Your Adjuster Has a Critical Role in Legal Defense Management

 

 

 

Advertisements Influence Employees to Hire Attorney

 

With the public bombardment of attorney advertisements, it is becoming harder for the claims adjuster to work directly with an injured employee.  The plaintiff attorney advertising is designed to get the public to think that they need attorneys for everything. However with proper claims handling, the claims adjuster can still control the workers’ compensation claim.

 

 

Once Attorney Hired, No Further Contact with Employee

 

Once the employee has retained counsel the adjuster can have no further direct contact with the employee.  The adjuster cannot advise the employee to terminate a relationship with their legal counsel.  The adjuster cannot tell an employee not to retain legal counsel.  While some employees can be very difficult to deal with and extremely demanding, the adjuster can never tell an employee to get an attorney.  If asked about getting an attorney, the adjuster should tell the employee it is their decision on whether or not they hire an attorney.  The adjuster should request a letter of representation from the employee’s attorney as soon as notified of their existence.

 

The adjuster may reevaluate the claim when an attorney appears, but the adjuster should not be stampeded into an excessive change of opinion.  Claims have been settled for less with attorneys than they might have been settled with the employee direct.

 

The adjuster will price the settlement values of the workers’ compensation claim based on the facts and exposures regardless of legal representation.  The injured employee will determine after the disposition of the claim whether or not the attorney was worth it and needed.

 

 

Adjuster to Maintain Positive Contact with Employee Before Attorney Representation

 

Prior to an attorney representation, the adjuster should maintain a direct dialogue and interface with the claimant.  This is accomplished by showing empathy and concern for the person and injury.  The adjuster should not allow sympathy to overrule the facts and necessities of the loss.

 

The adjuster can maintain control of the claim by prompt contact, kept promises, returned telephone calls, and questions answered with fact, law, and honesty.  Explanation of all steps as to what will happen, when it will happen and how it will happen, builds confidence of the employee in the adjuster’s professionalism.

All of these steps may not keep the employee away from an attorney.   Nor may it prohibit a request for a hearing, even if the adjuster works in the same professional manner with the claimant’s attorney.  Many attorneys receiving such consideration will usually delay filing for a hearing and are more apt to be receptive to a prehearing resolution of the claim.  (Some jurisdictions have hearings in front of an official from the work comp board, while others will have an industrial commission, and others used the court system of their state).

 

 

First Notice of Claim Could Be Request for Hearing

 

On the other hand the first notice of a claim may be by a request for a hearing.

Regardless of when or how a hearing request arrives, the adjuster is under the gun to process the legal papers as fast as possible.   Most hearing requests must be answered in a specific time frame, often 30 days, but some jurisdictions have a shorter time frame of 20 days from the date the employer is notified.  If the answer period is going to expire before an answer can be given due to investigation needs, the adjuster should request an extension of time from the employee’s attorney.  The adjuster should attempt any disposition that might be possible before referring to defense counsel.

 

The hearing request should be sent to defense counsel at once by the adjuster.  The adjuster will need to keep the claim file on a daily diary until the employee’s attorney agrees to an extension of time, or until the adjuster has employed defense counsel to respond to the hearing request.

 

The adjuster should send defense counsel a copy of the file with a covering letter outlining legal steps to take, and the adjuster’s summary assessment of the file.  The adjuster should provide written litigation management guidelines to the defense attorneys. The adjuster should request a litigation plan and a litigation budget. The adjuster should set a legal reserve for the defense cost. The legal plan should be the guide for setting the legal reserve.  However, until a litigation plan arrives from defense counsel, the adjuster can use an average of past legal costs for similar losses to set the legal reserve.

 

 

Stay with File Before and After Referral is Made to Defense Counsel

 

The adjuster should keep the file on a daily diary until the claim referral is acknowledged by defense counsel and an answer has been filed.

 

The adjuster should not abandon the file handling and management to defense counsel.  The adjuster is responsible for gathering the facts for the defense counsel.  If the file has recorded statements from the injured employee and other employees as witnesses, the adjuster should defer expensive depositions until absolutely necessary.  The adjuster should prevent needless litigation steps and not allow the defense attorney to use outside investigation without prior approval and need.

All specialist investigation or experts needs the adjuster’s approval. They are to be coordinated with the adjuster, the employer and the defense counsel.  The adjuster should control cost by the pre-agreement of fees and cost.  The adjuster should audit the billing by outside investigators or experts to be sure it is in keeping with the agreements.

