Employee Allowed to Sue Employer for Workers’ Compensation Fraud

Some Georgia workers’ compensation claims turn out to be more than just a workers’ compensation claim. In a recent case, a court considered whether an employee could bring a fraud claim against his employer after the employer denied his workers’ compensation claim.

GavelIn that case, according to the facts alleged in the complaint, the employee needed to move bags of concrete mix while he was working at a public transportation company. Since he had previously injured his back, and the concrete mix bag weighed 90 pounds, the employee asked his supervisor for permission to break down the bag into lighter bags or to have another employee help him lift the bag. The supervisor refused and ordered him to lift the bag.

The employee picked up the bag, immediately felt pain in his back, and partially collapsed. His supervisor asked him why he dropped the bag, and he told him it was because he injured his back when he lifted the bag. The employee filled out a workers’ compensation claim form the next day. His supervisor later filled out a work report, in which he wrote that he did not witness the employee’s injury. The supervisor was later deposed and testified that the employee did not request an accommodation and that he did not see him injure himself. The employer subsequently denied the employee’s workers’ compensation claim.

The employee then filed a lawsuit against the employer and the supervisor for a violation of the Insurance Frauds Prevention Act (IFPA). He alleged that the supervisor made a false statement in the report and that he provided false testimony because the supervisor did witness the injury. The employee also alleged that his employer adopted and ratified the supervisor’s misrepresentations and that the fraud resulted in his workers’ compensation claim being denied. He asked for an assessment of his workers’ compensation claim, attorney fees, costs, and a civil penalty.

The employer argued that the employee’s case should be dismissed in part because it was barred by the workers’ compensation exclusivity rule. A state appeals court found that the workers’ compensation exclusivity rule did not apply to the employee’s IFPA claims. It explained that although that state’s workers’ compensation act states that it is the exclusive remedy against an employer for an injury of an employee, the lawsuit is based on an injury suffered by the people of the state, and the exclusivity rule does not apply.

The Exclusivity Rule

Under O.C.G.A. 34-9-11 in Georgia’s Workers’ Compensation Act, the “rights and remedies” granted to an employee under the Act “shall exclude and be in place of all other rights and remedies of such employee, his or her personal representative, parents, dependents, or next of kin, and all other civil liabilities whatsoever at common law or otherwise, on account of such injury, loss of service, or death.”

However, as demonstrated in the case above, lawsuits are not barred by the Workers’ Compensation Act in all circumstances. For example, an employee may be able to sue an employer for fraud, property damage, malpractice, or a failure to provide workers’ compensation insurance, among other reasons.

Contact a Georgia Workers’ Compensation Attorney

If you have recently been injured in a Georgia on-the-job accident, you may be entitled to compensation through the Georgia workers’ compensation program. Having a diligent and experienced workers’ compensation attorney at your side can greatly increase your chances of being approved the first time you submit an application. For knowledgeable representation by experienced injury attorneys, you can rely on our office. Our attorneys have a combined 50 years of trial experience. To set up a free consultation about your workers’ compensation claim, call us today at 404-303-7770.

More Blog Entries:

Court Considers Constitutionality of Workers’ Compensation Filing Time Requirements, December 20, 2017, Atlanta Workers’ Compensation Lawyer Blog

Court Finds Employee’s Surgery Caused by Preexisting Condition and Not Entitled to Compensation, January 4, 2018, Atlanta Workers’ Compensation Lawyer Blog