Workers’ Compensation Fraud occurs when someone knowingly makes a false representation of a material fact to obtain or to deny workers’ compensation benefits or to avoid responsibility under the law.
Here are a few examples of a worker committing fraud:
A worker commits a fraud by misrepresenting his / her job status while collecting temporary disability benefits, a worker commits fraud by filing a claim for an injury that did not occur on or has no relation to the job, a worker commits fraud by knowingly misrepresenting his / her physical condition to obtain Workers’ Compensation benefits, or a worker commits fraud by misrepresenting previous trauma or treatment.
Workers’ compensation fraud is governed by the New Jersey Workers’ Compensation Statute, N.J.S.A. 34:15-57.4. This statute provides that a criminal violation occurs if a misrepresentation is made for the purpose of wrongfully obtaining benefits or withholding benefits or premiums regarding workers’ compensation. If an individual wrongfully obtains benefits, a Judge of Compensation has discretion to terminate benefits and order the forfeiture of benefits that might otherwise be properly received.
Under NJSA 34:15-57.4, a person who purposely or knowingly makes a false or misleading statement for the purpose of wrongfully obtaining benefits shall be guilty of a crime of the fourth degree. If that person has received benefits to which the person is not entitled, he is liable to repay that sum plus simple interest to the employer or the carrier or have the sum plus simple interest deducted from future benefits payable to that person, and the division shall issue an order providing for the repayment or deduction. The Division of Workers’ Compensation may also order the immediate termination or denial of benefits with respect to that claim and a forfeiture of all rights of compensation or payments sought with respect to the claim.
The Division of Workers’ Compensation is committed to preserving the integrity of the system. If you suspect fraudulent activity by a worker with respect to a pending workers’ compensation case, please contact the following:
NJ Division of Workers’ Compensation
Attn: WC Fraud Coordinator
PO Box 381. Trenton, NJ 08625-0381
(609) 292-2414, FAX (609) (609) 984-2515,
Your referral will be kept completely confidential.