Federal Workers' Compensation Fraud Charges and Defenses (18 U.S.C. § 1920)
Federal employees injured on the job are entitled to benefits under the Federal Employees' Compensation Act (FECA). Because these benefits involve substantial government disbursements, federal law enforcement aggressively investigates suspected fraud.
An individual accused of making false statements to secure benefits faces severe criminal penalties under 18 U.S.C. § 1920. However, complex reporting rules often lead to honest errors being misconstrued as deliberate fraud.
What Is Federal Workers' Compensation Fraud under 18 U.S.C. § 1920?
Under federal law, workers' compensation fraud is prosecuted as a specific form of perjury.
18 U.S.C. § 1920 makes it a federal crime to knowingly and willfully:
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Falsify, conceal, or cover up a material fact
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Make false, fictitious, or fraudulent statements or representations
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Use a false report or document regarding an application for or receipt of federal employee compensation
To secure a conviction, federal prosecutors must establish two key elements beyond a reasonable doubt: materiality (the statement affected benefit eligibility) and intent (the act was committed knowingly and willfully, not by mistake).
Common Types of Federal Workers' Comp Fraud Conduct
Federal investigations by agencies such as the U.S. Department of Labor Office of Inspector General (DOL-OIG), FBI, or Postal Inspection Service frequently focus on:
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Exaggerating Injuries: Claiming a disability or physical restriction that does not exist or is less severe than reported.
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Double-Dipping: Working another job, running a business, or earning unreported income while collecting total disability payments.
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Falsifying Cause: Claiming a non-work-related injury occurred during official job duties.
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Concealing Prior Conditions: Willfully failing to disclose pre-existing injuries or prior benefit claims.
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Duplicate Claims: Submitting multiple benefit claims for a single injury event.
Penalties for 18 U.S.C. § 1920 Convictions
Statutory penalties for federal workers' compensation fraud depend on the total dollar value of the benefits fraudulently obtained or sought:
|
Severity Threshold |
Maximum Prison Term |
Potential Fines & Restitution |
| Benefits Over $1,000 (Felony) | Up to 5 years in federal prison | Fines up to $250,000, mandatory restitution, loss of federal employment |
| Benefits $1,000 or Less (Misdemeanor) | Up to 1 year in federal prison | Fines up to $100,000 and mandatory restitution |
Note: Related charges, such as Perjury (18 U.S.C. § 1621), Mail Fraud (18 U.S.C. § 1341), or Wire Fraud (18 U.S.C. § 1343), may also be filed, increasing potential prison exposure.
Federal Defense Strategies for 18 U.S.C. § 1920 Charges
An experienced federal criminal defense lawyer at Eisner Gorin LLP can employ several core strategies to counter government allegations:
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Lack of Criminal Intent / Good Faith Error: Demonstrating that inaccurate statements resulted from confusion, administrative oversight, or ambiguous medical reporting rather than a willful attempt to deceive.
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Insufficient Evidence: Challenging surveillance video, undercover logs, or medical evaluations presented by DOL-OIG agents to show they fail to prove guilt beyond a reasonable doubt.
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Legitimate Medical Disagreements: Highlighting conflicting opinions between treating physicians and government-retained Independent Medical Examiners (IMEs).
Early intervention before a grand jury indictment allows defense counsel to negotiate directly with Assistant U.S. Attorneys, potentially preventing formal charges or resolving allegations administratively.
Frequently Asked Questions (FAQs)
What federal agency investigates workers' compensation fraud against federal employees?
The U.S. Department of Labor Office of Inspector General (DOL-OIG) leads most investigations, frequently collaborating with agency-specific investigators such as the U.S. Postal Inspection Service or the FBI.
Is making an honest mistake on a federal workers' comp form considered a crime?
No. To convict someone under 18 U.S.C. § 1920, prosecutors must prove the false statement was made knowingly and willfully. Clerical mistakes, misunderstandings, or unintentional omissions lack the requisite intent for criminal liability.
What is the threshold for a felony charge under 18 U.S.C. § 1920?
If the value of the compensation or benefit obtained or sought exceeds $1,000, the offense is charged as a felony carrying up to five years in prison. If the amount is $1,000 or less, it is charged as a misdemeanor punishable by up to one year.
Can you work another job while receiving federal workers' compensation benefits?
Working another job without reporting earned income to the Department of Labor while collecting total disability benefits is classified as illegal "double-dipping" and forms the basis of many federal fraud prosecutions.
What should I do if federal agents contact me about a workers' compensation claim?
Politely decline to answer questions or provide statements without legal counsel present, and contact a federal criminal defense attorney immediately to protect your constitutional rights.
Eisner Gorin LLP can help you. Schedule your consultation by calling (818) 781-1570 or by using the contact form. Our law firm is based in Los Angeles.