Game show winner accused of workers’ comp fraud

Workers’ compensation benefits are designed to help those who are injured during the course of employment receive compensation without having to go through a lengthy litigation process. If approved, a claim can provide the employee with the funds needed to cover medical expenses and potentially provide compensation for missed wages.

Although most who apply for workers’ compensation benefits have valid injuries, some may attempt to take advantage of the system. Recently, one worker who received these benefits was caught on television completing a physical task that she should be unable to do with the injury that led to the workers’ comp claim: spinning the giant wheel on “The Price is Right.”

The postal worker claimed she was unable to lift mail trays into her truck because of a shoulder injury she received while working. The claim was accepted and the woman was receiving payments for the injury, an injury that allegedly resulted in an inability to sit, stand, squat, reach or grasp. In order to spin the wheel the woman needed to stand, reach and grasp. All activities she claimed she was unable to complete.

This current event provides an opportunity to review the workers’ compensation benefits that are available in California and tips on how, in the midst of fraudulent claims, to better ensure a valid claim is accepted.

Is workers’ comp fraud a problem in California?

The workers’ compensation program in California allows injured workers to receive payment to cover medical expenses and, in some cases, a portion of their salary when injured on the job. Some employees may seek to take advantage of these benefits by filing a false claim. The Fraud Division of California reported 254 workers’ comp fraud arrests in 2010 and a potential loss of over $275 million.

Not only is fabricating injuries for the purpose of receiving these benefits a felony, but, according to the California Department of Insurance it also raises the cost of insurance to “policyholders, taxpayers and the general public.” It is important to note that the vast majority of the overall cost is taken directly out of the insurance company’s profits; only a small amount is passed down the line.

How can I increase the odd of success for my valid workers’ comp claim?

The occurrence of fraud in California can make it difficult for a valid claim to be accepted.

If you are injured on the job, you are entitled to receive help paying for medical care by your employer and payments of lost wages if unable to continue to work. Contact an experienced California workers’ compensation benefits lawyer to increase the odds of a successful application.