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Alleged Horseplay Unsafe Work Practices Lead to Investigation

A video of what appears to be horseplay and unsafe work practices on a Calgary construction site has prompted an investigation by Alberta Employment and Immigration (AEI) and action from the city's building officials.
Canadian OH&S News reports the video was filmed at a condominium development site in Calgary, according to AEI spokesman Barrie Harrison. The vides, apparently shot by a worker, captures one co-worker tossing a clamp to another co-worker across elevated scaffolding.
"I was extremely disappointed to see workers, professionals, acting in such a manner, and obviously, extremely shocked for the disregard for the safety of the public [and] the safety of the workers below," Kevin Griffiths, Calgary's chief building official, said.
If the horseplay as seen in the video is proven to have occurred, it would be a violation of Section 189 of Alberta's Occupational Health and Safety Code, stipulating "if a worker may be injured if equipment or material is dislodged, moved, spilled or damaged, both the employer and the worker must take all reasonable steps to ensure the equipment or material is contained, restrained or protected to eliminate the potential danger." (WCxKit)
"When there's activity like this going on, (in) any sort of scaffolding construction, there should be some sort of safety netting beneath," Harrison said. "In some cases, you may want the sidewalk or street below to be cordoned off, but from the looks of the video, it doesn't look like any of that is in place." However, he adds, he does not want to assume anything until AEI's investigation is complete.
The workers were employed by Edmonton-based construction firm Skyway Canada, according to company president and chief operating officer Gary Carew. He added a pair of the workers in the video were suspended without pay, pending the results of investigations by both Skyway and AEI. The third involved worker recently left the company.
"Skyway Canada Ltd is deeply disturbed by the images in the video which we learned of last week," Carew says. "We do not condone the high-risk behavior of the workers in this video. We have commenced a comprehensive investigation into this incident and will share the results when completed."
Gary Wagar, executive director of the Alberta Construction Safety Association (ASCA) in Edmonton, notes that companies are obligated to manage horseplay through their safety management systems. "I think that there's a culture in general in young people, not just in the construction industry, when it    comes to horseplay," he contends.
Wagar suggests that if AEI inspectors were authorized to issue OH&S fines on-site, workers and employers might have more incentive to comply with safety regulations. (WCxKit)
Griffiths, meanwhile, would like to see municipal fine amounts raised for sites that endanger public and worker safety. "We want to send a strong message that everyone needs to do everything possible not to inflict any possible endangerment to the public, and in extension, to workers obviously, on-site," he says.
  \
Contact: Info@ReduceYourWorkersComp.com  or 860-553-6604.
  
TD Calculator:  http://www.LowerWC.com/transitional-duty-cost-calculator.php 

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.
  
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact
 Info@WorkersCompKit.com 
Posted in Canada Workers Comp, Fraud and Abuse, Safety and Loss Control |


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Work Comp Scheme Sends Woman to Prison

Open Mouth – Insert Foot
A Colorado woman who collected more than $25,000 in a workers compensation claim faces two years in prison.
Although originally charged with felony theft and forgery, reported by the Sentinel newspaper, the woman pled guilty to one count of making a false statement to achieve a benefit.
The 42-year-old woman claimed she injured her ankle while employed as a housekeeper at a Grand Junction hotel, but failed to report the injury for a month.
A doctor diagnosed her injury as a minor sprain. A month later, however, additional tests indicated more damage to her ankle and she began receiving partial disability and wage benefits from Pinnacol Assurance.
According to the arrest affidavit, the woman bragged about her ability to fool the system and informed some friends the injury wasn't even work related. A co-worker told investigators the woman said she injured her ankle away from work when she got drunk and fell on a street curb. (WCxKit)
The judge ordered the woman to repay $25,500 in restitution, along with serving the prison sentence.
  \Author Robert  Elliott,  executive vice president, Amaxx Risks 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.  Contact: Info@ReduceYourWorkersComp.com  or 860-553-6604.  
 
TD Calculator:  http://www.LowerWC.com/transitional-duty-cost-calculator.php 

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.
  
