James Lee of Summit County, Ohio, pleaded guilty to theft by deception after he was caught unlawfully claiming workers compensation for temporary total disability. Although his injuries gave him a status of temporary total disability, which meant he could not work while receiving benefits, Mr. Lee nevertheless continued to work a second and similar job as truck driver while continuing to receive workers compensation for his first job. In addition to a suspended sentence and three years of probation, the court ordered Mr. Lee to repay almost $70,000 in benefits that he received between 2006 and 2010 through fraud and deception.
Under Pennsylvania law, if you have been injured at work you can claim benefits for lost wages of approximately two-thirds of your average weekly income. The amount of time for which you are entitled to collect compensation depends on the nature of your disability:
Temporary total disability — You are more than 50 percent impaired by your injury and unable to work
Temporary partial disability — If you are only able to return to work at a lower paying job, due to your partial disability, you can claim benefits for up to 500 weeks
Permanent disability — If your injury leaves you with permanent damage that renders you unable to work, you can claim compensation indefinitely
If you were initially determined to have a temporary total disability, you may have the nature of your disability reassessed after 104 weeks. In some instances, after this assessment, you may drop into the temporary partial disability category if you are no longer more than 50 percent impaired.
In some instances you may also be entitled to claim social security disability benefits, depending on the nature of your disability.
In all cases of injury and disability, you can often claim for your medical expenses associated with the injury or illness, and you may be able to claim monetary compensation for certain permanent injuries such as an amputated limb.
In all instances, you should make certain to report any earnings you make while receiving disability benefits under workers compensation, to avoid the possibility of insurance fraud.
Posted in Workers Compensation | Tagged disability benefits, temporary total disability, theft by deception, workers compensation, workers compensation fraud