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NYC Workers Comp Fraud Lawyers

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NYC Workers Comp Fraud Lawyers

The workers comp system helps protect employees who are injured on the job. Injured workers don’t need to prove negligence, in order to get their disability benefits, or to get medical bills covered pertaining to the on-the-job injuries. As long as the employee shows the injury, illness, was from work tasks – the employee gets the benefits. The benefits can be big, especially if the employee can no longer work due to the disabling illness or injury. The problem is – if you lie about it, or lie about the extent of your injuries, and then you’re proven to be lying. That’s when you need a New York workers comp fraud lawyer to help defend you.

Workers compensation fraud is taken VERY seriously by authorities. The New York State Insurance Fraud regularly encourages people to report suspected workers compensation fraud. The Office of the Inspector General of the Worker’s Compensation Board is dedicated to investigation any violations of workers compensation fraud, and finding fraud cases. If fraud can be proven, you could face jail, restitution, fines, and other penalties. If you’re accused of worker’s compensation fraud, you need to ensure you understand your legal options. You need to fight aggressivelly, in order to make sure these allegations don’t compromise you and your future. At Spodek Law Group, PC, we understand the importance of having a competent workers compensation fraud claims attorney. We understand the long lasting impact this can have on your life, and your family. We understand the legal complexities associated with fraudulent workers compensation claims. Our criminal defense law firm was founded by former prosecutors, and knows how to win cases. If you need a solid defense, then you need our New York criminal defense lawyers who can advocate for you, and give you the legal representation you deserve.

What’s workers compensation fraud

Workers compensation fraud happens when someone knowingly makes false statements in order to obtain benefits for themselves, or someone else. Workers comp fraud can be committed by employees who apply for and receive these benefits. In some cases, employers and health care providers have also been known to commit workers compensation fraud when they knowingly try to deny benefits in order to save money. Anyone whose involved in a workers compensation scam, can end up facing charges for criminal behavior that he/she did, in addition to the behavior of co-conspirators. Often, we see “fraud rings,” which consist of many people working to manipulate the workers compensation system in order to gain, or deny, benefits.

Examples of fraud

Worker’s comp fraud can come in many forms, depending on whose carrying out the scam. Sometimes, it can be an employee, or an employer, or even a health care provider. Here are some examples of fraud we’ve seen in the past.

  • Claiming an injury happened on the job, when no injury occurred
  • Claiming the injury was sustained through work related tasks, when it was in fact caused by something else
  • Exagerating the symptoms to make the injury look worse, with the goal of remaining on disability for as long as possible
  • Working under the table, and not reporting income, while collecting workers compensation benefits
  • Falsifying medical records to deny coverage

Employers have also been known to commit workers compensation fraud. Employers are required to purchase workers comp insurance, and are restricted from deducting the premium payments from the wages of workers. If an employer does something to commit any form of fraud related to workers compensation coverage, this can result in serious criminal penalties.

Health care providers have also been known to commit worker’s compensation fraud as well. Often, providers work hand-in-hand with employees who are committing fraud. Medical care providers help employees fake, or exaggerate, injuries so the employee can collect disability benefits and not work. The medical care provider continues to collect payment for unnecessary medical services.

Here are some examples health care providers workers compensation fraud our lawyers can help with:

  • Unnecessary testing of workers to bill insurers
  • Unnecessary treatment to bill insurers
  • Billing for medical treatment not performed
  • Double billing for same service

Employers, employees, and medical care providers alike, can be charged with criminal fraud. If you are such a party, we encourage you to contact our NYC workers compensation criminal lawyers today.


There are penalties that can be imposed for workers compensation fraud. It’s a class e felony to knowingly prepare, or submit, statements that support a workers compensation claim if the written statement is false, or has material misrepresentations.

The same also applies to employers, insurance carriers, who make false statements when reporting, investigating, or adjusting benefit claims in order to avoid providing benefits. Employers making such false representations can be charged with a Class E felony. Repeat offenders, who commit similar offenses within a 10 year period of a conviction, can be charged with a Class D felony.

Felony convictions are severe. Class E felonies can lead to imprisonment for 1-4 years. Defendants could also be charged with other fraud crimes, and offenses, such as mail fraud and wire fraud.


NYC Workers Comp Fraud Lawyers

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