The authors of this letter are journalists, columnists, bloggers and content publishers for the workers' compensation industry across the United States. We are a politically and professionally diverse group. We do not agree on everything, yet find ourselves of one opinion on a highly critical matter. We are competitors who are now colleagues for a common cause; to bring light to a serious injustice being committed within your state.
The prosecution of Charles (Sandy) Blunt was, in our view, an outrageous and almost farcical event. It is, in the final analysis, a travesty that has damaged the national view of your state, hampered the operation of a State agency, and ruined the life of a good man wholly undeserving of such results. (WCxKit)
Sandy Blunt was Director of North Dakota's Workforce Safety & Insurance from May of 2004 until December of 2007. He was, as you are likely aware, prosecuted by state authorities for “misspending government funds”. Specifically, he was charged and convicted on two counts
1. During his almost 4 year tenure his agency spent approximately $11,000 on employee incentive items, including flowers, trinkets, balloons, decorations and beverages for Workforce Safety and Insurance employee meetings, and on gift certificates and cards in small denominations for restaurants, stores and movie theaters. Blunt personally approved some of these expenditures. Others were made by managers as part of daily operations under his watch. Not a dime went into an employee’s pocket, nor did Blunt personally benefit from any expenditure.
2. His agency paid $8,000 to an employee, David Spencer, for sick pay when he was not apparently sick, and it also failed to collect $7,000 from Spencer when he left prior to the end of his employment agreement. The $7000 was for moving expenses incurred that prosecutors felt Spencer owed the state. Blunt’s position was that the agency was not entitled to collect these funds, since Spencer’s departure was not voluntary.
All told, the state prosecuted Sandy Blunt, and he is now a convicted felon for “misspending” $26,000 of government money.
No one has ever alleged that Blunt personally benefited from any of these expenditures. Blunt was acting like other capable, ethical North Dakota executives ‐ in the best interest of customers and of the mission of his employer. In our industry it is considered a best practice to provide employees and supervisors with incentives. It is not frivolous, it's necessary, and what every employer should do.
The first of these two charges would be, to many people, laughable if it were not for the damaging consequences associated with them. The notion that buying inexpensive incentive items for your employees could result in a felony conviction is simply stunning. This would not be elevated to a criminal status in most states in the nation. The fact that it is in North Dakota should have a chilling effect on businesses looking to move there.
The second and more serious charge, involving the sick pay and moving expenses of employee Spencer, has been fatally undermined by the revelation that the prosecutor in the matter, Cynthia Feland, withheld critical evidence from the defense – evidence that largely clears Blunt in this area. A disciplinary panel for the North Dakota Supreme Court has found on November 7, 2011 that
“Cynthia M. Feland did not disclose to Michael Hoffman, defense attorney for Charles Blunt, the Wahl memo, and other documents which were evidence or information known to the prosecutor that tended to negate the guilt of the accused or mitigate the offense.”
Withholding of evidence by prosecutors is one of the most serious acts of prosecutorial misconduct in North Dakota and all other states. In recognition of this, the panel recommended Ms Feland’s license to practice law be suspended. We urge that you read the entire report of the panel, including the penalties the board recommended be imposed on Ms. Feland. For the report, go here.
Had the prosecutor not withheld evidence, in all likelihood the case would never have come to trial, and the reputation of Blunt and the WSI would be free of taint. The evidence in question shows that WSI’s auditor’s own findings backed Blunt’s position on payments related with Spencer. However, those findings were not made available to the defense, and the prosecutor was found to have allowed testimony to be given at the trial that directly conflicted with information she had. As we indicated, Feland, now a judge in your state, has been recommended for suspension and a fine over these findings.
Yet Sandy Blunt remains a convicted felon. His crime? Buying balloons, trinkets and $5 gift cards – for his employees, not for himself. For that, Blunt, who is married with two children, has had to spend half a decade, and untold thousands of dollars trying to clear his name.
