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Articles Posted in Workers’ Compensation

When workers’ compensation claims arise, the details surrounding an individual case can vary dramatically. Whether the injuries were caused by repetitive stress, a construction site accident, unsafe working conditions or any other factor, these incidents (and the types of injuries people suffer) are often quite unique. However, regardless of the details pertaining to a claim, it is imperative for anyone in San Francisco and throughout the state who has been injured on the job to receive the benefits they need to move forward. Unfortunately, some people experience legal difficulties after filing a claim, which makes thorough evaluation and taking the right approach so crucial.

A 29-year-old California woman was recently taken into custody after allegations of workers’ compensation fraud arose. The woman, who used to work as a probation officer in Los Angeles County, is believed to have illegally collected more than $29,000 in workers’ compensation benefits. Authorities apprehended the woman on wire fraud, forgery, grand theft and 14 counts of insurance fraud.

She filed for workers’ compensation benefits after claiming to have suffered an injury to her shoulder when she tried to restrain an inmate in the summer of 2013. However, investigators reportedly discovered that she was not working on the day the alleged injury took place and could not find records of the injury. According to probation officials, this incident serves as an example of the department’s attempts to address fraud.

When an employee is injured at work, a number of problems could arise, such as having difficulty paying medical expenses, lost wages and physical pain. In San Francisco and throughout California, employees deserve to be protected from these types of issues with workers’ compensation. However, employers do not always fulfill their obligations and sometimes commit fraud, which could not only cause hardships for staff but also result in costly fines and even prison time. As a result, it is imperative for companies to ensure compliance with employment laws.

A 69-year-old man from Corona Del Mar recently pleaded guilty to workers’ comp fraud and is facing up to 10 years behind bars. The expansive system involved over 150 insurance companies and is the most notable case in California history, costing taxpayers hundreds of millions.

From 2008 to 2013, over $500 million was fraudulently billed by the hospital, according to prosecutors. The U.S. Attorney’s Office claims a majority of the fraudulent bills were charged to the state’s workers’ comp system. A spokeswoman for the hospital claims that the company, which has been renamed and is under new ownership, has not been contacted by investigators.

Although there are many things for an employer to focus on, compliance with workers’ compensation laws and regulations is imperative. There are numerous pressures that can always arise, but the penalties for workers’ comp violations (such as fines and potential imprisonment) can be especially tough. If you are a business owner in San Francisco, it is smart to make sure you understand California law and are able to provide employees with quality workers’ compensation in case a workplace injury accident ever occurs.

After an insurance company alerted the Monterey County DA’s Office in 2009, a California business became the focal point of an investigation. According to investigators, the business owner was reporting fraudulent information in order to lower his insurance premiums.

While the man faces over six years in prison, the district attorney’s office has stated that he will be put on probation. The Employment Development Department became involved in the investigation to determine just how much this employer failed to pay and estimates that he owes $294,594 in restitution (on top of penalties and fines).

Employers have many things to take into consideration when it comes to their business, from the hiring process to turning a profit. However, workers’ compensation is extremely important and can lead to problems when not addressed properly. In San Francisco and the rest of California, there have been numerous examples of workers’ comp stories in the news. While some of them pertain to changes in state law, others discuss cases of fraud.

According to the Department of Insurance, a contractor in Hanford was dishonest when dealing with the State Compensation Insurance Fund, which allowed him to receive a reduction in rates and an improper edge against other businesses. His premiums were lowered because he repetitively changed the name of his company and attempted to present his business as new.

The 47-year-old farm labor contractor plead guilty and was sentenced to prison and ordered to pay over $4 million in restitution. This incident was investigated by The San Joaquin Valley Premium Task Force, which consists of local and state authorities who work together to battle fraudulent workers’ comp cases.

When it comes to workplace injuries, workers sometimes wonder if they will able to secure compensation for their inability to continue working. Missing out on work can not only interrupt life, but lead to financial difficulties as well. As a result, it is important for those who have been injured in San Francisco to look into workers’ compensation right away.

For injured athletes, California has been particularly welcoming. However, recent legislation will make it more difficult for athletes to qualify for workers’ compensation in the state. Due to these changes in law, some are worried that the state and those who pay taxes will ultimately end up paying for the treatment these athletes need.

Among those who will be impacted by this bill are professional football players that have suffered from concussions and significant head injuries. Now, many of them will not be eligible for workers’ compensation any longer. While supporters claim that these injured athletes, including some from other states, have placed a significant amount of stress on the system, others argue that both insurers and football teams are failing to properly take care of players.

When it comes to workers’ compensation, companies are required to carry it in order to protect employees in case they are injured. However, workers’ comp does not typically pay for the entire cost of the worker’s damages. In San Francisco, some business owners worry about the cost of workers’ compensation, so many pay attention to industry recommendations.

Due to an increase in the cost of medical care and an abundance of claims, some predict that there could be a significant increase in workers’ compensation premiums. While some businesses remain optimistic and believe that legislation will reduce the severity of rate increases, many worry that workers’ comp premiums will continue to rise, having already gone up 35 percent from 2009 rates.

One advisory group that the workers’ comp industry supports has recommended a 6.9 percent increase in premiums, which would begin next year. Additionally, other insiders think there could actually be even more of an increase. The insurance commissioner will decide whether or not these recommendations are acceptable, and while insurance companies do not have to abide by what the commissioner recommends, many do. With regard to the most costly states for workers’ compensation, California ranks in the top three.

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