 

If defense counsel needs information from the employer, the adjuster should obtain it. When a meeting or conference is necessary, the adjuster should be present with defense counsel and the employer.  If the self-insured employer needs to be contacted for disposition authority, it should be done through the adjuster.

Good adjusters know the value of the claim, can negotiate the settlement themselves, and should try to keep defense counsel out of settlement negotiations to limit legal fees.  However, when a case is in a hearing, arbitration, or statutory judgment the attorney may have to settle on the spot.  The adjuster should provide defense counsel with the necessary settlement authority. Telephone discussions for additional authority can prevail in these situations. If the self-insured employer input is required, the adjuster should comply.

 

The adjuster should control defense counsel reporting. It is not necessary for the attorney to parrot back factual information already in the file.  All that is necessary for the attorney to do is state how the facts will be used in the litigation process.  The attorney’s report should contain an opinion as to disposition.  A request for any additional investigation is necessary.  A time frame and necessary legal steps should be in the report.

 

 

Adjuster Critical in Management of Attorney Costs

 

Once the initial assessment report is completed by defense counsel, it is necessary for the adjuster to receive supplemental reports for current activities and opinions.  If legal research is necessary the attorney must discuss and get the adjuster’s approval.  Limitations must be set to avoid runaway costs.

 

The adjuster should have defense counsel eliminate from their reports all, or at least surplus copies of interrogatories, pleadings, depositions, and other legal information.  The attorney generally reports on the contents of these items and their impacts, so it is seldom, if ever, necessary for copies to come to the adjuster’s file.  Not only will this save attorney copy cost, it will reduce a cumbersome file.  If a need arises for these actual documents, the adjuster can always request them.

All defense counsel legal billings should be reviewed and approved by the adjuster.  The adjuster should check the defense counsel bill line by line to be certain there is no duplicity, overlap, or non-authorized handling.

 

The adjuster should be cognizant of excessive telephone and other uses.  The adjuster should supply photocopies of documents to counsel when possible so they do not have to copy.  The adjuster should before sending any file to defense counsel go through the file page by page and eliminate any duplicates, or needless paper.

 

When a case goes to a hearing and an adverse decision gives grounds for appeal, the adjuster should handle the appeal response period on daily diary until the defense counsel has filed the appeal.

 

 

 

Multiple Defense Relationships Should be Engaged

 

The adjuster should develop relationships with several defense counsel firms. It is recommended that the different firms be used simultaneously. This generates competition between the firms, allows for spreading work, and keeps the assignments on a fresh approach for service and thinking.

 

 

 

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.

 

Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher.  www.reduceyourworkerscomp.com Contact mstack@reduceyourworkerscomp.com

 


WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com

VIEW SAMPLES PAGES

MODIFIED DUTY CALCULATOR:  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.

 

©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.

 

British Manufacturer Sentenced after Worker Has Hand Crushed

A British manufacturing firm has been sentenced after a worker's hand was crushed in a metal press at a St Helens factory, according to a report from the Health and Safety Executive (HSE).
 
 
Barry Kelleher lost his little finger and part of the palm on his right hand as a result of the incident at Crane Building Services and Utilities. The 47-year-old from Leigh also needed two skin grafting operations.
 
 
The owner of the factory, Crane Ltd, was prosecuted by HSE after an investigation found the machine could still be operated when a workers hand was underneath the mould. Note:  Physical guards and light curtains generally prevent a workers hand from entering the pinch point area.
 
 
Knowsley Magistrates Court in Huyton was told the machine had been installed at the factory on Delta Road in St Helens in 1967, but had not been upgraded to comply with modern health and safety laws.
 
 
Kelleher does not remember the incident on Jan. 19, 2011, which occurred while he was using the press to mold metal parts, used by the gas industry.
 
 
However, the HSE investigation concluded that the most likely explanation is that he inadvertently pressed the foot pedal on the machine while his hand was under the mould.
 
 
Crane Ltd pleaded guilty to a breach of the Provision and Use of Work Equipment Regulations 1998 by failing to prevent workers from being able to access the dangerous parts of the machine while it was operating.
 
 
The company, of West Road in Ipswich, was fined $15,530 and ordered to pay $7,080.77 in prosecution costs.
 
 
Kelleher was off work for seven weeks as a result of his injuries, before returning to work initially for one day a week.
 