Some of us have known Sandy for quite a while. Some have come to know him while learning of his situation. Others of us have never met Sandy, but recognize the tenuous nature of his treatment. Collectively we speak to thousands within our industry every day. Our opinions have been clear; this situation needs the light of truth shone brightly upon it. The time and resources expended prosecuting a man on such questionable grounds should be more closely examined, by the business community, workers compensation professionals and the media in North Dakota. (WCxKit)
Sandy Blunt is a good and decent man. He deserves better. So, it would seem, do the people of North Dakota.
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Texas Mutual Insurance Company reported recently that a Travis County district court sentenced Thomas Mikulenka of League City, Texas on workers compensation fraud-related charges.
The court sentenced Mikulenka to three years deferred adjudication and 100 hours of community service. Mikulenka was also ordered to pay $7,221 in restitution to Texas Mutual. (WCxKit)
Mikulenka reported a job-related injury while working as an electrician for IGC Construction, Inc. in Houston. He claimed he was unable to work as a result of the injury, and Texas Mutual began paying income benefits to him.
Meanwhile, Texas Mutual uncovered evidence that Mikulenka was working as a laborer while receiving income benefits.
Investigators call this type of scam double-dipping because claimants collect benefits for being too injured to work when, in fact, they are gainfully employed. Texas law requires claimants to contact their workers comp carrier when they return to work. (WCxKit)
Left unchecked, double-dipping and other workers comp fraud can lead to higher premiums for all Texas employers.
Maryland Woman Sentenced in Nevada Workers Comp Fraud Case
A Maryland woman has been sentenced to 2 ½ years in a Nevada state prison for attempting to defraud her employer’s workers compensation insurer of $20,000 while at a professional conference at the Las Vegas Hilton, according to Nevada Attorney General Catherine Cortez Masto’s office.
Tamara Thompson-Johnson, 45, was ordered to pay $20,000 in restitution, $4,000 in extradition costs and serve 2 ½ years in a Nevada prison after pleading guilty to making false statements to obtain workers comp benefits from her employer, officials say. (WCxKit)
According to officials, Thompson-Johnson claimed she was injured at the Las Vegas Hilton when a vase, dislodged by an intoxicated person, fell from its pedestal. Although she refused medical treatment at the scene, she reported to security that she had been struck by the vase and checked herself into a hospital.
The Nevada General Attorney’s office says Thompson-Johnson hired a lawyer and requested a claim for compensation from the Las Vegas Hilton. Her claim was turned down when surveillance footage of the incident surfaced showing that the vase narrowly missed Thompson-Johnson.
Although her lawyer ceased representing her Thompson-Johnson filed another claim through her employer’s workers comp carrier Travelers Insurance, claiming the vase hit her on the back of her head, neck and back, leaving her disabled. As a result she was paid $20,000 on her fraudulent claim.
According to the Nevada Attorney General’s office, Thompson-Johnson was extradited from Maryland when she did not appear for court hearings in Las Vegas.
She pleaded guilty to one felony count of making false statements or representations to garner benefits and was sentenced in November. (WCxKit)
Along with a 2 ½ year jail sentence, she was ordered to pay $20,435 in full restitution to Travelers Insurance, $4,005 in extradition costs and to reimburse the state $1,000 for costs in connection to the case and was ordered to disclose her conviction to present and future employers and insurers.
Author Robert Elliott, executive vice president, Amaxx Risk Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. See www.LowerWC.com for more information. Contact: Info@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com
Morale hazard is loosely defined as the presence of an outside item or system that affects typical behavior. I like to use an example of SUV-type vehicles. Because of added safety features and the enormity of the vehicle, drivers report feeling safer and often take more risks then when driving smaller, less-safe vehicles. For example, an SUV driver may be more aggressive during dangerous snowy conditions, or drive more aggressively in general simply because she feels safer. WCxKit
To put this in a Workers Compensation context, the morale hazard is the comp system itself. The system’s rules and laws make people behave differently than if they were presented with the same injury and medical scenario outside of the work comp atmosphere. We further discuss these scenarios below:
1. Increased pain behavior
Within the WC world, adjusters often complain about claimants overreacting to pain and complaining about the presence of pain with even the most trivial injury. This is thought to happen due to the nature of the claimant feeling that they have to prove their injury to the doctor and to the carrier. Even though, as adjusters, we understand injuries occur and most times they do indeed hurt, the need presents itself for the claimant to feel as if they have to be sure to state how unbearable this particular injury is, in order to make the injury seem more believable.
