Fraud is a hot topic in workers’ compensation, not only in New Jersey, but across the country. If you are found to be guilty of fraud in New Jersey, you are subject to both criminal and civil penalties. Civil penalties may include: termination of your benefits, forfeiture of future benefits, and repayment of benefits obtained due to the fraudulent act with interest. Fraud is a crime of the fourth degree in New Jersey.
Fraud is defined as “a false or misleading statement, representation or submission concerning any fact that is material to that claim for the purpose of wrongfully obtaining benefits;”,see NJSA 34:15-57.4 (1). Aside from the most egregious cases, what constitutes fraud in New Jersey? Some not so obvious examples of fraud include misrepresenting your job status while collecting temporary disability, misrepresenting a previous injury, or knowingly misrepresenting the nature of your physical condition.
If you are working in any capacity, you may not also collect workers’ compensation temporary disability benefits. This includes working your part-time job if you were injured on your full-time job and vice versa. If your doctor told you that you could continue your part-time work because it does not require the same level of physical exertion that your full time job does, you may work, but you are not entitled to collect workers’ compensation benefits at the same time. Most people that have a second job do so to make ends meet and this rule puts injured workers in a tight spot. However, if you are caught, you may face criminal and civil penalties. If you had a previous injury to the same part of your body, and you do not divulge that information during the prosecution of your workers’ compensation claim, you could also be found guilty of committing fraud. It is important that you reveal any and all prior accidents, injuries and surgeries to guarantee your credibility. It may be difficult to remember which knee you injured in that car accident 25 years ago, but you should make every effort to provide enough information so that it can be further investigated. If you tell your workers’ compensation carrier or medical providers that you cannot do certain things and you are videotaped doing them, be prepared to see yourself on the news. In order to receive an award of permanent disability in New Jersey, you must have evidence of a permanent disability that affects your daily or working life. If you have no residual problems, then you do not have a permanent disability. You should never exaggerate or over state your physical problems to build up your case. You may very well have a serious injury and have an award coming to you, but if you fudge the truth, you may lose your right to the benefits.
It is important that you understand what your obligations under the workers’ compensation laws include. As always, we offer free consultations and our fees are contingent upon you receiving an award. Our experienced attorneys and staff look forward helping you navigate through the workers’ compensation system.
Vicki Beyer is a Shareholder in Stark & Stark’s Lawrenceville, New Jersey office, concentrating in Workers’ Compensation Law. For more information, please contact Ms. Beyer.