Consequences of Filing a Fraudulent Workers’ Compensation Claim

by Ambrosio Rodriguez | Mar 13, 2018 | Fraud

If you’re injured on the job in Los Angeles you may be entitled to collect workers’ compensation benefits. These benefits can be extremely helpful as you fight to recover from a serious workplace injury, illness, or disease. It is important to make sure that you only submit a request for benefits if you have actually suffered a workplace injury. Filing a false claim for workers’ compensation benefits can have serious criminal and non-criminal consequences.

What is Workers’ Compensation?

All employers in California are legally required to carry what is known as workers’ compensation insurance. This is basically a policy that helps to cover costs that may arise because of an employee’s injury. When an employee agrees to accept workers’ compensation benefits, they waive their right to file a lawsuit against their employer. Workers’ compensation benefits help to limit legal actions between employers and their employees while ensuring that injured workers get the money they need after an accident.

These benefits can help to pay for medical bills, temporary disability, permanent disability, and rehabilitation. Workers’ families can even recover death benefits if their loved one is killed at work.

When Am I Eligible for Workers’ Compensation Benefits?

Any worker who is classified as an employee is entitled to collect workers’ compensation benefits after sustaining an on-the-job injury, illness, or disease. Generally speaking, anyone who is not classified as an independent contractor is considered to be an employee for workers’ compensation insurance purposes.

California follows a no-fault workers’ compensation system. This means that employees do not have to prove that an injury or accident was someone else’s fault. Insurance benefits will be awarded to an injured employee regardless of who was at fault.

Filing Fraudulent Workers’ Compensation Claims

Since employees do not have to prove fault, the workers’ compensation system is vulnerable to fraudulent claims. Workers could conceivably injure themselves on their own private time, say that an injury occurred on the clock, and then turn around and recover insurance benefits. Since fraud is a very real possibility, there are penalties for filing a fraudulent claim. Not only can you face criminal charges for filing a false claim, but you can also be named in a civil lawsuit for your deceitful actions.


Since workers’ compensation benefits are a form of insurance, filing a false claim is a crime under the False and Fraudulent Claims Act. The Act makes it a crime to knowingly file a false claim, submit false evidence, make a false statement, or help another person receive unearned benefits.

Criminal Consequences of Filing a False Workers’ Compensation Claim

Filing a false workers’ compensation claim for benefits can be charged as a misdemeanor or a felony under the False and Fraudulent Claims Act. A misdemeanor charge is punishable by up to a year in jail, while a felony carries a sentence of 2-5 years in prison.

Filing a fraudulent workers’ compensation claim is also punishable by:

  • The greater of $150,000 in fines or twice the amount of your fraudulent claim, and
  • Restitution to our employer or insurance company.

Civil Consequences for Workers’ Compensation Fraud

Filing a fraudulent workers’ compensation claim can be incredibly costly. In an effort to deter false claims, the state of California allows defrauded employers to recover significant fines and damages. Workers who are found guilty of workers’ compensation fraud can be subjected to the following penalties:

  • Civil fine of up to three times the amount of medical treatment expenses,
  • Civil fine ranging between $4,000 and $10,000 for each fraudulent claim.

A criminal conviction can increase the fines that an employee is required to pay under Labor Code Section 3820a.

Fighting Charges of Workers’ Compensation Fraud

Have you been accused of filing a fraudulent workers’ compensation claim? Contact Los Angeles criminal defense attorney Ambrosio Rodriguez for immediate legal assistance. Filing a false claim for benefits can have significant consequences, including time behind bars and extremely expensive fines. Future employers who see that you have submitted false claims in the past may be hesitant to hire you after you’ve served your criminal sentence.

Fighting these criminal charges today is the best way to protect your future. Call the Rodriguez Law Group today to set up a free consultation and learn more.

To learn more, call our Los Angeles criminal defense law firm at 213-995-6767 or visit our contact us page to send us an email.