Figure 2: Flow of Benefit Dispute Resolution
Violations and fraud in Florida The following are criminal violations of s. 440.105, Florida Statute (FS) that constitute a felony of the first, second, or third degree depending on the monetary value of the fraud as provided in s. 775.082, s. 775.083, and s. 775.084 F.S. Filing a false claim of on-the-job injuries or exaggerating injuries An injured employee or any party making a claim of an on- the-job injury will be required to provide his or her personal signature attesting that he or she has reviewed, understands, and acknowledges the following statement : "Any person who, knowingly and with intent to injure, defraud, or deceive any employer or employee, insurance company, or self-insured program, files a statement of claim containing any false or misleading information, commits insurance fraud, punishable as provided in s. 817.234." If the injured employee or party refuses to sign the document, benefits or payments shall be suspended until such signature is obtained. Conclusion In the industry of cosmetology, accidents can and do happen in the workplace. Fortunately, WC laws are in place to protect both employees and employers in the event of these on-the-job injuries. It is of high importance for every worker and employer
There is much to be said regarding “fraud” and the WC system. The most recent news is below told by Insurancejournal.com and written by Amy O’Conner based on the Florida Office of Insurance Regulation’s (OIR) 2015 Workers’ Compensation Annual Report. “WC fraud continued to plague the state, the report says, but the Bureau of Workers’ Compensation Fraud, within the Division of Insurance Fraud made 540 workers’ comp fraud- related arrests for fiscal year 2014-2015 , an increase of 14%. In excess of $4.3 million in restitution was requested as a result of the Bureau’s investigations of shell companies, labor brokers and check cashing stores.” These numbers definitely express the prevalence of fraud in Florida originating from employees, employers, businesses, and labor brokers. When it comes to WC fraud, employees and employers both contribute to the problem. Employees file unsubstantiated claims and employers find avenues to reduce their WC payments and/or misrepresent themselves in order to pay lower WC rates.
to familiarize themselves with their rights responsibilities in regard to WC. If you are injured on the job, contact Florida’s Division of Workers’ Compensation to find out more information.
Book Code: CFL1024
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