 
Kelleher was one of more than 3,800 workers who suffered a major injury while at work in the manufacturing industry in Great Britain in 2010/11. Another 27 lost their lives.
 
Note: machines should be designed so that when body parts are in or near a pinch point, the machine will not operate; machines are then said to be "fail safe." If an adjuster sees such an injury, they must make serious inquiry into whether the machine manufacturer should be brought into the situation as a third party or subrogee.
 
 
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.
 
Our WORKERS COMP BOOK:  www.WCManual.com
WORK COMP CALCULATOR:  www.LowerWC.com/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.
 
©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.

Small but Mighty New Zealand Taking Occupational Injuries Seriously

New Zealand Employer Fined after Serious Injuries to Workers
 
Two companies  from Taranaki, New Zealand  have been fined a total of $71,500 after an employee suffered serious injuries when the hired machine he was operating rolled down a slope, pinning him underneath.
 

According to details
from the Department of Labour, Taranaki Civil Construction Limited was fined $38,500 and ordered to pay $12,000 in reparation to its employee who suffered a compound fracture to his right arm and lacerations to his scalp and neck. (WCxKit)  Graham Harris (2000) Limited , the company that hired out the roller, was fined $33,000 and ordered to pay $4,000 in reparation for failing to ensure the roller was safe to use.
 

The New Plymouth
 District Court  heard that the company was working on a project in New Plymouth to improve flood defenses in February this year.  The employee was using a roller to compact clay at the top of the stop bank.
 

The roller that the company hired was not fit for the operation as it did not have a roll over protective structure or a seat belt,” says the Department of Labour’s Taranaki Service Manager Jo Pugh.
 “This type of machinery is not appropriate to use on top of a narrow stop bank of clay and it put this employee at serious risk of harm,” says Pugh.  
 

 
This accident could have been prevented had some basic safety steps been followed, saving this employee from a number of operations that were required due to his injuries.”

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. He is an editor and contributor to Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: Info@ReduceYourWorkersComp.com.

 



WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com

VIEW SAMPLES PAGES

MODIFIED DUTY CALCULATOR:  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.

 

©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.

Former Mass Restaurant Owner Violates Wage and Hour Laws

The former owner of a Woburn, Massachusetts restaurant has been arraigned for allegedly violating the Commonwealth’s wage and hour laws, Attorney General Martha Coakley announced. 
 
 
Lynne A. Howell, 50, of Woburn, former owner of La Stanza Diva Ristorante, was arraigned on charges of Failure to Pay Wages (3 counts), and Failure to Provide Suitable Pay Stub Record (3 counts). WCxKit
 
 
According to authorities, Howell failed to pay three of her employees’ wages for work they performed at the restaurant and failed to provide the three employees with pay stubs.
 
 
The Attorney General’s Office began an investigation in March of 2009, after a former employee filed a nonpayment of wage complaint with the Fair Labor Division.  In August 2009, the Fair Labor Division issued a civil citation against Howell and La Stanza Diva Ristorante for failure to pay timely wages in the amount of $1,650 and a penalty in the amount of $500.  A penalty for failure to produce records for inspection in the amount of $1,000 was also assessed. 
 
 
While the citation was under appeal by Howell, the Fair Labor Division received complaints from two additional employees in November 2009, alleging that Howell failed to pay them their wages.
 
 
Under Massachusetts law, employers must pay employees within six days of the termination of the pay period. Employers must provide a pay stub with proper information, including rates of pay and legal deductions. (WCxKit)
 
 
Howell was arraigned recently in Woburn District Court at which time she pleaded not guilty and was released on personal recognizance.  Howell is due back in court on Dec. 16, for a pre-trial hearing. 
 
 
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.
 

NEW 2012 WORKERS COMP BOOK:  www.WCManual.com 
WORK COMP CALCULATOR:  www.LowerWC.com/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.
 
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact

Texas Man and Maryland Woman Sentenced on Workers Comp Fraud Charges

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.

NEW 2012 WORKERS COMP BOOK:  www.WCManual.com
 
WORK COMP CALCULATOR:  www.LowerWC.com/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.
 
©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

Texas Sheriff Guilty in Retaliating Against Pair of Nurses Who File Complaints

A Midland County, Texas jury found Winkler County Sheriff Robert Roberts guilty of misuse of official information, retaliation, and official oppression.
 
