Workers' Compensation Fraud in California - Insurance Code 1871.4
Workers' compensation fraud laws are defined under California Insurance Code 1871.4, Penal Code 549, and 550 PC. This form of insurance pays employees for an injury or disability occurring where they work.
It's imperative to grasp the gravity of workers' compensation fraud laws. Any attempt to receive payment from a compensation claim one is not entitled to is a serious violation.
California workers' compensation fraud laws can be violated by:
- Knowingly making a false statement, or
- Encouraging someone else to make false statements to receive insurance benefits,
- submitting multiple claims for the same treatment.
A typical example of workers' compensation fraud is when someone falsely claims they were injured while at work, but the injury occurred at another location unrelated to their employment.
Workers' compensation fraud cases are usually “wobblers,” which can be charged as a misdemeanor or felony.
Our Los Angeles criminal defense lawyers are reviewing the law below for additional information.
California Insurance Code 1871.4
Insurance Code 1871.4 is used by prosecutors to file most workers' compensation fraud cases, which is described under the False and Fraudulent Claims Act. This statute is defined as:
- “Knowingly making a false or fraudulent statement, either written or a material representation, to obtain insurance benefits. Knowingly assisting, aiding, conspiracy, or soliciting a person to recover insurance benefits without cause.”
Workers' compensation is an insurance policy employers pay injured employees to cover medical expenses, lost wages, permanent disability, and death benefits.
To receive insurance benefits, the employee doesn't have to prove their injury was someone else's fault.
You can violate Insurance Code 1871.4 in many different ways, such as:
- claiming a non-work-related injury occurred at work,
- claim a fake injury or falsely exaggerate the seriousness of an injury,
- falsely stating no previous claims were filed,
- failing to disclose a previous injury,
- collecting insurance benefits from several employers for the same injury,
- working another job while receiving benefits (double-dipping).
California Penal Code 549 and 550 PC
California Penal Code 549 PC describes how a business owner can commit the crime of workers' compensation fraud.
California Penal Code 550 PC describes how workers' compensation fraud is connected to health care fraud.
Other related statutes include Penal Code 487 PC grand theft, Penal Code 470 PC forgery, and Penal Code 118 PC perjury.
Penalties
If convicted of a misdemeanor violation of workers' compensation fraud, it's punishable by:
- up to one year in a county jail,
- a maximum fine of $150,000, or two times the amount of fraud,
- payment of restitution to employer and insurance company
If convicted of felony workers' compensation fraud, the consequences are severe. The offense can result in up to five years in a California state prison, a maximum fine of $150,000 or double the amount of fraud, and restitution.
Defending Workers' Compensation Fraud Cases
Workers' compensation fraud charges are being increasingly filed across Los Angeles County, a jurisdiction that spans over 40 courthouses. With nearly three decades of experience, I have successfully defended numerous individuals facing these serious charges. The prospect of imprisonment is a legitimate concern in such cases.
I've been practicing there for almost three decades and have successfully defended people with workers' compensation-related charges. Being concerned about going to jail or prison if you're charged with these charges is a legitimate concern.
When you're taking any government money and claiming some injury or loss and lying about it or putting in multiple claims or falsifying any documentation, and they've got the evidence to prove the same, you've got a real problem because stealing from the government is like stealing from the mafia.
They get a piece of everything; if you take any of their money unlawfully, they will come after you. They have unlimited funds, investigation power, and authority regarding these types of offenses.
Judges and prosecutors bow down to the government in workers' compensation fraud-related offenses and will settle most arguments in their favor.
Guiding You Through a Difficult Situation
That's why the first thing you need to do if you're charged with a workers' compensation fraud-related offense or if you're being investigated is to get a great attorney because your attorney is going to be the one who will help guide you through a prickly situation when the government is coming after you and when their agents are coming after you:
- I get right to the forefront;
- I deal with the government;
- I deal with their agents;
- I deal with the prosecutors;
- I deal with the police;
- I deal with the Insurance Commission.
In a workers' compensation fraud-type situation, the government is trying to help injured employees.
They're making employers get specific insurance to protect employees, so if they get hurt or injured on the job, they can be compensated, and their boss won't cheat them.
But if you then try to cheat the system in any way, or a boss or an employer tries to cheat the situation in any way, then that strikes at the fabric of our workers' compensation employment process, and it puts you in a position where they're going to try to punish you; they're going to try to make an example of you.
Despite the seriousness of the situation, there is always room for negotiation to achieve the best possible outcome in your case.
So, we need to take you out of that mold where they're making an example of you. We need to show other things about you — your history, record, future, family, and what happened in this case.
When you give your side of the story and explain why you found yourself in this position, we have to figure out what you will do about it to make things right.
If you can pay the money back, that's a good start. That will help you with the prosecutors, who feel they must get this money back. However, you must pay the money back anyway if you're guilty of the crimes. If you don't, the consequences could be severe.
But if you can pay it back up front, you now have the leverage to negotiate a solid deal for yourself to preserve your rights, freedom, and future.
Do you want to stay out of jail? Do you want to keep out of prison? Give them their money back, explain why you did what you did, and let your attorney work for you.
When you come in, we'll strategize together. Your honesty about the situation is crucial. I will guide you through the legal system, resolve the issue as swiftly as possible, and achieve the best possible outcome.
Hedding Law Firm is in Los Angeles County at 16000 Ventura Blvd #1208 Encino, CA 91436.
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