Source: http://lois-llc.com/category/fraud/
Timestamp: 2017-08-19 13:00:59
Document Index: 220880411

Matched Legal Cases: ['§ 114', '§ 114', '§ 15', '§ 13', '§ 16', '§ 114']

Fraud | LOIS LLC
Fraud, New York, Workers Compensation
July 7, 2017 Jeremy Janis
What happens when the carrier provides publicly available social media evidence as a basis for fraud and the claimant subsequently makes the social media posts private? LOIS was recently successful in arguing that prior disclosure of social media evidence obtained by the employer is not required and that an employer/carrier can introduce “private” social media evidence into the case and using it to cross-examine the claimant. Continue reading Raising Fraud: No Prior Disclosure Needed for Social Media Posts in New York →
Matter of Gary CummingsMatter of Losurdo v Asbestos FreeMatter of Morelli v Tops Mkts.Workers’ Compensation Law § 114-a
Today’s topic is fraud. Attorney Christian Sison welcomes New York defense litigator Usra Hussain to the show to discuss fighting fraud in New York workers’ compensation claims. Can employers prove that claimants “knowingly” violate Section 114-a? Is it always beneficial to raise fraud at the outset of a claim? The episode ends with Usra taking her turn at “Guess the Outcome”! Continue reading Fraud – Third Fridays Podcast →
Explainer: Fraud as a Defense in New York Workers’ Compensation Claims.
November 9, 2016 Greg Lois
How does New York define “Fraud”?
Any person who knowingly and intending to defraud the workers’ compensation system by presenting (or assisting in presenting) an application for benefits, which contains a misrepresentation of a material fact. The penalty: Class E Felony charges. In addition to a Class E Felony conviction, the claimant who is convicted loses the right to all past and future compensation benefits. Fraudsters have to return any money they got through their fraud. WCL § 114. This is contrary to the general rule of law that claimants do not have to pay back money fraudulently obtained.
A claimant who applies for workers’ compensation benefits is required to provide accurate records and truthful statements to the WCB, the insurance carrier, and the employer. However, the law does not require the claimant to give a truthful account of their condition to their medical care provider. The prohibition on false representations appears to only apply to false statements made to get a monetary benefit – it does not appear to apply to medical awards or benefits, since the prohibition on lying applies only to WCL § 15 (indemnity awards) and not expressly to § 13 (medical benefits) or § 16 (death benefits).
An employer has the right to report suspected workers’ compensation fraud to the Fraud Inspector General. However, fraud will actually be inspected by the office of the Workers’ Compensation Fraud Inspector General which is actually staffed by WCB employees. The Fraud Inspector does not prosecute cases – rather, it refers cases to local authorities for prosecution. Continue reading Explainer: Fraud as a Defense in New York Workers’ Compensation Claims. →
FraudHusak v. New York City Transit AuthorityRetz v. Surpass Chem. Co.WCL § 114