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Worker's misrepresentations don't add up to valid fraud defense

In Florida, a worker's misrepresentations about his medical condition and workers' compensation claim history on a medical questionnaire to obtain employment in order to pay overdue bills does not support an employer's fraud defense.

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Case name: Welch v. Crom Equipment, 19 FLWCLB 12 (Fla. JCC, Gainesville 2011).

Ruling: A Florida judge of compensation claims held that a worker was entitled to benefits for his right inguinal hernia.

What it means: In Florida, a worker's misrepresentations about his medical condition and workers' compensation claim history on a medical questionnaire to obtain employment in order to pay overdue bills does not support an employer's fraud defense.

Summary: A worker felt a burn and pull in his right side while lifting heavy beams at work. He was diagnosed with a right inguinal hernia. The employer denied compensability of the accident. Later, the worker filled out a medical questionnaire in which he indicated he did not have any medical conditions for which he had been treated in the past three years, he did not have any health concerns that would prevent him from working, he had no illnesses requiring him to seek medical attention in the last five years, and he never filed a workers' compensation claim. The worker said he provided this inaccurate history in order to get a job to pay his bills. The JCC rejected the employer's fraud defense and found the worker's condition compensable.

Because the worker's misrepresentation was to obtain employment with another employer, not to obtain workers' compensation benefits, the fraud defense did not apply.

Read more at the WorkersComp Forum homepage.

April 12, 2012

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