Labor Law: Workers’ Compensation Fraud

Workers’ compensation fraud is a crime that is punishable by law. It happens when an individual willfully makes a false statement to receive worker’s compensation benefits. Based on this, if I suspect that a patient was committing worker’s compensation fraud, I would report the matter to the hospital administrator. After reporting the issue, the hospital administrator will investigate the matter and make a decision. I will go ahead to provide the administrator with information on the name and address of the person. In addition, I will explain why I believe the patient is making wrong claims. For example, I will inform the authority that the patient is my neighbor and that I saw the patient in their yard, pushing moving, and raking leaves. Therefore, this information will assist in investigating the matter and taking appropriate action.

I would not be worried about HIPAA laws because I did not violate one for reporting the fraud. According to Martin et al. (2018), HIPAA law ensures that a patient’s health data is adequately secured while enabling the flow of data required to enhance high-quality care and protect the public’s health and welfare. In addition, the law establishes appropriate standards to ensure the privacy of personal health information (Reamer, 2018). In regards to my decision stated above, I did not disclose any personal health information of the neighbor to the hospital authority. I only reported my suspicion regarding my neighbor’s behavior to the authority. The information I gave regarding my neighbors’ conduct of appearing to be fine and not wearing any braces at home while appearing sick during the appointment and wearing braces. I believe that reporting the incidents to the authority is not a violation of the HIPAA law.

References

Martin, E., Lober, C., Benabio, J., & Feldman, S. R. (2018). Addressing public criticism: a potential HIPAA violation. Dermatology online journal, 24(6). Web.

Reamer, F. G. (2018). Ethical issues in integrated health care: Implications for social workers. Health & social work, 43(2), 118-124. Web.

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StudyCorgi. 2022. "Labor Law: Workers’ Compensation Fraud." November 4, 2022. https://studycorgi.com/labor-law-workers-compensation-fraud/.

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