Tag Archives: Fraud

New York Workers’ Compensation Webinar: Fraud Update (3 PM EST Session)

Title: “Fraud Update: New York Workers’ Compensation, 3 PM EST Session”

Register for our monthly webinar series:

Register for this Webinar, 3 PM EST Session

In this LIVE webinar on Monday, March 15, 2021 at 3 PM EST, Greg Lois leads a presentation and discussion on the impact of claim fraud on workers’ compensation in New York. This webinar is offered at two different times, always on the Third Monday of the month, at 12:00 PM and 3:00 PM EST.

We will discuss:

  • Recent case law decisions on fraud.
  • Tactical and strategic considerations in raising fraud.
  • Red flags for fraud in New York workers’ compensation cases.

Join us by registering for the New York Workers’ Compensation Webinar Series, 3 PM EST Session on March 15, 2021 at:

https://attendee.gotowebinar.com/register/7249849108834235650

After registering, you will receive a confirmation email containing information about joining the webinar. This webinar is also offered earlier, at 12 PM EST also the Third Monday of the month. You can register for the 12 PM EST Session here.

New York Workers’ Compensation Webinar: Fraud Update (12 PM EST Session)

Title: “Fraud Update, New York Workers’ Compensation, 12 PM EST Session”

Register for our monthly webinar series:

Register for this Webinar, 12 PM EST Session

In this LIVE webinar on Monday, March 15, 2021 at 12 PM EST, Greg Lois leads a presentation and discussion on the impact of claim fraud on workers’ compensation in New York. This webinar is offered at two different times, always on the Third Monday of the month, at 12:00 PM and 3:00 PM EST.

We will discuss:

  • Recent case law decisions on fraud.
  • Tactical and strategic considerations in raising fraud.
  • Red flags for fraud in New York workers’ compensation cases.

Join us by registering for the New York Workers’ Compensation Webinar Series, 12PM EST Session on Monday, March 15, 2021 12:00 PM EST at:

https://attendee.gotowebinar.com/register/2268573251846804738

After registering, you will receive a confirmation email containing information about joining the webinar. This webinar is also offered in a second session, also the Third Monday of the month, at 3 PM on the same day. You can register for the 3PM EST Session here.

New York Workers’ Compensation Webinar: Fraud Update (12 PM EST Session)

Title: “Fraud Update, New York Workers’ Compensation, 12 PM EST Session”

Register for our monthly webinar series:

Register for this Webinar, 12 PM EST Session

In this LIVE webinar on Monday, March 16, 2020 at 12 PM EST, Greg Lois leads a presentation and discussion on the impact of claim fraud on workers’ compensation in New York. This webinar is offered at two different times, always on the Third Monday of the month, at 12:00 PM and 3:00 PM EST.

We will discuss:

  • Recent case law decisions on fraud.
  • Tactical and strategic considerations in raising fraud.
  • Red flags for fraud in New York workers’ compensation cases.

Join us by registering for the New York Workers’ Compensation Webinar Series, 12PM EST Session on Monday, March 16, 2020 12:00 PM EST at:

https://attendee.gotowebinar.com/register/2268573251846804738

After registering, you will receive a confirmation email containing information about joining the webinar. This webinar is also offered in a second session, also the Third Monday of the month, at 3 PM on the same day. You can register for the 3PM EST Session here.

False Statements Made in New York State Workers’ Compensation Claims Can Lead to Forfeiture of Right to Receive Future Benefits

Joseph Melchionne
Joseph Melchionne, Esq.

New York State workers’ compensation fraud may take many forms and result in a myriad of consequences.  WLC § 114(a) not only governs circumstances of fraud but also describes significant penalties for those who are caught committing fraud such as a permanent ban on their eligibility to receive indemnity benefits and/or a permanency award.

WCL § 114(a)  directs that a claimant is to be penalized if he or she “knowingly makes a false statement or representation as to a material fact . . . .” in furtherance of receiving workers’ compensation benefits. This mandatory penalty is a forfeiture of all compensation that is directly attributed to the false statement.  Workers’ compensation fraud penalties only apply to indemnity benefits and permanency awards, paid medical benefits are not subject to forfeiture in a fraud determination. See Jacob v. New York City Transit Auth., 26 A.D.3d 631, 809 N.Y.S.2d 618 (App. Div. 2006); Matter of Robinson v. Interstate Natl. Dealer, 50 A.D.3d 1325 (3rd Dept. 2008).

Pursuant to WCL § 114(a):

“If for the purpose of obtaining compensation pursuant to section fifteen of this chapter, or for the purpose of influencing any determination regarding any such payment, a claimant knowingly makes a false statement or representation as to a material fact, such person shall be disqualified from receiving any compensation directly attributable to such false statement or representation.”
Continue reading False Statements Made in New York State Workers’ Compensation Claims Can Lead to Forfeiture of Right to Receive Future Benefits

Is this Workers’ Compensation Claim Fraud in New York?

  1. Claimant denies having gainful employment while collecting temporary disability benefits. He actually started up a small business, but the business lost money.
  2. Claimant says he applied for jobs at 34 different businesses while seeking benefits. The employer performed its own follow-up search and learned he applied for only two (2) jobs.New York Workers' Compensation law 2017
  3. Claimant lying about his physical restrictions to our IME doctor
  4. Concealing volunteer work while “too disabled” to do your regular job?
  5. Caught selling street drugs while collecting workers’ compensation benefits?
  6. Claimant first admits to working, but her attorneys later state she isn’t. Claimant later found working seasonally while collecting benefits.
    Continue reading Is this Workers’ Compensation Claim Fraud in New York?

Appellate Division Rules Misrepresentations by the Claimant to an IME Is Sufficient for Fraud Finding

In New York, pursuant to Workers’ Compensation Law § 114-a (1), a claimant may be disqualified from receiving workers’ compensation benefits “[i]f for the purpose of obtaining compensation . . . or for the purpose of influencing any determination regarding any such payment, [he or she] knowingly makes a false statement or representation as to a material fact.”    A fact is “material” if it is “significant or essential to the issue or matter at hand,” and it need not be demonstrated here that claimant received compensation to which he was not otherwise entitled or that he did not sustain a compensable injury (Matter of Losurdo v Asbestos Free, 1 NY3d 258, 265 [2003].

Jeremy Janis
Jeremy janis, Esq.

Recently the Third Department of the New York Appellate Division entertained an appeal in which the claimant was disqualified from receiving future benefits and forced to pay back past benefits as a result of violating Workers’ Compensation Law § 114-a, therefore committing fraud.  The case, Matter of Poupore v Clinton County Highway Dept. 2016 NY Slip Op 03037 was decided on April 21, 2016.  In this case, the penalty imposed by the Law Judge and the Board Panel was upheld on appeal.

Continue reading Appellate Division Rules Misrepresentations by the Claimant to an IME Is Sufficient for Fraud Finding