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact
 Info@WorkersCompKit.com 
Posted in Fraud and Abuse |


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New Ways a Private Eye Can Reduce Fradulent and Frivolous Claims

FACT: Your employees will file Workers Compensation claims . . .
FACT: Not all of them will be legitimate.
Patrick Barger, President of Arcane Invesigations, LLC, tells us that unfortunately, many try to beat the system by filing fraudulent or frivolous claims. The National Insurance Crime Bureau estimates Workers Compensation claim fraud costs the industry $5 billion per year. This occurs when your employees falsely claim to injure themselves at work; exaggerate minor work injuries to receive benefits; and/or take sick leave from your company while working another job. You become the victim. THE BOTTOM LINE: It costs you a lot of money!
Private Detective Agencies Can Verify ALL Claims
Hiring a reputable, experienced and credentialed Private Detective Agency for workers compensation claim verification can go a long way to deter would-be fraudsters. Private investigative services are routinely used by employers, claims adjusters and third-party administrators to confirm the legitimacy of certain claims where fraud is already suspected. But when investigators are hired after a claim has been filed and much time has elapsed, it costs you more money in surveillance fees. In these cases, insurance companies (and ultimately, the policyholder) and self-insurers pay for the “pound of cure.” (WCxKit)
Consider this potential solution to reducing surveillance fees and creating a blanket of deterrence to throw over those people waiting to cash-in on your workers compensation insurance: hire a Private Detective Agency to take the initial report of ALL workers compensation claims. In most cases, HR personnel take the initial report of a workplace injury. Likewise in most cases, HR personnel are not trained fact-finders or interview specialists. Good Private Investigators are subtle, know the right questions to ask and are experienced in determining and documenting the facts you need to know. When suspected fraud is discovered, investigators are already familiar with the case and can capture the necessary evidence to prove it. 
After the first time an employee visits with a private investigator to discuss an injury, it won’t take long for your entire workforce to know the first place they will stop when filing a workers compensation claim is a Private Detective Agency. As a result, those employees considering a fraudulent or frivolous claim will always think twice. This is a very inexpensive “ounce of prevention.”
Review ALL Claims
In addition to taking the initial injury report, Private Detective Agencies can also do a world of good toward terminating fraudulent and frivolous claims by conducting a review of existing open cases. For example, Arcane Investigations currently contracts with a major employer to periodically review each and every open workers’ compensation claim they currently have on the books. In this case, HR asks all injured employees to meet with us individually for a periodic review of their case. It is well publicized this is a review of all cases, not just one person’s — an audit of the employer’s entire workers compensation procedure, if you will. We go over the initial injury report and ask a series of follow-up questions concerning their current status. If we did not take the claimant’s initial injury report, this review process allows us to subtly inform them of our ongoing involvement.
A review strategy puts claimants on notice that there are trained professionals involved in their employer’s process. For our clients, it has had a profound effect on speeding-up the rate at which would-be malingerers return to work as well as toward early and reduced settlement or dismissal of claims in favor of the employer. Another valuable “ounce of prevention” versus a more expensive “pound of cure.”
Reduce Workers Comp Claims in General
Using a Private Detective Agency to verify all workers compensation claims is having an impact on reducing the overall number of claims for many employers. Arcane Investigations, LLC, has been taking the initial report of workers compensation injuries for several employers over several years. Those employers have experienced an average 35% decrease in overall claims filed since we began our program. This is attributed to the average employee asking themselves, “Do I really need to file a workers’ comp claim?” If the injury is "real" then of course they do, but if not, there is pause and reflection.
Various Investigation Types
If you do not use a Private Detective Agency to take the initial report of all workers compensation claims as an inexpensive “ounce of prevention,” then there are techniques that will definitely give you the “pound of cure” you’re looking for. A Private Detective Agency can use the following methods to help you verify workers compensation claims: 
·       Activities Checks are general in nature and determine several key elements of a subject’s life to document the person’s daily routine
·       Sub-Rosa Surveillance is specific in nature and uses video or still-photo evidence to document physical activity to compare to claimed injuries
One or both of these types of investigations will help determine if your employee’s claim is a legitimate one. Private Detective Agencies use a combination of both of these techniques in various degrees depending on the unique characteristics of the case. This is where the “rubber meets the road” and is no place to cut corners in your efforts.
Not All Private Detective Agencies Are Credible
When choosing a private detective agency, make sure the one you hire is reputable. Depending on your state’s requirements, many people who manage to get a license as a private detective are those who failed to be hired as police officers. In Nebraska for example, prior to about 15 years ago, anyone who could pass a background check could manage to get a license. Some were highly credible while others clearly were not. Many of these people who were not are still in business today. Since then, Nebraska has implemented a requirement that all private detectives must possess 3,000 hours of investigative experience before they are granted a license. Ask your potential private detective for references and credentials and know your state’s requirements for licensure. (WCxKit)
Pay Legitimate Claims Only!
Whether you own a business, are self-insured, an insurance agent, or responsible for employees, a Workers Comp investigation can help ensure all claimants are entitled to the compensation they receive.
 