If you take WC presence away, when a similar strain injury occurs, outside of the workplace, for example, the reaction may be wildly different. Claimants may shrug off the pain as “age-related” or due to overdoing it instead of feeling the need to play up the pain to their doctor, as is often the case in workers compensation claims. Adjusters will rely on physicians using the “Waddell’s signs” to evaluate pain behaviors in relation to the severity of injury. As you see, the mere presence of the work comp system can provide the means to making claimants overplay pain as much as possible to make their case more concrete or believable.
2. Increased drug-seeking behavior
Minor strain injuries generally resolve with modified activity and time. But when a work comp case is present, some claimants feel the need to seek out certain types of medications, typically opiate in nature, to cement the legitimacy of their injury. The thought process is, “If I did not have a bad injury, why would I need these stronger medications? Therefore, my claim must be legitimate.”
One factor muddling this is physicians who are quick to prescribe opiate medication even when the clinical need is not present. Strain type injuries can heal with assistance from anti-inflammatory medication, not necessarily stronger opiate classifications of prescriptions. Many resolve with hot/cold compresses, several special deep knee bend type exercises, rest and 1-2 chiropractic treatments. I speak from experience.
Removing the comp system again can show the normal behavior. If a person injures themselves mowing their lawn, if they do not like going to the doctor in general, they may take over the counter medications and feel just as good the next day as if they did indeed take a stronger medication prescribed to them by their physician. So you see, drug-seeking behavior is rampant in work comp cases due to the need for the claimant to seek approval from their comp carrier for that injury.
3. Poor work quality in light duty work classification
If you have the capability for light duty at your factory, when claimants get injured and have work restrictions, proactive employers place them in lighter duty jobs until they get released by their doctor to full duty. A common situation in comp is the worker complaining even the light duty work makes their pain worse. This can happen even when it seems impossible the light work could cause pain. This is due to the presence of workers compensation. Had the worker not been injured, and you placed them in this light-duty job, it is doubtful they would be making the same complaints.
4. Increased work absences due to pain
Similarly, employers may see an increase in work absences due to alleged pain complaints. Workers will say, no matter what job they do, they just cannot get out of bed and back to work due to injury pain. In the example of the lawn-mowing injury – when the comp system is removed, it is probable this worker will show up as scheduled and ready to work as if it were any other day. This again may be due to the claimant feeling the need to legitimize their claim to the carrier. True, sometimes it's not.
5. General avoidance with the employer
Sometimes outright avoidance becomes apparent. Missed phone calls, voicemails not returned, and an employee not bringing in medical slips to the HR department as instructed may start to happen. Remove the comp system and injury, and this wouldn’t happen. A responsible worker injured outside of work keeps the HR department up to date with medication restriction slips. Once you introduce the work comp system to this same scenario, avoidance behavior may come to fruition. WCxKit
To review, morale hazard is the presence of a particular system or entity that can affect a person’s behavior negatively. This is made clear within the presence of workers compensation. Adjusters see these behaviors day in and day out. What the employer calls a “great, dependable employee” could be to the adjuster a claimant who exaggerates pain, has drug-seeking behavior, and exhibits typical avoidance maneuvers in general. This all negatively impacts the claim, and actually makes it more difficult in the long run. From the workers point of view, these behaviors make their claim more legit — just the opposite occurs.
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.
A new Washington state law, protecting consumers from immigration-related fraud, went into effect, according to a report from the Attorney General’s Office.
The recently enacted Immigration Services Fraud Prevention Act, requested by the Attorney General’s Office, prohibits anyone from engaging in the unauthorized practice of law in an immigration matter, unless that person is a licensed attorney or is otherwise authorized to provide legal services under federal immigration law. (WCxKit)
Designed to protect consumers from deceptive business practices, the new law prohibits non-lawyers and unauthorized individuals from engaging in several other activities.
