Whenever uninformed members of the public hear the words “workers compensation” “on-the-job injury” and “fraud” they almost always associate those words with an injured worker; however, most Georgia injury lawyers know that employers and insurers are sometimes guilty of fraud when it comes to workers compensation claims.
In all of our years of representing Georgia’s injured workers, one case of employer fraud stands out above all others. Several years ago we represented a young lady who worked for a large architectural aluminum building products corporation who provided systems for the commercial construction industry. Our client, who had been employed in their plant for many years, injured her back and requested authorization to see a doctor. After weeks of being ignored, the client finally called her boss and advised him that she was going to go see her own doctor. Thereafter, the plant safety manager called her at home and told her not to make such an appointment and advised her that he was going to set up an appointment with their “company doctor”. A couple of weeks after that conversation, the young lady retained our firm to represent her and we filed a Notice of Claim and a Request for a Hearing with the State Board of Workers’ Compensation. The depositions of her supervisor and the plant’s safety director were scheduled. Incredibly, both of the employer’s representatives denied, under oath, having notice of the employee’s on-the-job injury and claimed that the first notice they had came upon receipt of the Notice of Claim and a Request for a Hearing they received from our firm. What neither of the employers managers knew was that the employee had recorded the conversation with the safety manager. With the unrefutable evidence of the employer’s fraud and misrepresentations clearly documented, the employer/insurer settled the case with the injured worker under very, very favorable terms.
In the State Board of Workers’ Compensation, there is a Fraud and Compliance Unit which is charged with the responsibility of assisting the Chairperson of the State Board in administratively investigating allegations of fraud and non-compliance and in developing and implementing programs to prevent fraud and abuse. Georgia law provides, in part, that any person who knowingly and intentionally makes any false or misleading statement or representation for the purpose of facilitating the obtaining or denying of any benefit or payment under the Workers’ Compensation Act may be assessed a civil penalty of not less than $1,000.00 nor more than $10,000.00 per violation.
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