What is Workers’ Compensation?
Workers’ Compensation is a no-fault insurance program in the state of Nevada that is paid for by the employer. It provides benefits to employees who are injured on the job and protection for employers who have provided coverage at the time of the injury.
Workers’ Compensation coverage is is requirement, by the state of Nevada, for employers who employ one or more employees. In addition to the coverage requirement, Nevada also requires that employers furnish a safe workplace with no hazards that may cause death or serious injury to employees. However, no matter how safe the workplace, injury is always possible. As such, benefits provided by workers’ compensation coverage may include: Medical Treatment, Lost Time Compensation, Permanent Partial and/or Total Disability, Vocational Rehabilitation, and Death Benefits.
Workers’ Compensation Fraud:
While the Workers’ Compensation policy comes from a good place, unfortunately, exploitation of the system is rampant. In Nevada, the Workers’ Compensation Fraud Unit is responsible for investigating and prosecuting workers’ compensation fraud by claimants, employers, or health care providers. Knowing the signs of fraud can go a long way to deciding whether or not to contact the fraud unit to report an incident.
Claimants:
Often, fraud may be perpetrated by the claimant themselves. This scenario often takes place when a reported accident occurs just before or after a strike, layoff, end of a major project or the conclusion of seasonal work. A lack of witnesses, although not determinative by itself, can lead to a suspicion that fraud is being perpetrated by the claimant. This is especially true if the claimant is refusing treatment to diagnose the injury. A claimant who has a history of frequently changing health care providers, addresses, or employment also leads to reasonable suspicion of workers’ compensation fraud.
Employers:
Employers are also possible culprits of workers’ compensation fraud. Underreporting the number of employees on the payroll, failure to pay insurance premiums, deducting insurance coverage from employee’s pay, asking an employee not to see a doctor, concealing information about an employee receiving benefits, referring an employee to a medical facility only to receiving compensation for the referral at a later date, and delaying reporting of an employee injury are all signs that lead to possible fraud on the part of the employer.
Health Care Providers:
Although less frequent, health care providers are also susceptible to workers’ compensation fraud. Possible warning signs include: an inconsistent diagnosis by the health care provider where the treatment doesn’t fit the initial diagnosis; Boilerplate Reports where majority of reports created by the provider appear similar in nature; Incomplete Bills where the bills are submitted without a date or descriptions of office visits extends for a lengthy period of time without interim billings.
What To Do?:
If fraud is suspected The Workers’ Compensation Fraud Unit can be reached toll-free at 1-800-266-8688. However, hiring experienced and competent legal counsel may be the best choice. 702 Defense has years of experience in the area of workers’ compensation and can be reached at 702-333-3673.