• Selecting or assisting another in selecting an immigration-related government form;
• Advising another as to his or her answers on an immigration-related government form;
• Soliciting to prepare documents for another for submission in a judicial or administrative immigration proceeding;
• Charging a fee for referring another to a person licensed to practice law;
• Drafting or completing legal documents affecting the rights of another in an immigration matter;
• Referring oneself as an “immigration assistant,” “immigration consultant,” “immigration specialist,” or any other term in any language (including the Spanish term notario publico), that conveys or implies that the person possesses professional legal skills in the area of immigration law
While the law does not prohibit the provision of translation services, the law does prohibit non-lawyers and other unauthorized persons from advising customers as to their answers on immigration forms.
As the new law goes into effect, the Attorney General’s Office warns consumers to be careful who they trust when it comes to immigrant assistance.
“In Washington and around the country, people advertising immigration services use the title notario publico on business cards and in their business dealings to deceive consumers into thinking that they have special legal training in immigration affairs,” said Attorney General Rob McKenna. “However, a notario publico is not a lawyer and is not authorized under state or federal law to provide you with legal assistance in your immigration case.”
In several Latin American countries, the term notario publico refers to an individual who has received extensive legal training over the course of several years.
In the United States, a “notary public” is an individual who has the authority to administer an oath or affirmation or witness the signing of papers. The title is relatively simple to obtain. (WCxKit)
Many people use this linguistic accident to deceive Spanish-speaking customers into thinking that they are experts in immigration law. Do not be deceived by a person described as a notario or notario publico. He or she is probably just a “notary public” with no legal skills whatsoever, according to McKenna.
Author Robert Elliott, executive vice president, Amaxx Risk Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. See www.LowerWC.com for more information. Contact: Info@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact
Most states allow an injured worker to seek care with whatever physician the employee prefers. There are some rules to follow, but as long as the doctor cooperates there usually is not a problem.
But when there is a problem, it is a big problem. When the adjuster is working with a doctor that does not want to cooperate and respond to certain questions, that is a major issue. This issue will affect the injured worker by affecting care and time off of work. It can cause the claim to go to litigation, etc. So something as simple as going to the doctor for an injury can morph into a really big deal. Here are some warning signs that a claim could be heading down the bumpy road. (WCxKit)
1. The physician places the worker off of work with no restrictions and no explanation
This one item frustrates adjusters more than any other. If a person comes in with a hand laceration, and the doctor places them off of work for 4 weeks, how is that legitimate? The worker has another hand that is perfectly fine. Even if the workplace is a dirty environment it does not mean it is risky to be at work with a hand laceration to one hand.
Physicians familiar with workers comp know better. They know if they place a worker totally off of work and do not address restrictions, the adjuster will call. In the world of workers comp, if a worker is on total off work status that means the employee either just had surgery or sustained a major injury.
There are 2 roadblocks to return to work: (1) the employer does not cooperate with creating light duty work for the injured workers, and (2) the doctor totally disables the employee for no good reason. But it depends, if this injury is acute and very severe, then certainly some time off of work is warranted for rest. But the doctor has to explain why. There is nothing the adjuster hates more than to see a back injury, and the worker is totally disabled, but in physical therapy. So the worker is good enough to go to therapy, but not good enough to go do some light desk work for the employer?
Physicians have to explain the diagnosis and work restrictions, and they have to have good objective evidence to support the decisions. The adjuster has the right to demand that the doctor answer specific questions, and if the doctor disregards that, then it can affect the benefits being paid out on the file. So warning sign #1 if there is an off work slip with no real explanation as to why.
2. Makes a return appointment in 3-4 week intervals
A doctor that is monitoring a condition on a comp claim knows the worker’s main goal is to get back to work. So they closely monitor the situation. They schedule to see the injured party at least once every week, if not sooner depending on the injury. A warning sign for a complacent doc is a return visit in 4-6 weeks. That is a long period of time to go without being evaluated. If it is a surgical claim, and this worker is post-surgery, and starting rehab, then this may be ok. But for early on in a comp claim, anything over 7-10 days I would raise an eyebrow. He will drag out the claim costing the employer more money.
