Workers’ Compensation: A Cautionary Tale

Claimant, an outdoor technician, suffered work related injuries to both of his knees.  The case was established by the Workers’ Compensation Board and the claimant was collecting weekly benefits while not working for the employer.  Although there was no dispute over the claimant’s work related injuries, the insurance carrier raised the issue of fraud.  The carrier alleged that the claimant was working in another capacity while he was out of work.  The insurance company obtained videotape surveillance of the claimant performing activities, which they claimed were inconsistent with the degree of disability he allegedly suffered.  The carrier also alleged that the claimant filled out a questionnaire at an appointment with the insurance company doctor (IME) stating the following: the claimant was only able to walk one block, could only stand for one hour, was not working and unable to drive.

The videotaped evidence was viewed during trial showing the claimant working as a volunteer youth athletic coach, walking more than the equivalent of one block, standing for more than one hour and driving a vehicle.  The carrier also produced evidence that the claimant maintained and promoted a separate business through the internet.  The Workers’ Compensation Board Panel determined that the claimant knowingly made false statements and representations of material fact for the purpose of obtaining compensation benefits and entered a finding that he committed fraud.  As a result, the claimant is barred from obtaining monetary compensation for his injury.

Claimants must be very careful if they are out of work and claiming weekly benefits.  The insurance company will closely review Workers’ Compensation forms, doctor’s reports and your activities.   Even if you are not getting paid while doing an activity, you must report that activity.   The insurance companies have become very aggressive in pursuing claims of fraud.  If you suffered an injury you should speak with us about what you can and cannot do while seeking Workers’ Compensation benefits.

–Written/Submitted by FOA Attorney Robert Seidner, Esq.

Dear Friends and Clients,

Our firm is dedicated to act with compassion, concern and commitment to our clients, community and colleagues. As such, we have been taking precautions to ensure that we are still fulfilling our ethical and moral obligation to our clients, while also ensuring the health and safety of our employees.

Until further notice, our offices will be closed to the public to encourage social distancing and to help prevent the spread of COVID-19. Our team is still hard at work, most from home, and you may still call, email, live chat or video conference us if you or a loved one is seeking legal assistance. As the first law firm to offer our clients secure online access to their case file more than a decade ago, we have always been believers in using technology to make life easier and information more accessible. In these present times it has been a smooth transition for us to continue to offer our clients the same seamless and thorough service that you deserve and are accustomed to.

This pandemic is unlike anything any of us have faced in our lifetimes, and while we can continue to emotionally support one another through it all, staying home and keeping your distance is vital to the health and wellness of our communities. It does not feel good to break routines, cancel events and retreat from our normal, day-to-day socializing, but let us remember that, in times of strife, prior generations were asked to go to war and we are simply being asked to stay home. Your isolation equals more lives saved, and more time for medical providers to prepare for the treatment of patients battling COVID-19.

When the dust settles, we will join together with a greater appreciation for the country we live in, local businesses, loved ones and health. Until then, we will continue to offer guidance and representation from a safe distance.

Very truly yours,

Marvin Anderman and the firm family of Fine, Olin & Anderman, LLP