Although claimant may not have fully understood the contents or purpose of the employer’s W.C. claims forms, he made a false statement when he provided a fictitious social security number, thus his claim was denied.

In this misrepresentation case, the employer sent the claimant a form to complete at the onset of his claim. In return, the claimant provided a false social security number on the fraud statement and completed an authorization for the release of medical information and a work force innovation release form. The employer then asserted fraud and denied all benefits. The judge concluded that, while the claimant may not have fully understood the contents or purpose of the forms, he made a false statement when he provided the fictitious social security number and did so for the purpose of obtaining workers’ compensation benefits. The claimant was barred from receiving any benefits.

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