What Happens if You are Caught Committing Workers’ Compensation Fraud in Arizona?

12 Sep What Happens if You are Caught Committing Workers’ Compensation Fraud in Arizona?

If you are injured in a job-related accident, you must list all the injuries and associated injuries that occurred when the accident happened. Never lie on a government document as you could face felony charges if it is proven that an injury you made a claim for, is not really the truth.

Logical Injury Claims

            Injuries can be so severe that you may have lost fingers or the whole hand, an arm, a foot, or other visibly distressing losses. There is no question that you would be immediately approved and receive your benefits. Your case would hardly be considered as a case of fraud.

 

           Injuries to the spine causing misalignments are also visibly obvious when a person stands before a Workers’ Compensation medical reviewer. The misalignment shows the hip out of place, or that the upper torso is not aligned properly with the hips and leg stance. X-rays show more clearly where the problems are in the spine, and this evidence gives an almost automatic approval of your claim, whether it be a temporary situation or one that cannot be fixed.

Less Obvious Claims of Injuries

            Strained or torn muscles and tendons are less obvious, although doctors can test your movement capabilities, as well as have x-rays and an MRI done to see what any structural damage has occurred.  Tendons can be seen on x-ray and if one has pulled away from the bone in one area, then this is the cause of your muscle pain.

MRIs will show any area where a hematoma has occurred, due to an injury in which blood is collecting, because of a partial or full tear. Always be sure to follow any recovery instructions your doctor gives to you, and do not deviate from the recovery plan.

Documentation is Everything to Achieving a Successful Outcome

            If your injury can be documented by a doctor through the consultation, exam, and any x-rays, MRIs, and mobility tests, then you will have a better chance of receiving temporary disability benefits, until you finish recovery. Follow the doctor’s instructions.

Claiming an Injury but Seen Playing Football on the Nearby Football Field

           Arizona is not above using private investigators to monitor your daily activity if your claim is somewhat questionable. This can happen in any state in the U.S. Do not claim that you are injured, only to later show up at the local baseball or football field, playing ball games with others.

            If you are receiving benefits because of your claim, even though the doctor could not find anything physically or structurally wrong with you, but you claim you have a lot of pain, stay home and recuperate. If you are caught being actively engaged in any physical activities that adversely affect your supposed injury, you may be accused of fraud.

Penalties for Fraud

            Arizona Revised Statute (A.R.S.) § 20-463 governs fraud and you could receive a conviction of a Class Six Felony. This means you may spend up to 10 years in prison, be fined up to $150,000 or, at least be liable for repaying to the state all your benefits received so far. You may also receive a fine of $5,000 for each violation of fraud uncovered in your claim which you signed off on. If you need help filing your workers’ compensation claim the right way, call us at once and let us help you every step of the way to receiving your rightful benefits. 602-346-9009

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