There are guidelines regarding false claims and fraudulent activities regarding workers comp claims and receiving benefits under the program. The Attorney General for the State of Nevada oversees the Workers Compensation Fraud Unit, which is responsible for investigating and prosecuting any fraudulence involved in the workers’ comp process. There are laws and guidelines within the Nevada Revised Statutes regarding compensation for injured workers, including prohibited acts and the prosecution and penalties for those who violate the standards regarding such industrial insurance.

About the Nevada Workers Compensation Fraud Unit

The State Attorney General oversees the investigation and prosecution of fraudulent activities regarding workers’ comp throughout the state. This specially designated unit within the Bureau of Criminal Justice handles all types of alleged fraudulence regarding the main parties involved in the workers’ comp process, including the claimant, the employer, and the medical care provider.

The claimant may try to file a false claim through faking, exaggerating, or otherwise distorting the facts regarding an injury.

The employer may provide false or misleading information in order to pay less for insurance premiums or may fail to provide required coverage.

The provider of medical services may overcharge by padding a bill or performing unnecessary treatments.

Additionally, this division handles the oversight of any fraudulence regarding the administration of the workers’ comp program, including the investigation and prosecution of fraudulent activities through the administration of the program.

Nevada Attorney General and Workers Compensation

Although the workers’ comp program is handled through the Nevada Division of Industrial Relations, any allegations of fraud are investigated on behalf of the state or employers that are self-insured by the Attorney General’s Workers Compensation Fraud Unit. It is important to note that any party involved in the workers’ comp process may be investigated and ultimately prosecuted if found to provide false information or engage in fraudulence in order to illegally obtain benefits from the program. In addition, any person who helps or conspires with the guilty party may be prosecuted as well. Those found guilty of committing fraudulence against workers’ comp may face imprisonment, fines, restitution, repayment, loss of benefits, suspension or revocation of professional licenses, and temporary or permanent restrictions from the program in the future. Regulations are governed by the Nevada Revised Statutes 616D.

N.R.S. 616D

The Nevada Revised Statutes in N.R.S. 616D provide the rules governing workers compensation. Sections in these guidelines are broken down to include general provisions, administrative proceedings, prohibited acts, fraudulent practices, reporting violations, and prosecution. These Revised Standards provide detailed information regarding an employer’s responsibility to provide accurate information and the proper industrial insurance coverage for employees, claimant responsibilities and regulations against providing false information or filing for false claims, the duties of other parties involved in the workers’ comp process to report any concerns regarding fraudulent activities to the Fraud Unit, as well as certain issues regarding prosecution and penalties for fraudulent actions, including civil liabilities. Any penalties provided in N.R.S. 616D are not necessarily exclusive, but are considered to be cumulative, meaning that anyone who violates these rules can also be prosecuted for other related violations of law provided for in other sections of the Nevada Revised Statutes.

Legal Resources for Nevada Workers Compensation

Navigating the workers’ comp process can be complicated, especially if you are trying to do it on your own. If you would like more information regarding the workers’ comp process or would like legal assistance in these matter, the Morris / Anderson Law Firm is available to help you through this process.

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