Author Patrick Barger is President and Supervising Investigator of Arcane Investigations, LLC who we are pleased to welcome as our latest guest contributor. His firm consists of staff who were former law enforcement officers, government investigators or academics. Patrick is also a keynote speaker specializing in the area of fraud. He can be reached at 402-473-2773 or www.ArcaneInvestigations.com

WC Calculator:  http://www.LowerWC.com/calculator.php
TD Calculator:  http://www.LowerWC.com/transitional-duty-cost-calculator.php 
WC Round Table LinkedIn:  http://www.linkedin.com/groups?homeNewMember=&gid=1922050/

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.

  
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact
 Info@WorkersCompKit.com 
Posted in Fraud and Abuse |


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New York Business Owner Arrested for Failing to Provide Workers Comp Insurance For Employee Who Was Raped and Murdered

A business owner was arrested for failing to provide workers’ compensation insurance for an employee who was raped and murdered in 2007 according to an investigation by the New York State Insurance Department’s Frauds Bureau and the Workers’ Compensation Board Office of the Inspector General.
 
The man is accused of failing to insure the woman whom he employed as a property manager when she was killed. He is also accused of lying by testifying at a Board hearing saying the worker did not work for him. He could be sentenced to up to seven years in prison if he is convicted. (WCxKitz)
 
Authorities learned the individual failed to carry insurance when the deceased employee’s estate filed a death benefit claim with the Workers’ Compensation Board. The Board paid the woman’s estate $50,000, an amount the man reimbursed to the Board earlier this year. The money was paid from the Board’s Uninsured Employers’ Fund, which pays claims for people whose employers neglect to carry workers’ comp insurance.

In addition,
the employer paid $5,000 for the woman’s funeral and another $6,000 in penalties to the Board for failing to carry insurance.  (WCxKitz) He also has an outstanding $30,000 penalty for operating without insurance this year. He is disputing the penalty, saying he doesn’t have any employees.
 
 Author Robert Elliott, executive vice president, Amaxx Risks 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. Contact:  Robert_Elliott@ReduceYourWorkersComp.com   or 860-553-6604.

FREE WC IQ Test:
 http://www.workerscompkit.com/intro/
WC Books:  
http://www.LowerWC.com/workers-comp-books-manuals.php
WC Calculator:  http://www.LowerWC.com/calculator.php
TD Calculator:  http://www.LowerWC.com/transitional-duty-cost-calculator.php 

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.

©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact
Info@WorkersCompKit.com 
Posted in Fraud and Abuse, NY Workers Comp Issues |


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New York Contractor an Alleged Workers Comp Cheat, Again

A  sub-contractor who received a one-year conditional discharge for passing a phony workers’ compensation coverage certificate allegedly has done it again, this time leaving the unsuspecting certificate holder liable for thousands of dollars in extra insurance premium.
 
Detectives from the Nassau County DA’s Office arrested the man, charging him with fraudulent practices, possession of a forged instrument, and falsifying business records, all felonies.
 
