Beating The Workers Comp System

jackpotIf you’re injured at work, you may thinking you’ve hit the “jackpot” of a lifetime.


While there are thousands of lawyers out there soliciting injured workers to bring their cases to them, there is usually little chance that you’re going to get rich quickly, or ever at all on a workers comp claim.


Because workers compensation is a “statutory” benefit which means the state sets the amount your medical bills will be reimbursed at, as well as what your replacement wages will be while you’re disabled.  True, you may be eligible for a lump sum reimbursement for a permanent disability should you actually have one, but even those payouts are not that generous.  The payments for disability or lost wages in New York equal two-thirds of your average weekly wage times the percentage of your disability, subject to a maximum cap.  As an example if your average weekly wage last year was $500 per week and you are 50% disabled, you’ll receive $250 per week that you’re unable to work.  The maximum payable in New York this year (2014) is $808.65 per week.

If you’re legitimately injured on the job, report your injury immediately to your employer, your supervisor, or manager.  Have the injury attended to by a medical professional.  Sometimes your employer or their workers comp insurer will direct you to a specific doctor for an initial visit, which is fine.  Follow the instructions your doctors or medical providers give you and have the mindset that you’d like to get back to work as soon as you’re eligible to work.  Dragging out a claim or prolonging your disability really doesn’t make a lot of sense.

Do you need an attorney?

Probably not.  As we’ve described, the benefits you’re entitled to are statutory or governed by the workers comp law.  Getting an attorney isn’t going to increase those benefits.  Some attorneys may show you how to prolong your injury so you get more money from a claim, but at the end of the day you’ll owe them about 20% of what you get, so it’s likely that you’ll actually end up with less in your pocket by hiring an attorney!

Now, if you’ve thought about beating the system and “malingering” or just trying to prolong a disability, think again.  Insurers and many employers today understand the costs involved with workers trying to get away with cheating the system.  So they hire private investigators that will perform surveillance, make home visits, and will check up on you to make sure you’re not working a second job or just home watching television!  I have seen videos of workers who are supposedly too disabled to go to work, caught in the act of re-roofing a home, playing football, and water skiing.  When these videos are shown at a workers comp hearing not only are the worker’s claims denied, but the claimants are then arrested and charged with workers comp fraud, which in most states is a felony punishable by jail time.

Insurance fraud in New York and many other states is taken seriously by prosecutors so chances are good that you will get caught if you try and fake, pad, or malinger on a workers comp claim.  Jail time or not, it’s probably not worth the risk.