a co-worker’s accident either to prevent or assist that employee’s reception of benefits
• Claiming an injury was suffered on the job when it was actually suffered elsewhere
• Billing workers’ comp insurance for medical services that were not necessary or never provided

In all workers’ compensation fraud cases, evidence regarding the injury or illness that was the subject of the claim is crucial. An experienced Oakland workers’ compensation fraud lawyer can help collect and preserve evidence to help ensure it is presented in the most favorable light.

Speaking with an Oakland Workers’ Compensation Fraud Attorney

Employers, employees, and insurance companies all have the potential to commit workers’ compensation insurance fraud. The penalties can be severe, even for a first offense. But a knowledgeable Oakland workers’ comp lawyer knows that there are several defense strategies that can be used to reach a more positive outcome.

If you are facing charges of fraud involving workers’ compensation, talk to an Oakland workers’ compensation fraud lawyer who could ensure that your rights are protected and to begin working toward the best possible resolution of your case.