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New Workers’ Comp Fraud Law Penalties

Webster & Carlton

What are the Penalties Under the New Workers′ Compensation Fraud Law?

Both employers and employees face serious criminal penalties for violating Missouri’s new workers’ compensation fraud laws.

Workers’ compensation provides a safety net for employees when on-the-job accidents and injuries occur. While it is a federally mandated program, it is up to individual states to oversee how benefits are administered and processed. In Missouri, workers’ compensation laws have been updated to increase the penalties involved in cases of fraud. Employees face serious criminal charges for filing false or misleading claims, while employers and insurers can find themselves liable for engaging in deceptive practices and discouraging workers from filing for benefits.

Penalties for Workers’ Compensation Fraud

The Missouri Division of Workers Compensation (DWC) is responsible for overseeing benefits available to employees who become injured or ill on the job or during the course of work related activities. These benefits include payment of medical expenses along with compensation for lost wages and temporary or permanent disabilities and can add up to significant amounts of money. The DWC is vigilant in screening applicants and the details surrounding their claims, in order to prevent cases involving workers’ compensation fraud. Fraud is a crime that involves knowingly deceiving or misleading others and misrepresenting facts for personal gain. The Department of Labor (DOL) warns that new laws increase the criminal penalties associated with workers’ compensation fraud in Missouri. These cover actions such as:

  • Knowingly presenting a false or fraudulent claim for payment of workers’ compensation benefits;
  • Knowingly presenting multiple claims for the same injury or illness;
  • Knowingly assisting or conspiring with another to obtain fraudulent benefits;
  • Submitting claims for health care benefits which were never used or required.

Under Missouri workers’ compensation laws, a first offense for any of the above actions is categorized as a Class E felony. This is punishable by a $10,000 fine or double the value of the amount obtained through the fraud, as well as up to a four-year prison sentence. A second offense is classified as a Class D felony, with similar fines but an increased jail sentence of up to seven years.

Employers and Insurers can Also be Held Liable

Employers and the insurance companies that represent them can also be held liable for workers’ compensation fraud and for attempts to defraud employees of benefits to which they are entitled. They can face felony charges, along with civil liability, for the following types of actions:

  • For refusing to comply with workers’ compensation obligations with the intent to defraud;
  • For knowingly providing or preparing an invalid certificate of insurance as proof of workers’ compensation coverage;
  • For making false statements with the intent of discouraging an employee from filing a workers’ compensation claim.

Our Missouri Workers’ Compensation Attorneys are Here to Help You

At The Law Firm of Webster & Carlton, we work to protect your rights when dealing with employers, their insurers, and the DWC so that you can get the benefits to which you are entitled. If you are injured on the job, call or contact our Missouri workers’ compensation attorneys online to request a free consultation today.

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