 
According to the Texas Attorney General’s Office, the guilty verdict stems from the sheriff's attempt to retaliate against two nurses in Kermit, Texas, who filed anonymous complaints against Dr. Rolando Arafiles Jr., a physician who worked with both victims at the Winkler County Memorial Hospital.      (WCxKit)
 
 
In an agreement reached at the close of the trial's punishment phase, Roberts, 56, was sentenced to four years felony probation on two counts each of misuse of official information and retaliation. He will serve 100 days in jail on each of four felony counts, to be served concurrently, and pay a $6,000 fine on four felony and two misdemeanor counts. Roberts will be removed from office by operation of law and will surrender his peace officer's license.
 
 
Sheriff Roberts was indicted on two counts each of misuse of official information, retaliation, and official oppression. Dr. Arafiles and County Attorney Scott Tidwell were also indicted on similar charges. Former hospital administrator Stan Wiley pleaded guilty to related charges after he acknowledged improperly terminating the nurses employment after they filed formal complaints against Arafiles with the Texas Medical Board. Under the terms of his guilty plea, Wiley was sentenced to 30 days in the county jail.
 
 
According to prosecutors with the Texas Attorney General's Office, the sheriff improperly used his position as the county's chief law enforcement official in order to help his friend, Dr. Arafiles, retaliate against the nurse’s for complaining to the Texas Medical Board about his professional conduct. Under Texas law, complaints filed against physicians with the Texas Medical Board are confidential. However, after Dr. Arafiles was notified about the complaints filed against him, Sheriff Roberts requested copies of the confidential complaints, which included the complainant’s names.
 
 
During the trial, Assistant Attorney General David Glickler explained to jurors that Sheriff Roberts improperly shared the confidential complaints with Dr. Arafiles and the hospital administrator. Subsequently, the sheriff executed a search warrant in order to obtain information stored on the nurse’s computers and confirm that the nurses were the source of the confidential complaints.
 
 
The nurses were improperly terminated in retaliation for complaining to the Texas Medical Board about Dr. Arafiles conduct. County Attorney Tidwell's office sought the nurse’s indictment and the Winkler County Sheriff's Department arrested the nurses for alleged criminal conduct they did not commit. A jury later acquitted one of the nurse’s, while charges against the other nurse were dropped by the prosecution. (WCxKit)
 
 
Dr. Arafiles and County Attorney Tidwell are still awaiting trial on retaliation and misuse of official information charges.
 
 
 
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.

NEW 2012 WORKERS COMP BOOK:  www.WCManual.com
 
WORK COMP CALCULATOR:  www.LowerWC.com/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.
 
©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

New York Corrections Officer Faces Fraud Charges for Working Second Job

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.
 
 

NEW 2012 WORKERS COMP BOOK:  www.WCManual.com
 
WORK COMP CALCULATOR:  www.LowerWC.com/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.
 
©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.

18 Arrested in New York for Workers Compensation Fraud

Benjamin Lawsky, superintendent of the Financial Services, recently reported that 18 people in 13 New York counties have been arrested in the latest effort to save businesses money by cracking down on workers compensation fraud.
 
 
The arrests were the result of a series of joint investigations led by the Department of Financial Services (DFS). Joining DFS in the investigations were the Office of the Inspector General (OIG) of the New York State Workers Compensation Board, the New York State Insurance Fund (NYSIF) and other insurers. (WCxKit)
 
 
The 18 arrests included:
 
Albany County — Charles Foster, 48, of Hoosick Falls, collected $22,800 in benefits after hurting his leg when cutting down a tree while employed by the Village of Hoosick Falls in February 2010. However, investigators found that he was managing a storage facility and running a scrap metal business while collecting the benefits from NYSIF. He is charged with workers comp fraud.
 
 
Schenectady County — Lee Kittle, 49, of Scotia, collected $22,600 in compensation from NYSIF after suffering an injury while employed at a mill in 1993. He was found to be working at Schenectady County Community College as a tutor and the Saratoga Race Track as a teller. He gave authorities a written confession. He is charged with offering a false instrument for filing in the first degree and workers comp fraud.
 
 
Erie County – John Czechowski, 45, of West Seneca, collected $12,000 from NYSIF after he was classified as totally disabled for a back injury he suffered working as a roofer. However, investigators discovered he was working off the books for a contracting company while collecting the benefits. He is charged with third degree insurance fraud, grand larceny, offering a false instrument for filing and workers comp fraud.
 
