Fraud Charges Raise Workers' Comp Questions

Fraud Charges Raise Workers' Comp Questions

In 2012, a former Crystal Lake police officer filed a workers' compensation claim over a wrist injury he received on the job. After being assigned to light duty, video cameras inside the police station recorded the officer, Michael Avila, lifting weights. His claim for workers' compensation benefits came under investigation. Charges were filed because Avila exaggerated his injuries in order to receive workers' compensation benefits.

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Workers' Compensation Eligibility in Illinois

According to the Illinois Workers' Compensation Act, any worker who is injured on the job is eligible for workers' compensation benefits. This is true regardless of who is at fault for the accident. However, if fraud is even remotely suspected, the whole process can come to a halt as an investigation is carried out. There are also some exceptions to Illinois workers' compensation coverage, including:

• Injuries that a worker inflicts upon him or herself


• Injuries that occur during a criminal act


• Injuries outside the workplace


• Injuries that occurred because a worker was in violation of company policy

Should a worker suffer an injury such as those listed above, and attempt to collect workers' compensation benefits, it could lead to fraud charges. However, for other types of injuries covered by workers' compensation, the injured worker may be entitled to:

• Medical expenses


• Rehabilitation expenses


• Temporary partial disability payments equal to two-thirds of the difference between the injured worker's gross average weekly pay and the net amount earned in light-duty position during recovery


• Temporary total disability payments equal to two-thirds of the injured worker's gross average weekly pay (available only to workers who are unable to work during their recovery period)


• Permanent total disability payments (available for workers who are permanently disabled by a work-related injury)


• Vocational training or rehabilitation (for workers who can no longer work in a specific field or job due to a work-related injury)

It's important to remember that not every injury is covered simply because it happened in the work place, and there are many myths surrounding workers' compensation that may lead workers to believe they aren't covered. For these reasons, injured workers may be advised to contact a Crystal Lake workers' compensation lawyer to understand how best to proceed with their case. Being mindful of the law is essential when filing a claim for a workers' compensation injury, especially if there are questions as to the severity or eligibility of the injury.