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If a person willfully makes a false statement or representation material to a Workers' Compensation claim for the purpose of obtaining benefits, payments, compensation, or awards such person commits a class 5 felony, punishable as provided in §18-1-105 C.R.S.
To be convicted of Workers' Compensation fraud in Colorado, it must be proved that material false statements or representations were made.
In order for the Workers' Compensation Fraud Investigation Unit to build a prosecutable case, we must be able to prove:
Possible "red flags" of fraudulent behavior may include:
Knowingly making a false Workers' Comp claim
Faked or exaggerated injuries
Injuries not sustained at work
Unreported income/second jobs
Billing or Provider Fraud
Services not rendered
Soliciting or assisting in the filing of a false claim
Direct claims to conspiring clinics
Altering claim evidence to support a denial
Accepting gratuities and/or bribes in exchange for implied promise of patient referral
Providing false information to obtain Workers' Comp policy at less than the proper rate
Knowing misrepresentation of the truth to avoid, deny, or obtain compensation on behalf of employees
Knowingly lies to discourage or prevent injured employees from pursuing claims
Misclassification of employees and/or under-reporting wages
Colorado Workers' Compensation Act, §8-43-402 C.R.S.
Division of Workers' Compensation | 303-318-8700 |