 
Onondaga County — Kemberlei Senke, 44, of Liverpool, is accused of claimant fraud for collecting $26,000 in benefits issued by NYSIF between June 2009 and January 2011. She reported suffering a knee injury while employed by Artistry in Wood. The investigation disclosed that she falsified reports to the NYSIF to inflate her wages and employment status. She is charged with insurance fraud in the third degree, offering a false instrument for filing in the first degree and workers comp fraud.
 
 
Onondaga County — Cheryl LaQuay, 62, of Calcium, is accused of fraudulently collecting $53,000 in benefits from the NYSIF between Oct. 2006 and Sept. 2011, while working as a home health aide. She is charged with insurance fraud in the second degree, offering a false instrument for filing in the first degree and workers comp fraud.
 
 
Oneida County — Aaron McElhinney, 26, of Vernon, is accused of collecting $11,600 in benefits from Chartis Insurance Company after falsely reporting that he suffered a work-related injury. Investigators found that he told his girlfriend and her mother that he was going to fake the injury so he could go to Florida. Co-workers corroborated that he did not hurt himself. He is charged with insurance fraud in the third degree and workers comp fraud.
 
 
Oneida County — William Ellis, 43, of Utica, admitted working for a construction company from 2004 through 2007 doing roofing, siding, plumbing and masonry while collecting $15,000 in benefits from NYSIF for an injury he suffered while working for a paving and excavating company in 1993.
 
 
Oneida County – William O'Neil, 30, of Rome, is accused of collecting $1,790 in benefits from 21st Century North American Insurance Company while working for a moving company. He was collecting benefits after suffering an injury while working as a carpenter. He is also accused of giving false testimony at a workers compensation hearing and causing a false independent medical examination report to be prepared and filed as part of his claim. He is charged with perjury in the first degree and workers comp fraud.
 
 
Ulster County — Sergio Cortez, 37, of Rosendale, collected $6,800 in benefits from NYSIF after claiming he suffered a slip and fall injury while working as a carpenter for ABD Stratford LLC in September 2009. However, investigators found that he was working as a landscaper while collecting benefits. He is charged with insurance fraud in the third degree and workers comp fraud.
 
 
Ulster County — Willie Dixon, 47, of New Paltz, collected benefits from NYSIF for an injury he reportedly suffered while working for the New York State Office of Family and Children Services in May 2010. An investigation revealed he failed to disclose on work activity reports that he was employed as a coach while collecting $4,700 in benefits. He is charged with insurance fraud in the third degree and workers comp fraud.
 
 
Ulster County – James Roy, 51, Hyde Park, is accused of attempting to collect benefits after falsely reporting that he suffered a work-related injury while employed by a tool-making company. He claimed that the injury occurred when he slipped on ice in the company’s parking lot, but witnesses contradicted his claim. He never received compensation because his claim was discovered to be false before benefits were issued. He is charged with workers comp fraud.
 
 
Otsego County — Susan Gridley, 61, of Schuyler Lake, started collecting benefits after an injury she sustained while working at a horse farm in 1986. She later failed to disclose on work activity reports submitted to the NYSIF that she was working as horse boarder and trainer while collecting $4,700 in benefits.
 
 
Oswego County — Kimberly Harrington, 53, of Lacona, is accused of cashing her dead husband’s workers comp benefit checks totaling $2461.90. The checks were issued by the NYSIF. She is charged with grand larceny in the fourth degree.
 
 
Warren County — Jeffrey Hamblin, 45, of Glens Falls, reportedly suffered a knee injury while employed as a truck driver for HR Logic/Doberts Dairy in November 2001. An investigation revealed he was employed as a general contractor for Painters Plus and worked for a doctor while collecting $7,700 in benefits from Liberty Mutual Insurance Company. He is charged with falsifying business records in the first degree and insurance fraud in the third degree.
 
 
Chenango County – Patricia Wilcox, 60, of Oxford, started collecting benefits from NYSIF after claiming she suffered a broken ankle while working as a teacher’s aide at the Chenango County Head Start program. Investigators found that her injury actually occurred at her home. She fraudulently collected $12,900 in benefits. She is charged with falsifying business records in the first degree and workers comp fraud.
 
