Workers’ compensation fraud is a big problem for the insurance companies that pay workers’ compensation benefits. Fraud by injured employees results in insurance carriers having to make payments, while fraud by employers means insurers do not collect full premiums.
The Florida Department of Financial Services takes allegations of insurance fraud very seriously, which is why it is important to remember to always be completely honest when filing for any kind of workers’ compensation benefits. Employers can be especially quick to invoke statutory defenses against any suspected false statement by an injured worker because certain violations of state law will result in the employee being ineligible for any workers’ compensation benefits.
Lawyer for Workers’ Compensation Misrepresentation in Miami, FL
Did you suffer a serious injury on the job in South Florida? It is important to be very careful with all statements that you make and all paperwork you sign in your effort to obtain workers’ compensation benefits, and The Hoffman Firm can help so you get the compensation you need and deserve.
Evan A. Hoffman is an experienced workers’ compensation attorney in Miami who represents clients all over Miami-Dade County, Broward County, and Palm Beach County. He can provide a full evaluation of your case when you call (305) 940-2307 to take advantage of a free, confidential consultation.
Florida Workers’ Compensation Fraud Information Center
- How might employees commit workers’ compensation fraud?
- What are some of the ways that employers commit workers’ compensation fraud?
- Where can I learn more about misrepresentation in South Florida workers’ compensation cases?
Florida Statute § 440.09(4)(a) establishes that an employee will not be entitled to workers’ compensation benefits if any judge of compensation claims (JCC), administrative law judge, court, or jury determines that he or she knowingly or intentionally engaged in any of the acts described in Florida Statute § 440.105 or any criminal act for the purpose of securing workers’ compensation benefits. Florida Statute § 440.105 establishes several prohibited activities, including:
- Knowingly making, or causing to be made, any false, fraudulent, or misleading oral or written statement for the purpose of obtaining any workers’ compensation benefit or payment;
- Presenting or causing to be presented any written or oral statement as part of, or in support of, a workers’ compensation claim for payment or other benefit, knowing that such statement contains any false, incomplete, or misleading information concerning any fact or thing material to such claim;
- Preparing or causing to be prepared any written or oral statement that is intended to be presented to any employer, insurance company, or self-insured program in connection with, or in support of, any workers’ compensation claim for payment or other benefit, knowing that such statement contains any false, incomplete, or misleading information concerning any fact or thing material to such claim;
- Knowingly assisting, conspiring with, or urging any person to engage in activity prohibited by this section;
- Knowingly making any false, fraudulent, or misleading oral or written statement, or knowingly omitting or concealing required material information for the purpose of obtaining workers’ compensation coverage; and
- Knowingly presenting or causing to be presented any false, fraudulent, or misleading oral or written statement to any person as evidence of identity for the purpose of obtaining employment or filing or supporting a claim for workers’ compensation benefits.
In addition to loss of eligibility for any workers’ compensation benefits, any of the violations listed above are also felony offenses. The specific classification of the crime depends on the monetary value involved, with violations involving less than $20,000 being third-degree felony offenses and violations involving $100,000 or more being first-degree felony offenses.
Employers can also face criminal charges and other penalties for violations of Florida Statute § 440.105. Presenting any false, fraudulent, or misleading oral or written statement as evidence of securing payment of workers’ compensation in compliance with Florida Statute § 440.38 and making deductions from the pay of any employee for the purpose of requiring the employee to pay any portion of premium paid by the employer to a workers’ compensation insurance carrier are violations of Florida Statute § 440.105(4)(a).
Among other violations listen in this chapter, Florida Statute § 440.105(2)(a) makes it unlawful for an employer to knowingly:
- Coerce or attempt to coerce, as a precondition to employment or otherwise, an employee to obtain a certificate of election of exemption from being covered by workers’ compensation insurance;
- Discharge or refuse to hire an employee or job applicant because the employee or applicant has filed a claim for workers’ compensation benefits; or
- Discharge, discipline, or take any other adverse personnel action against any employee for disclosing information to the department or any law enforcement agency relating to any violation or suspected violation of any of state workers’ compensation laws.
The Bureau of Workers Compensation Fraud (BWCI) | Florida Department of Financial Services — The Bureau of Workers’ Compensation (WC) Fraud has a Bureau squad in Miami and four other areas of the state. It handles such referrals as working without workers’ compensation coverage, claimant fraud, premium fraud, and money service business fraud. The Department of Financial Services offers a $25,000 reward to anybody who provides information “leading to the arrest and conviction of persons committing insurance fraud, including employers who illegally fail to obtain workers' compensation coverage.”
Division of Insurance Fraud
Miami Field Office
40l N.W. 2 Avenue, Suite N-32l
Miami, FL 33128
Matrix Employee Leasing v. Leopoldo Hernandez, Case No. 1D07-1455 — Leopoldo Hernandez presented what appeared to be a valid Social Security card when he was hired to work for Matrix Employee Leasing. Matrix appealed the JCC’s decision to allow Hernandez to collect workers’ compensation benefits despite having used a false Social Security card to obtain employment. The First District Court of Appeal affirmed the lower court’s decision because it said Hernandez did not use the false Social Security card for the purpose of obtaining workers’ compensation benefits.
The Hoffman Firm | Miami Workers’ Compensation Misrepresentation Lawyer
If you or your loved one sustained a catastrophic injury on the job in South Florida, it will be in your best interest to retain legal counsel as soon as possible so you can be sure that you do not make any kind of accidental misstatement that is later used to deny your benefits. The Hoffman Firm represents clients throughout the greater Miami area, including Aventura, Hallandale Beach, Boynton Beach, Fort Lauderdale, West Palm Beach, Miami Beach, Homestead, and several other nearby areas.
Miami workers’ compensation attorney Evan A. Hoffman represents clients on a contingency fee basis so you do not have to pay one cent unless you receive a financial award. You can have our lawyer review your case and answer all of your legal questions as soon as you call (305) 940-2307 or complete an online contact form to schedule a free consultation.
Evan A. Hoffman
Mr. Hoffman’s philosophy is "our knowledge and experience is your best defense." He has been a featured author on criminal law issues such as driving under the influence, domestic violence and illegal searches.Read More