If a Georgia worker is not honest about their condition, it can not only take away their right to workers’ compensation benefits but could also land them in jail. However, in a recent case from one state, a court found that a worker might still be entitled to benefits even after a criminal conviction for workers’ compensation fraud.
In that case, the employee was working at a car company and slammed the trunk of a car on his hand accidentally. He crushed one of his fingers and claimed he could not continue to work, due to pain in his hand and shoulder. He filed a workers’ compensation claim in California and received benefits as a result. The workers’ compensation provider later hired a private investigator to monitor the employee. The investigator filmed the employee leaving three doctor’s visits. Video showed the employee taking off his sling, using his hand to get in and out of his car, using his hand to drive, and using his hand to carry a bag of groceries. The workers’ compensation provider notified the district attorney, who then began their own investigation.
In certain circumstances, under that state’s law, if a worker is convicted of fraud in obtaining workers’ compensation benefits, the worker cannot recover benefits arising from the fraud. However, if a worker is able to show that he or she was entitled to benefits independent of fraud, benefits can still be awarded. In this case, the court found that there was evidence that the worker had suffered a compensable injury and was entitled to benefits independent of the fraud. Therefore, even though the worker eventually was convicted of a misdemeanor crime, the court found he was entitled to benefits as a result of his work injury.