Welch v. Workforce Safety & Insurance

Marqus Welch appealed, and Workforce Safety and Insurance ("WSI") cross-appealed a judgment affirming an administrative law judge's ("ALJ") decision that affirmed a WSI order ending Welch's vocational rehabilitation benefits and disability benefits and that reversed a WSI order finding Welch committed fraud and requiring him to repay benefits. To trigger the civil penalties for making a false statement in connection with a claim for WSI benefits, WSI must prove: (1) there is a false claim or statement; (2) the false claim or statement is willfully made; and (3) the false claim or statement is made in connection with any claim or application for benefits. The North Dakota Supreme Court concluded the ALJ did not err in affirming WSI's disability benefits order because a reasoning mind could reasonably conclude Welch could return to work. The Court concluded, however, the ALJ misapplied the law in failing to apply the proper definition of "work" and in analyzing whether Welch had "willfully" made false statements. View "Welch v. Workforce Safety & Insurance" on Justia Law