The arrest follows a prior arrest of the individual in which his company reportedly presented two fraudulent insurance certificates to a Suffolk County contractor. (WCxKitz)
 
Allegedly, the individual presented two fraudulent insurance certificates to a NYSIF-insured contractor in Nassau County, leading to his arrest. The contractor had retained the individual to perform work as a sub-contractor in 2008 and 2009, leaving the contractor responsible for an additional $4,000 in workers’ comp insurance premium. (WCxKitz)The alleged fraudulent documents indicated that the company had valid workers’ comp coverage with NYSIF when, in fact, the company did not.
 
In the previous arrest, the individual pleaded guilty in Suffolk County Court to attempted fraudulent practices as a misdemeanor on Dec. 15, 2009, and received a one-year conditional discharge. (WCxKitz)
 
Investigators said the contractor who hired the individual that time was liable for an additional workers’ comp premium of $1,000.
 
  \FREE WC IQ Test:  http://www.workerscompkit.com/intro/
WC Books:  
http://www.LowerWC.com/workers-comp-books-manuals.php
WC Calculator:  http://www.LowerWC.com/calculator.php
TD Calculator:  http://www.LowerWC.com/transitional-duty-cost-calculator.php 

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.

©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact
Info@WorkersCompKit.com 
Posted in Fraud and Abuse, NY Workers Comp Issues |


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May I Run A Business and Collect Workers Comp Benefits at the Same Time

Um …. No, you may not, at least not in New York. Common sense (which seems to be in very short supply these days) tells us if we are too injured to return to work at our regular, full-time job with our employer because of a workplace injury, then we are too injured to run an independent business, as this New Yorker found out.
 
A man was convicted in a New York court by a jury of illegally collecting $66,000 in workers' compensation benefits while operating a fish stocking business near his home following an accusation he earned thousands of dollars through his business while claiming a previous job-related injury prevented him from working.  (WCxKitz)  He was found guilty of submitting numerous work activity reports falsely stating he was not working in any capacity.
 
According to the prosecution, the man started collecting workers’ comp benefits after suffering a back injury while moving sheet rock.
 
The man was  convicted on charges of offering a false instrument for filing and workers' comp fraud.  Both charges are felonies and he could be sentenced to up to three to (WCxKitz) four years in prison.  Judge W. Howard Sullivan ordered a probation report pror to scheduling a date for sentencing.
 
The man was convicted on charges of offering a false instrument for filing and workers’ comp fraud. Both charges are felonies and he could be sentenced to up to three to (WCxKitz) four years in prison.  Judge W. Howard Sullivan ordered a probation report prior to scheduling a date for sentencing.

 

Author Rebecca Shafer, J.D. Consultant, Amaxx Risks 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. Contact:  RShafer@ReduceYourWorkersComp.com   or 860-553-6604.

FREE WC IQ Test:
 http://www.workerscompkit.com/intro/
WC Books:  
http://www.LowerWC.com/workers-comp-books-manuals.php
WC Calculator:  http://www.LowerWC.com/calculator.php
TD Calculator:  http://www.LowerWC.com/transitional-duty-cost-calculator.php 

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.

©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact
Info@WorkersCompKit.com
Posted in Employment Law Issues, Fraud and Abuse, NY Workers Comp Issues |


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I’ve Fallen But I Don’t Know Where

Or, Why Every Employer Needs a Clear, Definitive Post-Injury Response Procedure
Often the question arises:  “Why report so much on workers’ comp fraud? Isn’t that just highlighting other people’s bad behavior? It may seem like that, but in actuality reporting on fraud highlights the very serious cost factor, in both money and time, employers suffer from not only “other people’s bad behavior” but also, sometimes, their own. It also highlights why every company needs a tight post injury response procedure.

A recent newspaper article*
gave a very detailed report of a woman who suffered a fall. The problem was, she collected $4,500 in workers’ compensation benefits before anyone questioned her story.
 

