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Injured Worker Deemed Eligible for Benefits Despite Conviction for Fraud

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.

NewspaperIn 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.

Misrepresentations in Workers’ Compensation Cases

Georgia’s Workers’ Compensation Enforcement Division was created in 1995. The Division’s goal is to investigate allegations of fraud and noncompliance, to prevent fraud and abuse, to notify authorities of criminal activity, and to cooperate with authorities in investigating and prosecuting abuse. Individuals who engage in fraud in obtaining workers’ compensation benefits are subject to serious consequences.

The Georgia Workers’ Compensation Act states “Any employee who, with the intent to defraud, receives and retains any income benefits to which he or she is not entitled shall be guilty of a misdemeanor and, upon conviction thereof, shall be punished for each offense by a fine of not less than $1,000.00 nor more than $10,000.00 or by imprisonment not to exceed one year, or by both such fine and imprisonment.” An individual can also be given civil penalties for a violation of the Workers’ Compensation Act.

Contact a Georgia Workers’ Compensation Attorney

If you have been injured on the job, you may be entitled to Georgia workers’ compensation benefits. At the Georgia law office of J. Franklin Burns, P.C., our attorneys have decades of experience handling workers’ compensation claims. If you have been hurt in a workplace accident, our experienced Atlanta workers’ compensation attorneys will skillfully lead you through the process of pursuing benefits. Our Georgia law firm offers quality legal representation and responsive client service. To learn more about how we can help you seek workers’ compensation benefits, call us for a free consultation at 404-303-7770.

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Court Considers Psychological Workers’ Compensation Claim, October 5, 2017, Atlanta Workers’ Compensation Lawyer Blog