News show, 20/20 recently aired a story about several workers’ compensation beneficiaries who were committing fraud. One woman, who was a former postal worker, claimed that she had so much should pain that shoulder could barely lift her arms. However, she was shown as a contestant on The Price is Right lifting her arms high enough to spin the iconic wheel. She also shared photos on Facebook of her zip-lining adventures. Such media stories of workers’ compensation fraud that air on television are usually amusing to viewers as they almost always depict the “injured” worker enthusiastically participating in a strenuous activity such as dancing, zip-lining, or wrestling; often making for “great TV”. However, these incidents are not at all amusing to the employers or insurance carriers who are providing the benefits for these employees. One estimate is that workers’ compensation fraud amounts to over $1 billion a year.
What is Workers’ Comp and Are You Not Allowed to Work?
Workers’ compensation is available to employees who are injured while at work. In order to be approved for benefits, a physician must certify that the employee was indeed injured and unable to work. Benefits often include medical benefits and disability payments. Under Texas law, for example, an injured employee can receive workers’ compensation benefits for years. However, if the employee recovers from the injury he or she is required to inform the employer and the benefits will cease. Unfortunately, there are some employees who try to take advantage of the workers’ compensation program. They do so by faking an injury, and if caught, they may be accused of fraud, since faking the seriousness of an injury, or faking the continued existence of an injury falls under that charge. With some injuries such as back injuries, a doctor must to some degree rely on the patient’s report of his or her level of pain. If a patient continues to complain of pain that is so debilitating that he or she cannot work, then the doctor will continue to certify that the employee is entitled to workers’ compensation benefits.
Catching the “Frauds”
Because this type of fraud has become so widespread, employers and their insurers actively seek to catch employees who are fraudulently collecting benefits. The result is that more and more workers who are faking injuries are getting caught. Melody Tendayi, of Austin, Texas, was recently sentenced to deferred adjudication, 150 hours of community service and ordered to pay over $6000 in restitution when she was caught working while collecting worker’s compensation benefits. This is referred to as “double-dipping.” Terrance Hopkins of Tyler, Texas, was also recently caught double-dipping. Hopkins, a teacher, was receiving workers’ compensation benefits when he was caught working as a junior college coach.
In some cases, the employees are caught by accident when they post pictures or videos of themselves on social media sites engaging in activities that clearly show they are not disabled. In other cases, insurance companies or employers receive anonymous tips. In some instances, private detectives are dispatched by insurance companies to catch “cheaters”. If an insurer is suspicious that someone is faking an injury, a detective will follow that person and eventually videotape them jumping, zip-lining, playing the drums, golfing, playing basketball, or doing some other activity that they claim they are too injured to do.
Workers’ compensation fraud, Medicare fraud, and Medicaid fraud are huge problems. Such fraud impacts all of us as it causes increased insurance costs. Do you think that the penalties for workers’ compensation fraud and other types of insurance fraud should be increased and should jail time be mandatory?
CONTACT HERRMAN & HERRMAN IF YOU HAVE BEEN INJURED IN ANY OF THE FOLLOWING TYPES OF ACCIDENTS:
We can help you if you have been harmed by the following:
- Car accidents – Our lawyers have extensive experience handling car accident cases. We will work to identify the party or parties at fault for the crash and build a case to demonstrate persuasively how the parties caused the accident and your injuries. We will seek fair and full compensation through a negotiated settlement or at trial if necessary.
- Truck accidents – Thousands of large commercial trucks travel the roads of Texas every single day. Unfortunately, careless truck drivers and trucking companies disregarding safety put innocent people at risk of serious injuries. If you’ve been injured in a truck accident, let our experienced Texas personal injury lawyers stand up to the trucking companies and insurers on your behalf.
- Motorcycle accidents – Motorcycle riders often suffer grievous injuries in crashes caused by other motorists. Too many motorcycle accidents in Corpus Christi are caused by careless drivers who don’t look for motorcycle riders or violate their right of way. Our personal injury lawyers will work to cut through the bias and stigma against motorcycle riders. Our goal is to seek the financial compensation that you’ll need to recover from a serious motorcycle accident and injuries such as bone fractures, road rash, or traumatic brain injury.
- Product liability – Product manufacturers have a legal obligation to make products that are safe for their intended uses and to warn consumers of any risks that may come with the product. When products have design or manufacturing defects or undisclosed dangers, the product manufacturer may be legally responsible for injuries suffered by consumers. Our attorneys can help you evaluate whether you have a valid product liability claim.
- Brain injury – Brain injuries can leave accident victims with disabilities that leave them unable to work or perform many tasks of daily living. Seeking compensation for a brain injury in an accident often proves incredibly complex. The brain injury survivor may seek compensation for anticipated future medical care and the medical care already provided. Our personal injury lawyers can help you through the difficult recovery process following a brain injury and will fight to make sure you have the resources you need.
- Spinal injury – Spinal cord injuries could cost millions of dollars of care over the course of the victim’s lifetime, especially when those injuries result in partial or complete paralysis, such as paraplegia or quadriplegia. If you or your loved one has suffered a spinal cord injury, you deserve compassionate legal representation. Our attorney can help you determine whether you may be entitled to claim compensation for your injury and expenses related to living with the disability, such as making a home more accessible.
- Wrongful death – If you have lost a loved one due to the negligent or reckless actions of another party, your family deserves to seek accountability and compensation from those at fault for the wrongful death. Our caring and dedicated attorneys can help guide you and your family through this difficult and painful time and seek justice for your loved one.
ABOUT HERRMAN & HERRMAN PERSONAL INJURY LAWYERS
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