• 18
  • August
    2010

Fraudulent workers' compensation claims are a serious problem for employees in real need of workers' compensation benefits. Fraudulent claims cause employers' to become suspicious of all workers' compensation claims as well as raise their healthcare premiums. Fraudulent claims are a waste of resources and funds that could go to employees with legitimate work-related injuries.

Philip Silvernail was arrested June 7, 2010 for insurance fraud in the third degree. The Red Hook, New York man filed a report claiming a back injury in January 1992 while employed by the Poughkeepsie Housing Authority. Silvernail claimed he could no longer leave his house or walk due to his injury sustained on the job. Silvernail was awarded $20,546.20 in disability benefits from the New York State Insurance Fund.

An investigation by the New York State Department of Insurance found Silvernail well enough to paint from a ladder, replace window shutters and an outside deck, install awnings and handrails and use a backhoe. This misrepresentation of work status could result in a sentence of seven years in a New York state prison.

What is Workers' Compensation Fraud?

Fraudulent claims for workers' compensation benefits can include:

  • exaggeration of symptoms
  • working while allegedly disabled and not reporting the resulting income
  • claiming a non-existent injury
  • claiming a non-work related injury as work related
  • falsifying mileage reports in your claim

When filing a workers' compensation claim, make sure you are completely accurate in your claim. Even if you have a legitimate work-related injury, understand that any discrepancy between your claim and your actions can be construed as fraud.

If you are claiming you are unable to perform certain functions while at work, do not perform them outside of work. Be conscious that volunteer work performed while receiving disability benefits could be used against you as proof of fraud. Insurance companies and departments routinely perform investigations on suspicion of fraud. Assume that you are the subject of an investigation and that someone could be watching you at any given moment.