3. Everyone at work knows the physician or has treated there
If the injured worker goes to Dr. Smith, and everyone knows Dr. Smith at the shop, and everyone treats with Dr. Smith both for personal medical issues and for workers comp injuries, I would be concerned. Maybe Dr. Smith prescribes a lot of Vicodin for simple injuries. Maybe Dr. Smith disables them from working for a longer time than anyplace else. It could be anything, but if this particular clinic is a place where 85% of your workplaces treat, something is awry. It may not be “illegal” activity, but there is some trend that this doctor does that nobody else in town will do. And that is always cause for concern in an insurance claim.
4. The doctor prescribes narcotics for minor strain injuries
This is perhaps the most popular trend these days. I have observed countless claimants going to the doc for a simple strain and walk out of the clinic with a 30-day RX for Vicodin. That is never a good sign. I am not a physician. I did not go to med school. If Vicodin is needed for 3-5 days, that is warranted. But for an initial visit, for a simple strain, that is not really all that severe, a 30 day supply is unnecessary. RX stands for "prescription."
The cost of the RX is determined by quantity and type of drug. If you look at the work slip and the doctor prescribed Vicodin and Percocet, Valium, and Motrin, that is not acceptable. Not only did this doc over-prescribe by giving the worker 2 similar narcotic drugs (Vicodin, Percocet) but also prescribed Valium, which may or may not even be needed for this particular case. Probably the only RX a simple strain needs is the Motrin. All the other RX’s are warning signs that this doctor is happy to prescribe anything at will, and these medicines are not cheap, and some are not even necessary.
5. Recommend physical therapy (at his clinic) for everything
I recall a while back there was a large occupational clinic that would give anyone that walked in a script for physical therapy (PT). You can have sprained your hand, and you were going to go for 4 weeks of PT. Back injuries, finger lacerations, elbow pain, the answer was PT. They were using PT as a stall tactic, not the way it should be used by reputable doctors. Finally enough people must have stepped up and said “This is ridiculous! You mean to tell me every person that walks in needs PT?”
But this shows a crucial point. Some physicians are also financially tied in to therapy facilities as well as to other testing facilities. So not only do they make money off office visits for evaluating the patient, but they make even more money billing for 12-16 PT visits. Then they will probably see the patient again at the clinic for another evaluation. And maybe more PT is needed. And, before you know it, the cycle begins. In most states this is illegal and unethical. Excessive PT is an indicator that something fishy is going on, and you can use your tools, such as an IME, to deem if more PT is really reasonable and necessary treatment in your given claim. Employers can eliminate the risk of using the wrong PT facilities by using the services of a Physical Therapy Management Company instead of simply working with the least expensive PT network. Physical therapy can be extremely effective in facilitating recovery and return to work when used appropriately. I know, I've been there, done that.
6. Hesitant to refer out to a specialist
This is a warning sign because the physician wants to keep seeing the patient and wants to keep billing the carrier/TPA. As soon as the patient goes to an ortho or other specialist, that patient no longer treats at this clinic. So, the doc has incentive to keep that patient around for a longer period of time. Repeat business is what makes money, and if the patients are continually coming back, that is more money in someone's pocket. So if it has been a few months and the injured party is no better, it is way beyond time to be evaluated by a specialist. And if the treating doctor is not bringing this up, you may need to force the issue.
7. No dictation and very few hand-written notes
The adjuster will always want to see the doctor’s actual notes or transcribed dictation. This is where the adjuster can see exactly what the patient said, what the doctor saw on examination, and what the doctor’s plans are for resolving this medical condition.
If the adjuster requests the notes, and they consist of 1-2 sentences of barely visible hand written scribbles, this is not good. Not only is it worthless to the adjuster, it is worthless in general. There is no info about the patient, about the exam, or about the treatment plan. These doctors are out there. An example of their medical note could consist of the items below.
“Jack feels the same. Continue therapy for 4 weeks and return afterwards.”
As crazy as that seems, that sometimes is it. And the bill was probably $100-$150 for that “exam.” So beware of the doctor that does not dictate or does not have properly typed notes. It does not mean the doctor is necessarily bad, it just means that if the worker continues to treat with this physician, it is going to be a struggle to get information and clarification the longer the claim goes on. Those issues are very important, and if you struggle getting that much needed information, the rest of the claim will be a struggle as well.
