Hillsborough County Workers Comp Fraud Attorney
Workers’ compensation fraud costs Florida employers and insurers hundreds of millions of dollars each year, and the state takes enforcement seriously. But fraud allegations run in two directions. While employers and insurance companies are quick to accuse injured workers of exaggerating or fabricating claims, employers themselves commit fraud by misclassifying employees, underreporting payroll, or retaliating against workers who file legitimate claims. If you are an injured worker in Hillsborough County who has been accused of fraud, or if you believe your employer is the one acting dishonestly, understanding exactly what’s at stake matters before you say a word to any investigator or adjuster. Kobal Law represents injured workers throughout the Tampa area and knows how these situations actually unfold. A Hillsborough County workers comp fraud attorney at our firm can help you sort through what is actually happening in your case.
What Fraud Allegations Against Workers Actually Look Like in Florida
Florida Statute 440.105 is the state’s workers’ compensation fraud law, and it is broad. Prosecutors and insurers use it aggressively. Under the statute, it is a felony to knowingly misrepresent the extent of an injury, work for wages while receiving total disability benefits without reporting it, receive benefits from multiple employers simultaneously without disclosure, or provide false information on any claim or form related to workers’ compensation.
In practice, many fraud investigations targeting workers begin not with clear evidence of wrongdoing but with a tip from an employer, surveillance footage taken out of context, or a claims adjuster who has decided a claim seems too expensive. Insurance companies hire private investigators. They pull social media posts. They review bank records. They watch people at home and at recreational events, sometimes for weeks.
The problem is that surveillance footage rarely tells the whole story. An injured worker who cannot perform their assigned job duties may still be able to take a short walk with their family or attend a child’s soccer game. That footage, presented selectively, can look very different from what a treating physician’s records actually show. Before any investigation reaches a criminal referral or formal accusation, there is often an opportunity to correct the record, and that opportunity is far more valuable before statements are made than after.
Employer and Insurer Fraud in Hillsborough County: The Side That Gets Less Attention
The conversation around workers’ comp fraud is typically framed around injured workers, but employers and insurers commit fraud too, and it directly harms workers. In Hillsborough County, where construction, logistics, hospitality, and healthcare employs a large portion of the workforce, employer-side fraud is a genuine problem.
Misclassifying employees as independent contractors is one of the most common forms. When employers label workers as contractors, they avoid paying workers’ compensation premiums. If that worker is injured on the job, the employer then denies any obligation to cover the claim. The injured worker is left without benefits and often without any clear legal path forward unless someone pushes back.
Underreporting payroll is another issue. Insurance premiums are calculated based on the size and nature of a workforce. Some employers falsify payroll records to pay lower premiums. When an audit or injury claim exposes this, workers can find themselves in a coverage dispute that delays or denies their benefits.
Retaliation is also a form of illegal conduct that often intersects with fraud. Florida law prohibits employers from firing, demoting, or threatening workers because they filed a workers’ compensation claim. When employers fabricate disciplinary records or invent performance issues after a claim is filed, that is not just retaliation. It can rise to fraud and obstruction of the claims process.
What Happens When a Fraud Accusation Is Made Against You
If an insurer or employer suspects fraud, the claim will typically be referred to the Florida Division of Investigative and Forensic Services, which operates under the Department of Financial Services. Investigators assigned to this unit have subpoena power. They can obtain medical records, employment records, bank statements, and other documents. They will request an interview.
That interview request is where workers most often make mistakes. The instinct is to cooperate fully and explain everything, and in some situations that is appropriate. But in others, providing a recorded statement without legal guidance can introduce inconsistencies that become the foundation of a fraud case, even when no fraud actually occurred.
If an investigation results in criminal charges, the penalties under Florida law are serious. A first-degree misdemeanor applies to some violations, but many workers’ comp fraud charges are classified as third-degree felonies, which carry up to five years in prison. Repeated violations or fraudulent conduct involving large dollar amounts can elevate charges significantly. Beyond criminal exposure, a fraud finding can result in full repayment of all benefits received and permanent disqualification from future benefits.
The administrative and criminal processes run on separate tracks, which means a worker can face benefit termination on one hand and criminal prosecution on the other simultaneously. Having someone who understands both tracks makes a real difference in how a case gets handled.
Questions Workers Ask About Workers’ Comp Fraud in Hillsborough County
Can I be accused of fraud just for working a side job while on workers’ comp?
Possibly. Florida law requires workers receiving total or partial disability benefits to report any income earned during that period. Failure to report wages, even from occasional or informal work, can be characterized as fraud. That does not automatically mean charges will follow, but it is a significant risk that needs to be addressed carefully before any statement is given to an investigator.
What if the insurer’s surveillance footage shows me doing things my doctor says I cannot do?
This is one of the most common scenarios and one of the most misunderstood. The threshold question is what your physician has actually restricted. A worker restricted from lifting heavy objects at work is not necessarily prohibited from every physical movement. A detailed review of medical records against what the footage actually shows is the starting point for building a response.
My employer told me not to file a claim and then fired me when I did. Is that legal?
No. Florida law prohibits retaliation against workers who exercise their right to file a workers’ compensation claim. Termination, demotion, reduction of hours, or any other adverse employment action taken because of a claim is illegal. These cases can involve both workers’ compensation proceedings and separate civil claims depending on the circumstances.
If I am accused of fraud, does my employer’s insurer stop paying my benefits right away?
In practice, yes. Once a fraud referral is made, insurers typically suspend payments while the investigation proceeds. That leaves workers without income and often without medical coverage at exactly the moment they need it most. Challenging the suspension while the investigation is pending is possible but requires prompt action.
Can an employer be prosecuted for workers’ comp fraud in Hillsborough County?
Yes. The same statute that applies to workers applies to employers, carriers, and anyone else involved in the workers’ compensation system. The Florida Division of Investigative and Forensic Services investigates employers as well. Contractor misclassification schemes have resulted in both criminal charges and significant civil penalties in Florida.
What is the difference between a mistake on a claim form and fraud?
Legally, fraud requires a knowing and intentional misrepresentation. An honest mistake or oversight is not fraud, even if the insurer treats it that way. Distinguishing between a clerical error and deliberate misconduct is often the central issue in these cases and is something that requires a close look at the actual facts and documentation.
How quickly should I get an attorney if I receive a call from a workers’ comp fraud investigator?
Before you return that call. An investigator reaching out for an interview does not mean you are being arrested or charged. It means someone has questions and your answers will be recorded and may be used in a formal proceeding. Having legal guidance before that conversation is far better than trying to repair damage from an unadvised interview afterward.
Talking Through Your Situation With a Workers’ Compensation Fraud Lawyer in Hillsborough County
Kobal Law founder Jason Kobal has spent nearly two decades representing injured workers throughout Tampa and Hillsborough County. He has worked on both sides of workers’ compensation disputes, which gives him a clear-eyed understanding of how insurance companies and employers operate when they are trying to limit their exposure. Whether you have received an inquiry from an investigator, had your benefits suspended following a fraud allegation, or believe your employer is the one misrepresenting facts in your claim, this firm will look at the full picture and tell you plainly where you stand. Cases are handled on a contingency fee basis, meaning you do not owe any fees unless there is a recovery. Office staff can communicate in both English and Spanish. If you are dealing with a workers’ compensation fraud issue anywhere in Hillsborough County, a workers’ compensation fraud attorney at Kobal Law is available to review your case and help you figure out your next move.
