In Missouri it is unlawful to file a fraudulent workers' compensation claim, submit multiple claims for the same injury, help others present a fraudulent claim, to make or cause to be made any false or fraudulent material statement or material representation for the purpose of obtaining or denying any benefit, or to make or cause to be made any false or fraudulent statements with regard to entitlement to benefit with the intent to discourage an injured worker from making a legitimate claim. It is also unlawful for an insurance company or self-insurer to intentionally refuse to comply with known and legally indisputable compensation obligations, discharge or administer compensation obligations in a dishonest manner or discharge or administer compensation obligations in such a manner as to cause injury to the public or those persons dealing with the employer or insurer.  New changes to the law include making it a felony to submit a false/forged certificate of workers' compensation insurance and a misdemeanor to provide false information to an investigator with the Fraud and Noncompliance Unit. For example:

• An injured worker has a part-time job while receiving Temporary Total Disability (TTD).  An employer, claims adjuster, medical provider, etc. asks the employee if they are working.  The injured worker denies working during the period he or she received TTD. This would be an allegation of workers' compensation fraud.

• An employer informs an employee that if they do not have workers' compensation insurance when in fact they do. The purpose behind the false statement was to deny the injured employee a benefit.  This would be an allegation of workers' compensation fraud.

• An employee claims he or she cannot perform certain physical activities to a medical provider so as not to be returned to their place of employment.  The injured worker is later observed performing that or similar physical activities.  This would be an allegation of workers' compensation fraud.

• An employer under reports their payroll or misclassifies their employee's job description to reduce the employer's workers' compensation premiums.  This would be an allegation of workers' compensation fraud.

• The employer submits a false/forged certificate of workers' compensation insurance to a contractor as proof of coverage. This would be an allegation of workers' compensation fraud.

The above are just a few examples of allegations of workers' compensation fraud.  If you have questions or would like to file a complaint, please call the Fraud and Noncompliance Unit at 1-800-592-6003.