I have videotape of an injured employee, violating doctor′s restrictions. Has the employee violated Missouri′s workers′ compensation laws?

Maybe! Violating a doctor′s work restrictions may or may not be a violation of Missouri′s workers′ compensation laws. For example, an injured worker goes to the doctor and indicates that he or she is in a lot of pain. When asked how severe, the injured employee states, "8 out of 10". You have the employee on videotape building a barn. He or she is carrying 4′ x 4′ posts, bags of cement, hammering, climbing a ladder, etc. This scenario would not be fraud! Why? Where is the lie?

Consider the same scenario with the exception of the doctor′s visit. This time, the doctor asks the injured employee, "How has the injury affected your ability to perform daily functions". The injured employee responds, "prior to the injury I could climb ladders, mow my grass, go horseback riding, and work in my garden. Now, I can′t even pick up a bag of flour." Now you have a possible fraudulent act. Why? You have a lie! The injured employee indicated he or she could not perform at a certain level and there is evidence that this statement is not correct. The fraudulent statement must be made to someone in a position to determine if benefits are paid. That can be the medical provider, the employer, or the insurer.

Workers' Compensation - Fraud and Non-Compliance

  1. I have business locations in Missouri and Kansas. The Missouri location has 3 employees and the Kansas location has 5. I was informed that I didn′t have to have Missouri workers′ compensation insurance because I only have three employees. Is that correct?
  2. I am working for a company out of the state of Texas. A company representative told me the company has workers′ compensation insurance with Texas Mutual Insurance. Will this cover me in Missouri?
  3. I am representing a client who the insurance company is stonewalling. I can′t seem to get it to negotiate a settlement. If I file a complaint with the Fraud and Noncompliance Unit and the matter is then resolved, can I withdraw my complaint?
  4. I was looking at my pay stub and realized my employer is deducting money for workers′ compensation insurance. Can it do that?
  5. I was hurt at work and informed my supervisor about the injury. The supervisor refuses to file an injury report. Can the supervisor do this?
  6. I have an injured employee who is collecting TTD and is working at another job. Is this fraud?
  7. I have videotape of an injured employee, violating doctor′s restrictions. Has the employee violated Missouri′s workers′ compensation laws?
  8. I am a carpenter and was injured at work on Friday at a construction site and reported it to my supervisor. He asked me to wait until Monday to file an injury report because he doesn′t have workers′ compensation insurance. He said he would buy it today and I would be covered on Monday. Is that legal?
  9. I work for an employer who has 17 employees. She pays seven of us in cash, but I know she has workers′ compensation insurance. Is this legal?
  10. I recently hired a subcontractor to put a roof on a house I am building. I obtained a copy of its Certificate of Insurance (COI) for workers′ compensation insurance. My insurance company recently audited me and now I have to pay more in premiums because the COI was no good. Is there anything you can do?
  11. One of my employees is out on a workers′ compensation claim. She brought in an "off work" slip she said she got from her doctor. The form indicates she is to be off of work for seven days because of her injury. I called the doctor′s office and was told the doctor did not give her an "off work" slip. Is this a crime?

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