Insured Solutions
Insured Solutions

What are the penalties to an employee who makes a false claim?

Workers’ comp fraud is illegal and states levy fines (up to $10k) plus jail time (up to 2 years) to anyone caught lying about an injury. Even though employees can be prosecuted, instances are rare.

Only three states – Illinois, Florida and California – appear to actively go after employee workers’ comp fraud. Of the millions of workers’ comp claims, only a handful - 15-20 - are ever prosecuted in any given year.

As an example, from 1920 to 2010, Georgia administered over 13.6 million WC claims. Using traditional statistics, 20% of those were lost-time based, or those subject to prosecution, and 80% were medical only (MO) – meaning about 272,000 claims could have been investigated for fraud.

Georgia, in that 30-year timeframe, had ZERO prosecutions out of those 270,000 claims. Reason? The state does not have the money to prosecute individuals. But above that – their mission is to protect employees and make employers adhere to the rules of protecting employees, not to go after those they serve.

Since states have no problem going after employers if they fail to meet WC obligations, employers must protect themselves through the hiring process. Avoid hiring the wrong person and an employer can head off issues before they happen.