An investigation
by the employer’s workers’ comp insurer discovered these wildly varying accounts of when, where, and how the accident happened. (WCxKitz)
 
1st:     The woman said she fractured leg on the steps of the employer’s building.
2nd:    The woman said she told her employer she caught her foot outside on a loading dock step.
3th:     She left work, drove herself (using her left foot) to a friend’s, to get ice for her injury.
4rd:     Medical notes (at hospital) indicated she fell at home after a fall downstairs, twisting her ankle.
5th:     Another hospital note said she fell down steps indoors.
6th:     She had either two alcoholic drinks, or three.
7th:     A medical review by the insurer’s orthopedic surgeon showed her injury was so severe, he questioned the woman’s ability to walk on her ankle, at work, for the four-hour period she claimed – from noon, when the injury took place; until 4 p.m., when she arrived at the emergency room. Although, it’s not entirely clear if she was walking on her injured leg/ankle.
7th:     She was unable to provide the name of her friend who allegedly took her to the hospital to the employers WC insurance investigator. 

Whether this
woman committed fraud or not is beside the point. The conclusions one might draw from this story is either the employer did not have post-injury response procedure in place or, if they did, they failed to activate it.  (WCxKitz)
 

At minimum
a post-injury response procedure, an integral part of both the workers’ compensation and safety programs, must include.
 
1.     Post-Injury Response Procedure Guidelines
2.     Post-Injury Response Procedure Worksheet
3.     First Report of Injury Form. 

If this woman’s
employer followed a post-injury response plan, the injured worker would report to a designated person (supervisor) when the accident happened; the incident would be documented; witnesses could be secured; the injured worker would be accompanied by an employer representative to a treating facility; the attending physician would be presented with the necessary forms to fully document all aspects of the worker’s injury. 

Sample Post Injury Response Plan
 Click Image to Open Full Size
 
Instead, the worker is arrested and accused of fraud; no one can figure out what really happened; the employer’s workers’ comp insurer is suing, the woman’s attorney is outraged, and everyone is unhappy. Make sure employee statements and photographs of the injury scene are part of your post injury procedure.
 
 Oh, and by the way – does anyone think any of this is cost effect; will decrease the employer’s “mod” rate; discourage other workers from doing the same thing; be settled anytime soon?   
*Resource: Journal Inquirer, June 24, 2010.

   \Author Rebecca Shafer, President, Amaxx Risks 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. Contact:  RShafer@ReduceYourWorkersComp.com   or 860-553-6604 if you need help developing a workers compensation program and controlling your workers' compensation costs.

FREE WC IQ Test:
 http://www.workerscompkit.com/intro/
WC Books:  
http://www.LowerWC.com/workers-comp-books-manuals.php
WC Calculator:  http://www.LowerWC.com/calculator.php
TD Calculator:  http://www.LowerWC.com/transitional-duty-cost-calculator.php 

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.

©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact
Info@WorkersCompKit.com 
Posted in Fraud and Abuse, Implementation and Rolling Out Your Program |


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YouTube Video Leads to Cheaters Downfall

A California mail carrier who claimed she was injured and obtained nearly a quarter of a million dollars in worker's compensation has been accused of fraud after allegedly spending her time launching a career in mixed martial arts.

The woman is facing time in federal prison for fraud and theft for opening a pair of MMA gyms, named TNT MMA/Boxing, in Roseville and Elk Grove.

Federal investigators said the suspect, filed a claim for worker's comp following an injury in 2005. For the next four years, she never returned to work and continued to file for more money, eventually collecting $250,000, according to the indictment. (workersxzcompxzkit)

Court documents also allege the woman signed federal documents and personal letters claiming she wasn't working, couldn't work, was not self-employed or in another business. (workersxzcompxzkit)

Investigators discovered a clip on YouTube promoting the TNT MMA/Boxing gyms, allegedly showing the woman giving a tour of one of the gyms, owned by Buxmann Entertainment Inc.

The woman faces 15 criminal counts and up to 20 years in prison.

Author Robert Elliott, executive vice president, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers’ Compensation costs, including airlines, healthcare, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. Contact:  Robert_Elliott@ReduceYourWorkersComp.com   or 860-553-6604.