Summary
There are good doctors, and bad doctors. There are doctors that care about their patients, and doctors that could care less. There are doctors that write up fantastic notes, and some that jot down a sentence or 2. Physicians are just like everyone else. They all have a unique style. They have good days and bad days. Some have successful practices, and some do not. (WCxKit)
But the bottom line is if a doctor is going to treat the injured worker, in a workers comp situation, then they have to abide by the rules. And if they choose not to do so, it is going to complicate the claim one way or another. Use the above warning signs to evaluate current claims for rough roads ahead.
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Manage Your Workers Compensation: Reduce Costs 20-50% www.WCManual.com.
Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com
United States Attorney Benjamin Wagner announced that Chief United States District Judge Anthony Ishii sentenced 44 year-old Karina S. Beard of Turlock, California to one year in prison, to be followed by three years of supervised release, for four counts of mail fraud and two counts of federal workers compensation fraud. Beard was also ordered to pay $81,694 in restitution.
According to court documents, Beard worked as a distribution and window clerk for the Postal Service in Groveland. For two plus years, Beard received federal workers comp benefits for an on-the-job injury. Because of her claimed injuries, restrictions were placed on Beard's physical activities: no reaching, no pushing, no pulling, no driving for more than 20 minutes, etc.
Yet, Beard performed various physical tasks, such as horseback riding, caring for horses, yard work, and driving all using the purportedly injured part of her body. Because of claims Beard made in routine Department of Labor questionnaires, she continued to receive workers comp benefits, all while not entitled to such benefits. (WCxKit)
At least once a year the U.S. Department of Labor’s Office of Workers Compensation Programs is required to ask every total disability benefit claimant whether the claimant has had any employment, earnings, or changes in their medical condition over the previous 15 months. In compliance with regulations, OWCP sends out a questionnaire to each claimant. Claimants reporting changes in employment, earnings, or their medical conditions on the questionnaire may experience a reduction or termination of benefits.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.
Justice was served recently on a Glen Eden, New Zealand woman who evaded several previous Court appearances to face charges of defrauding the Accident Compensation Corporation (ACC).
According to a report from ACC, Emi Tuala, a 44-year-old solo mother, appeared in the Waitakere District Court and was convicted of nine charges under the Crimes Act, and two charges under the ACC Act. (WCxKit)
Tuala was sentenced to six months’ supervision, three months’ community detention and was ordered to pay reparation of $6,939.89. She must also complete a budgeting course, and observe a nightly curfew during the period of community detention.
The charges related to a seven-month period between 2003 and 2004, during which Tuala was paid weekly compensation on the basis that an injury prevented her from working. ACC investigations subsequently revealed that Tuala had worked full-time throughout this period.
During the same period, Tuala also claimed reimbursement for home help costs that she never incurred. (WCxKit)
Tuala was originally summoned to appear in Court in February 2005. After she failed to appear, a warrant for her arrest was issued. She failed to attend subsequent Court hearings and further arrest warrants were issued.
Author Robert Elliott, executive vice president, Amaxx Risk Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. See www.LowerWC.com for more information. Contact: Info@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact
A Corrections Officer from New York Mills is facing fraud charges after authorities say he wrongfully collected workers compensation benefits from the State, according to information from the New York State Police.
The police noted that Frank Caporale, 43, of New York Mills was charged with first-degree offering a false instrument for filing and fraudulent practices, both felonies.
Caporale, a New York State Corrections Officer at Midstate Correctional Facility, allegedly submitted written statements that contained materially false information to the New York State Insurance Fund as part of a claim for payment.
According to State Police, the statements indicated that Caporale was not employed, when he in fact was working a second job. As a result of these filings, the defendant did wrongfully collect $10,540 in workers comp benefits from the State Insurance Fund.
Caporale was subsequently given appearance tickets returnable in the Town of Marcy Justice Court.
Author Robert Elliott, executive vice president, Amaxx Risk Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. See www.LowerWC.com for more information. Contact: Info@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
A lot of employers use in-house video cameras and surveillance devices to monitor employees and customers. This is not only for workers compensation issues but also liability issues. Customer injuries are another facet of risk management. It is important to properly document, record, and use surveillance for even minor injuries. They can also deter criminal activity.
