33 U.S.C. § 931: Penalty for misrepresentation

Summary

If someone who is claiming benefits, or their paid representative, lies on purpose to get money under this law, they can be charged with a felony. If convicted, they can be fined up to $10,000, put in jail for up to five years, or both. The U.S. attorney where the injury happened must try to quickly investigate each such complaint. The Secretary must keep and publish a yearly list of people who are not allowed to represent claimants for a fee. The list covers people who were convicted for crimes related to claims, who committed fraud in claims, who were barred by other workers’ compensation agencies for similar misconduct, or who took fees that were not approved or were too high. Names are posted for workers and employers. People on the list cannot have their representation fees approved, the ban lasts at least three years, employees do not have to pay disallowed fees, and the Secretary will make rules to carry this out. Employers, agents, or insurers who lie to cut off or deny benefits face the same $10,000 fine and/or five-year jail term.

Title 33, §931

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(a)Felony; fine; imprisonment

(1)Any claimant or representative of a claimant who knowingly and willfully makes a false statement or representation for the purpose of obtaining a benefit or payment under this chapter shall be guilty of a felony, and on conviction thereof shall be punished by a fine not to exceed $10,000, by imprisonment not to exceed five years, or by both.

(2)The United States attorney for the district in which the injury is alleged to have occurred shall make every reasonable effort to promptly investigate each complaint made under this subsection.

(b)List of persons disqualified from representing claimants

(1)No representation fee of a claimant’s representative shall be approved by the deputy commissioner, an administrative law judge, the Board, or a court pursuant to section 928 of this title, if the claimant’s representative is on the list of individuals who are disqualified from representing claimants under this chapter maintained by the Secretary pursuant to paragraph (2) of this subsection.

(2)(A)The Secretary shall annually prepare a list of those individuals in each compensation district who have represented claimants for a fee in cases under this chapter and who are not authorized to represent claimants. The names of individuals contained on the list required under this subparagraph shall be made available to employees and employers in each compensation district through posting and in such other forms as the Secretary may prescribe.

(B)Individuals shall be included on the list of those not authorized to represent claimants under this chapter if the Secretary determines under this section, in accordance with the procedure provided in subsection (j) of section 907 of this title, that such individual—

(i)has been convicted (without regard to pending appeal) of any crime in connection with the representation of a claimant under this chapter or any workers’ compensation statute;

(ii)has engaged in fraud in connection with the presentation of a claim under this or any workers’ compensation statute, including, but not limited to, knowingly making false representations, concealing or attempting to conceal material facts with respect to a claim, or soliciting or otherwise procuring false testimony;

(iii)has been prohibited from representing claimants before any other workers’ compensation agency for reasons of professional misconduct which are similar in nature to those which would be grounds for disqualification under this paragraph; or

(iv)has accepted fees for representing claimants under this chapter which were not approved, or which were in excess of the amount approved pursuant to section 928 of this title.

(C)Notwithstanding subparagraph (B), no individual who is on the list required to be maintained by the Secretary pursuant to this section shall be prohibited from presenting his or her own claim or from representing without fee, a claimant who is a spouse, mother, father, sister, brother, or child of such individual.

(D)A determination under subparagraph (A) shall remain in effect for a period of not less than three years and until the Secretary finds and gives notice to the public that there is reasonable assurance that the basis for the determination will not reoccur.

(3)No employee shall be liable to pay a representation fee to any representative whose fee has been disallowed by reason of the operation of this paragraph.

(4)The Secretary shall issue such rules and regulations as are necessary to carry out this section.

(c)False statements or representation to reduce, deny, or terminate benefits

A person including, but not limited to, an employer, his duly authorized agent, or an employee of an insurance carrier who knowingly and willfully makes a false statement or representation for the purpose of reducing, denying, or terminating benefits to an injured employee, or his dependents pursuant to section 909 of this title if the injury results in death, shall be punished by a fine not to exceed $10,000, by imprisonment not to exceed five years, or by both.

Notes & Related Subsidiaries

Editorial Notes

Amendments

1984—Pub. L. 98–426 designated existing provisions as subsec. (a)(1), substituted “Any claimant or representative of a claimant who knowingly and willfully makes a false statement or representation for the purpose of obtaining a benefit or payment under this chapter shall be guilty of a felony, and on conviction thereof shall be punished by a fine not to exceed $10,000, by imprisonment not to exceed five years, or by both” for “Any person who willfully makes any false or misleading statement or representation for the purpose of obtaining any benefit or payment under this chapter shall be guilty of a misdemeanor and on conviction thereof shall be punished by a fine of not to exceed $1,000 or by imprisonment of not to exceed one year, or by both such fine and imprisonment”, and added subsecs. (a)(2), (b), and (c).

Statutory Notes and Related Subsidiaries

Effective Date

of 1984 AmendmentAmendment by Pub. L. 98–426 effective Sept. 28, 1984, see section 28(e)(1) of Pub. L. 98–426, set out as a note under section 901 of this title.

§931 Penalty for Misrepresentation