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Workers' Compensation Fraud

In Florida, when an employee is injured while on the job, he or she will most likely be eligible for workers’ compensation benefits, regardless of who was at fault. Because it plays such an important role in the lives of injured employees, government agencies carefully police the workers’ compensation program. Unfortunately, this can lead to innocent people being accused of fraud when they were unaware that their actions were illegal. If you live in south Florida and are being investigated for workers’ compensation fraud, it is crucial to contact an experienced white collar crime attorney who can protect your interests.

Fraudulent Activity

A person can be convicted of workers’ compensation fraud if he or she knowingly, and with intent to deceive or defraud an employer, employee, self-insured program, or insurance carrier, filed false or misleading information to obtain workers’ compensation benefits. In Florida, workers’ compensation fraud is broken up into two categories, which include claimant fraud and premium fraud. Claimant fraud involves fraudulent action on the part of an employee who is attempting to file a claim for compensation. Charges of claimant fraud often include allegations of lying about where an injury occurred or exaggerating the extent of an injury.

Premium fraud, on the other hand, occurs when an insurer or employer attempts to avoid paying compensation claims by:

  • Misrepresenting the number of employees on payroll;
  • Misclassifying employees;
  • Concealing information about an employee’s injury;
  • Failing to provide workers’ compensation benefits to employees; and
  • Violating a stop-work order issued by the Department of Labor.

Healthcare providers can also be charged with fraud if they engage in any of the following activities:

  • Provide unnecessary testing or treatment;
  • Bill for treatments that were never administered; and
  • Bill twice for the same services.

Physicians and attorneys who help someone commit workers’ compensation fraud can also be charged under Florida law.

Potential Penalties

The severity of a workers’ compensation charge depends in large part on the monetary value of the fraudulent activity. For instance, if the value of a violation was less than $20,000, a defendant can be charged with a third degree felony, which is punishable by five years in prison and a $5,000 fine. However, if the alleged fraudulent activity resulted in a loss of more than $20,000, but less than $100,000, the accused can be charged with a second degree felony, which carries the much harsher penalties of 15 years in prison and a $10,000 fine. Finally, an offender whose claim was worth more than $100,000 faces a 30 year prison sentence.

Consult With an Experienced White Collar Crime Attorney Today

Workers’ compensation charges can lead to prison time and expensive fines. With so much at stake, it is especially critical for those who have been charged with workers’ compensation fraud to contact an experienced Miami white collar crime attorney who may be able to get their charges reduced or even dismissed. If you are being investigated for fraud in relation to a workers’ compensation claim, please contact Jeffrey S. Weiner, P.A. Criminal Defense Attorneys by calling (305) 670-9919 or by initiating a live chat with a dedicated member of our legal team today.



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