Installing Surveillance Cameras in the Work Environment
Employers install surveillance cameras not to “spy” on workers, but to be able to record events when no witnesses are present. Again, it is about legitimizing, substantiating the claim and the injury. Take for instance a worker who reported being on the ground for 20 minutes before being able to get up and seek help after an injury, but what evidence is there to support this report with no witnesses? Surveillance cameras are the silent witness. Finding even one fraudulent workers compensation claim can save a lot of money for the employer. (WCxKit)
If workers are aware of being recorded, surveillance lessens horseplay in the workplace. Many workers comp claims result from horseplay. In such case, the claimant lied to the doctor about a pallet falling, when the worker was actually injured while running and flipping into a rolling cart while coworkers stood by and laughed.
This injury required surgery. Since cameras caught the worker behaving inappropriately, the claim was disproved 100%. The employee deceived the boss, doctors, and the adjuster about how the injury occurred. In this case, it changed the compensability completely. (WCxKit)
In the end, an employer finds it very beneficial to have cameras installed especially when insurance premiums are also reduced.
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing, publishing, pharmaceuticals, retail, hospitality, and manufacturing. See www.LowerWC.com for more information. Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
A Watertown, Massachusetts roofing company and its owners have been arraigned on charges they allegedly failed to disclose millions of dollars in misclassified subcontractor payroll and failed to pay the prevailing wage, Attorney General Martha Coakley’s Office announced.
Shaun Bryan and Antoinette Capurso-Bryan, of Newton, and their company, Newton Contracting Company, Inc., of Watertown, were arraigned on the following charges:(WCxKit)
Shaun Bryan, 47, of Newton
Workers Compensation Premium Evasion (4 counts)
Unemployment Contribution Evasion (12 counts)
Misclassification of Employees as Independent Contractors (4 counts)
Failure to Pay the Prevailing Wage
Newton Contracting Company Inc., of Watertown
Workers Compensation Premium Evasion (4 counts)
Unemployment Contribution Evasion (12 counts)
Misclassification of Employees as Independent Contractors (4 counts)
Failure to Pay the Prevailing Wage
Antoinette Capurso-Bryan, 47, of Newton
Misclassification of Employees as Independent Contractors (4 counts)
Failure to Pay the Prevailing Wage
Authorities began an investigation into the Bryans and their company in late 2008, after the JTF received complaints that Newton Contracting was misclassifying part of its workforce. The Attorney General’s Office also received a complaint that Newton Contracting had misclassified its roofing employees as laborers at the Suffolk County Jail Project and consequently failed to pay their employees the prevailing wage rate.
The EOLWD’s Division of Unemployment Assistance (EOLWD\DUA) conducted a compliance audit of Newton Contracting’s payroll records in early 2009. The EOLWD\DUA determined that Newton Contracting misclassified multiple employees as independent contractors and consequently failed to disclose to the EOLWD\DUA more than $2.4 million in misclassified subcontractor payroll for each quarter during 2006 through 2008. The EOLWD\DUA assessed more than $52,000 in additional unemployment contributions, including interest, against Newton Contracting.
During this time the IFB began an investigation of four of Newton Contracting’s worker’s compensation policies covering July 1, 2005, through July 1, 2009. The IFB discovered that the company allegedly misclassified half of its workforce as subcontractors. The IFB’s investigation further revealed that during its annual workers comp audits, Shaun Bryan allegedly failed to disclose to the auditor more than $3.4 million of Newton Contracting’s misclassified subcontractor payroll over the course of four policy periods.
The AG’s Fair Labor Division received a complaint that in 2009 Newton Contracting’s employees performing roofing work at the Suffolk County Jail Project were misclassified as laborers. The prevailing wage rate for roofing work was $53.86. Newton Contracting paid the workers $44.10 hour. In 2010, Newton Contracting paid two employees more than $5,000 in restitution for the misclassification and consequent failure to pay the prevailing wage violation.
A Suffolk County Grand Jury returned indictments against all three defendants on Dec. 19. The defendants were arraigned in Suffolk Superior Court where each pleaded not guilty and were released on personal recognizance.(WCxKit)
The defendants were to be in court Jan. 6, 2012 for further proceedings.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
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