Nevada Workers Comp Applicant / Claimant Fraud

Nevada workers compensation provides injured workers with medical and financial support during recovery. Applicants who try to fraudulently obtain benefits may be accused and convicted of workers compensation fraud. A claimant who is found guilty is subject to legal consequences.
Nevada Workers’ Compensation Applicant / Claimant Fraud Defined

In Nevada, workers compensation fraud occurs when someone tries to obtain benefits to which they are not entitled. There are several ways that an allegedly injured employee may try to scam the system. These include:

  • • Completing faking an injury
  • • Exaggerating the extent of a real injury
  • • Staging a fake accident on the job
  • Falsely claiming that a true injury occurred on the job when it occurred elsewhere
  • • Hiding or lying about an existing or previous injury
  • • Lying about previous attempts to file claims
  • • Collecting benefits for the same injury from multiple employers
  • • Performing unreported work while collecting benefits

Other Types of Workers’ Compensation Fraud

In addition to the claimant, other parties may attempt to deceive the system in order to help or hinder the applicant in receiving benefits.

  • • An employer may try to cheat the system to pay lower premiums by lying about how many people are employed or their job duties, failing to carry the proper workers’ comp insurance, deducting the cost of such coverage from the employees’ paychecks, or even threatening employees who try to file for benefits.
  • • The insurance carrier may misrepresent facts to try to lower the amount of benefits an injured worker receives.
  • • Organized rings, often called claim mills, consist of collaboration between doctors, attorneys, and other workers to provide false claims then share the benefits.
  • • Even the medical provider can try to scam for benefits by taking advantage of patients with true injuries by over-billing for necessary medical services, providing additional treatments that are not necessary, and charging for medical treatments and services that are never even provided to the injured worker.

Prosecution of Applicant / Claimant Fraud

The Nevada’s Department of Business and Industry oversees the laws that affect benefits and frequently performs audits on the legitimacy of such claims. If it is suspected that an allegedly injured worker may be lying in an effort to receive benefits, the case is prosecuted through the Workers Compensation Unit of the Nevada Attorney General’s Office. In addition to the applicant, anyone who helped the alleged injured worker to receive non-entitled benefits will face charges as well. Additional charges imposed by the state may include grand larceny, perjury, and forgery.

Federal Laws regarding Applicant / Claimant Fraud

Federal workers who are eligible for benefits under the Federal Employees’ Compensation Act (FECA) may face federal charges similar to those at the state level if they falsely try to obtain benefits to which they are not entitled.

Defense to Nevada Workers Comp Applicant / Claimant Fraud

If a claimant is accused of falsely obtaining benefits, there are several defenses that may be used as a defense. These include no intent to defraud, false accusations, and police misconduct.

No intent to defraud may be used if the injured worker did not intentionally use deceit in order to obtain benefits. Mistakes and misunderstandings will not result in punishment if fraudulent intent was not present.

False accusations may occur, especially if the party in the process who actually committed the offense made these claims. Because so many parties are involved in the process, careful investigation will uncover those actually responsible for committing the offense.

Police misconduct may occur because of an unlawful search. Any evidence obtained will have to be suppressed, often resulting in a dismissal due to lack of evidence.
Penalties for Nevada Workers Comp Applicant / Claimant Fraud

There are many penalties that may be imposed for those found guilty of fraudulently obtaining state-sponsored workers’ comp benefits. These include:

  • • Fines up to $5,000
  • • Imprisonment of 1 -4 years
  • • Repayment of fraudulently received benefits
  • • Temporary loss or permanent revocation of professional licenses
  • • Ineligibility to receive workers’ comp benefits in the future

Fraudulently obtained federal workers’ comp benefits may incur a punishment of $10,000 in fines, 5 years in federal prison, and loss of FECA benefits, including medical care and lost wage reimbursement.

Legal Resources for Nevada Workers Compensation Fraud

If you are accused of fraudulently obtaining benefits, the Morris / Anderson Law Firm can help. Our experienced attorneys can help obtain the necessary information to build a case to give you the best defense possible.

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