FREE WC IQ Test:
http://www.workerscompkit.com/intro/
WC Books:
http://www.reduceyourworkerscomp.com/workers-comp-books-manuals.php
WC Calculator: http://www.reduceyourworkerscomp.com/calculator.php
TD Calculator: http://www.reduceyourworkerscomp.com/transitional-duty-cost-calculator.php

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.

©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com 

Posted in Fraud and Abuse, Risk Management |


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Former School Employee Allegedly Intentionally Overpays Injured Worker

A former San Francisco Unified School District employee was arrested on suspicion of fraudulently distributing public money, according to the California Department of Insurance.
 
The woman allegedly issued $85,000 of public money to an injured school district employee in permanent disability advances, knowing she was overpaying the injured worker by more than $76,000, the insurance department said. The injured worker was found to be entitled only to $9,320 in permanent disability advances.
 
Insurance investigators started their investigation into the case when Tristar Risk Management, a third-party administrator of workers’ compensation claims hired to administer claims, suspected fraud.
 
The injured worker  told Tristar that she loaned half the permanent disability payments to the district employee and said she didn’t know her claim wasn’t worth $85,000 according to the insurance department. (workersxzcompxzkit)
 
The worker  said she made several attempts to contact her “friend” to get her to repay the loan without success. The money was never paid back to the injured worker.
 
Author Robert Elliott, executive vice president, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers’ Compensation costs, including airlines, healthcare, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. Contact:  Robert_Elliott@ReduceYourWorkersComp.com   or 860-553-6604.

FREE WC IQ Test:
http://www.workerscompkit.com/intro/
WC Books:
http://www.reduceyourworkerscomp.com/workers-comp-books-manuals.php
WC Calculator: http://www.reduceyourworkerscomp.com/calculator.php
TD Calculator: http://www.reduceyourworkerscomp.com/transitional-duty-cost-calculator.php

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.

©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com

Posted in Fraud and Abuse |


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Missouri Has More Reports of Fraud and Violation of Work Comp Laws

In Missouri  the Labor Department's Division of Workers' Compensation (DWC) reports a significant increase in referrals for fraud and noncompliance for  workers' compensation violations.  In the first quarter 2010, the Attorney General’s office received 87 cases as compared to 39 cases referred in the first quarter 2009.
 
The increase is attributed to the Division's enhanced efforts in its ability to analyze more cases and the fact that employers are likely to cut coverage during hard economic times.
 
These are staggering numbers, but we will continue to work with the Attorney General to enforce these laws so that Missourians injured on the job receive the benefits they deserve,” said Department Director Larry Rebman. “At the same time, we will work to remind Missouri employers of their obligations under the law.”
 
Any employer with five or more employees (one or more, if the employer is engaged in construction) must have workers’ comp coverage in Missouri, either by securing an insurance policy or by obtaining authority from the DWC to self-insure its liability.
 
For the last five years, approximately 80% of the cases referred to the Attorney General involved noncompliance – the failure of an employer to carry workers’ comp coverage. Of the 87 cases referred to the Attorney General this quarter, 67 involved noncompliance, 17 involved fraud by an employer or insurer (e.g. failure to report an injury that occurred), and 3 involved fraud by employees.
 
Failure to comply with the workers’ comp requirements is a Class A misdemeanor carrying a penalty of up to three times the insurance premium the employer would have paid or $50,000, whichever is greater. (workersxzcompxzkit)
 
Failure to report an injury is also a misdemeanor with a penalty of $50-$500 per violation.
 
Making a false representation in order to obtain a benefit is a class D felony carrying a fine of up to $10,000 or double the value of the fraud, whichever is greater.
 
Author Robert Elliott, executive vice president, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers’ Compensation costs, including airlines, healthcare, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. Contact:  Robert_Elliott@ReduceYourWorkersComp.com   or 860-553-6604.

FREE WC IQ Test:
http://www.workerscompkit.com/intro/
WC Books:
http://www.reduceyourworkerscomp.com/workers-comp-books-manuals.php
WC Calculator: http://www.reduceyourworkerscomp.com/calculator.php
TD Calculator: http://www.reduceyourworkerscomp.com/transitional-duty-cost-calculator.php

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.

©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com 

Posted in Fraud and Abuse |


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