When you meet with a Columbus workers’ compensation attorney for a free case evaluation, you will be asked to disclose all pertinent and relevant information related to your injury. This will help the lawyer asses whether your workers comp claim is valid and whether you have the right to collect benefits.
There is no point in trying to hide anything. You may believe that no one can find out about a pre-existing condition or the fact that you came in to work with a small injury on the day of the incident.
But once you file a workers comp claim, your employer and their insurance company will start looking for any piece of information that would give them grounds to deny your claim. Despite what you may read online, in such cases, an insurance adjuster has the right to look into things that you believe are well hidden from their scrutiny.
Ohio Laws Are Tough When It Comes to Workers Compensation Fraud
Fraudulently claiming and collecting workers comp benefits is a serious criminal offense in our state. The Ohio Revised Code 2913.48 defines workers compensation fraud, among others, as:
- Receiving benefits that you are not entitled to
- Making a false or misleading statement for the purpose of obtaining workers’ comp benefits
- Altering or falsifying records or documents needed to evaluate your workers comp claim.
The penalties increase with the amount of money a worker fraudulently collected as workers compensation benefits:
- Under $1,000 – first-degree misdemeanor, resulting in up to one year in jail
- Between $1,000 and $7,500 – fifth-degree felony, resulting in fines and at least one year in prison
- Between $7,500 and $150,000 – fourth-degree felony, resulting in extensive fees and at least one year in prison
- Over $150,000 – third-degree felony, resulting in very high fines and at least one year in prison.
As any Columbus workers compensation attorney will tell you, even an honest mistake in disclosing relevant information may prompt an insurance company to accuse you of fraud. While it will not amount to anything in terms of penalties, you will undergo a lot of stress until the case is closed.
Where Can an Employer Look for Information During your Workers Comp Claim?
In order to clarify what your employer can and cannot find out in relation to your workplace accident, here are some of the sources of information they have the right to access – and will do it:
1. Medical Records
HIPAA rules are no longer applicable when you file a workers comp claim. Your employer has a valid and reasonable right to know whether you were already injured or suffered from a debilitating condition, which made you prone to injury. While these are not grounds to deny your claim, your employer will try to do it.
However, an experienced Columbus workers compensation attorney can successfully defend your claim and show that the accident made a pre-existing injury worse and/or resulted in new injuries. However, they must know of the existence of any old injuries and health conditions.
2. Workplace Injury Diagnose and Treatment Plan
You will have to undergo an independent medical examination during the evaluation of the workers comp claim. Whatever the employer-appointed doctor finds out, your employer will find out, as well. Also, any kind of treatment they prescribe and their evaluation of the severity and extent of your injury will also be available to the employer and insurance company.
Any doctor can reasonably determine when you sustained an injury. This is why it is not a good idea to wait several days before reporting a workplace incident. Your employer will get suspicious and may believe that you delayed the report because you had consumed alcohol or drugs on the date of the accident. These are valid grounds for denying your workers comp claim.
3. Your Colleagues
The colleagues who witnessed your accident may issue statements in your favor. However, as part of the workers comp claim, your employer will interview them, as well. If they notice any contradiction between their statements and your description of the accident, this will likely result in your claim being denied.
Of course, it is possible for colleagues to change their stories out of fear of losing their jobs. This is why you need an experienced Columbus workers’ compensation attorney to identify any reliable evidence they can use to support your claim.
4. CCTV Camera Footage
As you may be aware, almost every inch of commercial properties are covered by CCTV cameras. This happens everywhere:
- In office buildings
- In warehouses
- On construction sites
- In malls and stores
- In workshops and production facilities.
Thus, there is a very high chance that the moment of your accident was captured by one, if not several of these cameras. The good news about this is that your Columbus workers’ compensation attorney can ask for copies of these recordings to analyze your accident and identify potential witnesses.
On the other hand, if you try to make your accident appear worse than it was, the images will show how things really happened. Always resist the temptation of embellishing your story during a workers comp claim.
5. Your Social Media Profiles
Insurance adjusters and your employer can find out what you posted on your social media profiles. They can also find photos shared by your friends where you are tagged. If you appear happy and smiling with them a few days after the accident, while you claim to have suffered painful injuries, that won’t look good for your workers comp claim.
The golden rule during the entire period of evaluating your claim and being out on workers’ compensation is to avoid posting any updates, photos or videos which contradict your claimed injuries and disability.
Your Columbus workers compensation attorney will tell you that your benefits will stop even after your claim is approved if your employer finds any evidence of you doing physical activities incompatible with the injuries for which you collect medical care costs and wage replacement.
Be Honest and Upfront With a Columbus Workers Compensation Attorney!
At Ohio Workers’ Compensation Lawyers, we strive to help every injured worker win the benefits they deserve. However, you must disclose any important information to a Columbus workers’ compensation attorney, especially pre-existing medical conditions.
These conditions will not stop you from winning your workers comp claim. However, if your attorney is not aware of any relevant element, they won’t be able to present strong arguments during negotiations. We encourage you to schedule a free case review with us as soon as possible after your accident and disclose everything connected to your workplace accident.
Call us at 833-406-0060 today!