A recent blog post by Byron Warnken titled: “Malingerers Everywhere! How Do We Deal with all the Fakers?” raises a very important question; how do we deal with all the fakers taking advantage of the Workers’ Compensation Act? You know who I am talking about, all those people who are faking an injury so they can simply stay at home and collect benefits.
Unfortunately, the media has created a pervasive perception that there are a lot of lazy people taking advantage of the workers’ compensation system. Of course, big insurance companies have had nothing to do with the creation of this perception, right? Insurance companies purport that fraudulent claims add billions of costs to the workers’ compensation system which in turn results in higher premiums for employers. Here, in Maine, however, employers were expected to save $15.2 million on workers’ compensation insurance this year.
So, the question is, how do we screen out the fakers? As Attorney Warnken said in his blog: We don’t.
To anyone not well versed in the process of handling workers’ compensation claims, this would seem quite unnerving. Having represented multiple claims through the workers’ compensation system, I can assure you that I have never represented an employee whom I thought was faking a work injury. As Attorney Warnken said, some injured workers “just don’t get back to work quite as quickly as John Wayne would. Some don’t get back to work as quickly as you and I would.”
So when you sit on your porch and question why your neighbor is out of work receiving workers’ compensation benefits, remember that pain isn’t something you can see. Pain is felt. Everyone perceives pain differently. You don’t know what your neighbor has had to endure. Maybe she hurt her back at work lifting heavy boxes of produce. In turn, maybe she had surgery to her low back. However, sometimes surgery doesn’t help. We call that a failed back syndrome. So, maybe her surgery failed.
Even though she can walk to her mailbox to collect her mail, it doesn’t mean she is not in pain. What you may not know is that her boss may have asked her to return to work shortly after the injury. Perhaps he didn’t care that she had restrictions and left her alone to lift heavy boxes of produce that she shouldn’t have lifted. She lifted them because she didn’t want to lose her job. Because after all, she has two kids to feed. She then suffered an increase in pain which in turn caused her to suffer further complications with her already injured back. Her doctor takes her back out of work. But is she faking it this time you ask? Given the increased pain symptoms, given the sharp, shooting pains down both of her legs, she has another MRI (for which her insurer refuses to pay.) So she now has an additional medical cost of approximately $2,000 that she has to pay out of her own pocket despite the fact that she’s a single mother with two young children to feed.
Given the results of the MRI, she can chose to have another surgery but the doctor has told her that the likelihood of improvement is marginal at best. Rather than risk further complications, she chooses to follow her doctor’s recommendation and opts
not to have the surgery. But is she faking it you ask? Does she really have pain? After all, you can’t see the pain.
Inside her home, she cannot pick up her 4-year old daughter because lifting even a gallon of milk causes her to have intense pain. So she needs to sit in a chair in order to hug her daughter after her daughter has fallen down. Christmas is coming and she wonders how she can buy her kids presents. Her daughter needs new boots, her son a new winter coat. She stays up at night running the figures through her head. But isn’t she faking it for the money?
After all, she is receiving about $350.00 per week right? And, out of that money, she has to pay her rent and buy food to feed her two kids, not to mention her other expenses like heat. She can’t pay her car payment, so the bank has repossessed it. Her employer has terminated her because she cannot return to work to her regular position. She can continue her health insurance coverage if she can pay $800.00 per month. She can’t pay for her car, let alone health insurance. But she still has pain. She still has a back injury. She still has kids to feed. And of course, she still receives $350.00 per week in workers’ compensation benefits.
So, ask yourself: Do you think she’s faking it? Because I don’t. I think she has suffered a work injury. Just because you can’t see the amount of pain she is suffering, just because she has a smile on her face when she greets you on the way to the mailbox, and just because she may be able to now pick her kids up after school, doesn’t mean she is faking it. She’s suffering, physically, emotionally and financially.
People who suffer work injuries need our help. They need our support. The last thing they need is to be questioned about their integrity. Let’s stop the madness and help those workers who need our assistance and support the most: injured workers
who have suffered work injuries.
About the author: Karen Bilodeau is an attorney and partner at the workers’ rights law firm, McTeague Higbee. She can be reached at 207-725-5581 or firstname.lastname@example.org.