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What if You’re Accused of Fraud in a Pennsylvania Workers’ Comp Case?

Being called a liar is not necessarily going to result in fraud charges.  However, accusations of fraud or deceit can hurt your claim for Workers’ Comp benefits.

It may merely be your employer’s case strategy to call you a liar or poke holes in your case without them outright accusing you of criminal fraud.  This could even be an attempt to scare you away from filing a claim.  However, our lawyers can review your case and put forth the true facts, and the court must follow the facts.  If you did actually commit fraud, you would typically lose your benefits, and criminal charges could follow.

For a free evaluation of your injury claim, call Cardamone Law’s Certified Pennsylvania Workers’ Compensation Lawyers at (267) 651-7945.

What if I’m Accused of Lying in a Workers’ Comp Claim?

In a Workers’ Comp case, the defendant employer wants to win.  This often means you will be accused of lying, or at least misremembering what happened.  However, the judge’s decisions usually do not go beyond deciding what happened; they do not investigate fraud.

The judge can make many findings short of calling you a liar:

  • That you were wrong
  • That you misremembered facts
  • That you misinterpreted facts or
  • That your evidence simply fails to prove your case.

Fraud accusations are only taken seriously when the judge witnesses potential criminal activity or when the lies are clear enough that the insurance company refers your case to the police.

How Can My Lawyer Help?

As lawyers, we have legal and ethical rules that require us to stand up for you, but we also have rules against lying or allowing lies to go uncorrected.  This actually helps your case in a few ways:

Lawyers Cannot Suborn Perjury

We will not be able to take a case based on lies and fraud.  We also cannot let lies go uncorrected in the record.  This potentially qualifies as “suborning perjury” and can get a lawyer disbarred or disciplined.

Ultimately, this means we cannot file your case unless the evidence shows us it is true from the beginning.

Judges Trust Lawyers

Because of these standards, judges often trust attorneys and will be willing to hear us out and make a fair decision.  That means that even when the defendant accuses you of lying out of the gate, the judge will consider both sides before making any rulings about the facts.

Most cases present two competing narratives, and it is always up to the court to figure out the truth.

We Can Present Evidence

You deserve your day in court to present facts and evidence to the judge.  If we have reasonable evidence that your claim is true, then the judge can review it and make their own determination, no matter how wild the defense’s accusations might be.

What Constitutes Workers’ Comp Fraud?

Fraud requires more than simply being wrong.  There must be an intent to lie, even though you know the truth, with the goal of getting benefits or money you are not otherwise entitled to.  This comes up in Workers’ Comp cases in a few common ways:

  • Using false names
  • Injuring yourself on purpose, then making up a story to claim benefits
  • Trying to pass off an outside injury as work-related
  • Falsifying medical records or doctors’ reports
  • Lying on forms or under oath.

How is Fraud Reported?

The judge can dismiss your claim because they think you are lying or wrong, but even this is often not enough for an actual referral to the police.

Report By Employer/Insurance Carrier

It isn’t fraud just because your opponent in the case says you are wrong.  Instead, the employer or insurance carrier needs to see more serious evidence of fraud before they will present it to the police – and the police need probable cause to charge you.

Report By Judge

The judge will also typically avoid referring you to the authorities unless they have concrete proof of your lies or fraudulent activity and actually witness it firsthand.

Report By Employee

You can also report fraud to the Department of Labor and Industry if you believe your employer, the insurance carrier, or your care provider is committing fraud.

Can I Lose My Case if I Lie?

Your case is often based on your story being true.  If you are wrong, make mistakes, misremember facts, or intentionally lie about the facts, then the judge is likely to dismiss your case.

Our Pennsylvania Workers’ Comp lawyers are also ethically obligated, as officers of the court, to correct lies and mistakes when they arise.  That means that if you do lie, we will have to present the truth to correct it.  We can only rely on the facts as they are, not as we would like them to be.

FAQs About Fraud in Workers’ Comp Cases

Do Workers’ Comp Judges Charge You with Fraud?

Workers’ Comp Judges may have the ability to penalize you with fines if they find you are committing fraud or perjury in a case before them.  They can also certainly dismiss the case and refer you to the authorities.

However, only the police and the DA can actually charge you with fraud.  They cannot do so without probable cause.

If I’m Telling the Truth, Can I Get Damages for Fraud Accusations?

Defendants must have some reasonable belief that you lied to outright accuse you of serious wrongdoing, like fraud or perjury.  If they do not, and they deny your Workers’ Comp claim without reasonable grounds, they could potentially be on the hook for Workers’ Comp penalties.  Baseless fraud accusations could even be grounds for a defamation lawsuit.

Because of this, fraud accusations are not common without some reasonable basis behind them.

Can I Be Charged with Fraud if I Make a Mistake?

Workers’ Compensation is a very serious system, and you must tell the truth on all forms and in all testimony and statements to the court.  However, mistakes happen, and we can correct the record if it does.

Merely making a mistake does not meet the intent requirement for fraud charges.  Plus, if every mistake were charged as fraud, everyone would be too afraid to file any legal claims.

Call Our Workers’ Comp Lawyers in Pennsylvania Today

If you need help proving your true Workers’ Comp claim, call our Philadelphia Workers’ Comp lawyers for a free case review at Cardamone Law at (267) 651-7945.

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