 
Tompkins County – Steven Odum, 65, of Ithaca, is accused of failing to disclose work activity as the lead guitarist with the “Steve Odum Trio” on reports he sent to the NYSIF while collecting $11,300 in benefits after suffering an injury in 1988 while working at a residential child care institution. He is charged with offering a false instrument for filing in the first degree and workers comp fraud.
 
 
Clinton County – Leonard Drown, 63, of Morrisonville, is accused of collecting $25,500 in benefits from Pennsylvania Manufacturers Association Insurance Company after claiming that he was not working because of an injury. Investigators found that he was, in fact, working while collecting the benefits. (WCxKit)
 
 
Broome County – Olga Shelestovsky, 43, of Johnson City, is accused of working as a waitress while collecting $2,200 in benefits from NYSIF and claiming that she was unable to do any physical work. She is charged with offering a false instrument for filing in the first degree and workers comp fraud.
All of the accused are innocent until proven guilty.
 
 
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. He recommends the #1 selling book on cost containment, Manage Your Workers Compensation: Reduce Costs 20-50% www.WCManual.com. See www.LowerWC.com for more information. Contact: Info@ReduceYourWorkersComp.com.
 
 

ABC;s of WORKERS COMP:  www.WCManual.com
 
WORK COMP CALCULATOR:  www.LowerWC.com/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.
 
©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.

Australian Employee Crushed to Death in Industrial Blender

A Western Sydney manufacturing company and its director were recently fined a total of $127,400 and ordered to pay WorkCover’s legal costs after a high powered industrial blender was turned on with a man inside it.
 
 
According to a report from the WorkCover Authority, FIP Brakes International (FIP) produces industrial sized brake pads, as well as other products, for trains and other railway vehicles and employs around 60 people mainly based at its facility in Wetherill Park. Its managing director is Chris Katakouzinos. (WCxKit)
 
 
A machine operator was killed when he was cleaning out an industrial blender at FIP’s premises.
The power to the machine had not been isolated and the machine became operational with the worker still inside. He died at the site with extensive crush injuries and lacerations.
 
 
A WorkCover investigation found a significant number of safety failings:
 

1.      The machine should not have been able to operate while its front

       doors were open. 

2.      The safety switches were either broken or malfunctioning. 

3.      The machine’s electrical power supply had not been turned off. 

4.      The machine operator should not have been working alone. 

5.      The machine was not properly maintained. 

6.      The operator was not given proper training.

 
 
FIP and its director were charged with breaches of the Occupational Health and Safety Act 2000.
 
 
In handing down her finding in the Industrial Court, Justice Backman said the incident was foreseeable and that there were serious deficiencies in the company’s systems. (WCxKit)
 
 
They both pleaded guilty. FIP was fined $117,000 and Mr. Katakouzinos $10,400. The court ordered them to pay WorkCover’s legal costs.
 

 
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.

WORKERS COMP BOOK:  www.WCManual.com
 
 

 

WORK COMP CALCULATOR:  www.LowerWC.com/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.
 
©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.

Automobile and Appliance Shredder Agreed to Settlement for Operating Without Air Pollution Controls

A Los Angeles area metal shredding facility accused of releasing toxic substances into the atmosphere has agreed to pay more than $2.93 million to comply with air pollution laws and to settle an environmental protection lawsuit, according to a report from the Los Angeles County District Attorney’s office.
 
 
Deputy District Attorney Daniel Wright of the Environmental Law Section said SA Recycling, LLC – an automobile and appliance shredding company – agreed to the settlement, which was signed by Los Superior Court Judge Debre K. Weintraub. The civil lawsuit and settlement were filed last week. (WCxKit)
 
 
The action alleged that SA Recycling violated air pollution laws when an explosion at its San Pedro facility at Terminal Island destroyed its air pollution control system in May 2007 and the company continued operating for weeks without proper equipment.
 
 
At the time of the violations, the company was operated by Hugo Neu Corp. SA Recycling purchased the company in September 2007.
 
 
The injunction permanently enjoins SA Recycling from operating its San Pedro shredder without a fully functioning air pollution control system.
 
 
Under the terms of the stipulated judgment, SA Recycling has agreed to install an air pollution control system to minimize emissions at its San Pedro location and two other sites in Orange and Kern counties. The company also has agreed to work closely with state and local regulators to address compliance issues related to its operations.
 
 
SA Recycling must additionally pay $260,000 in civil penalties and investigative costs to the Los Angeles County District Attorney’s Office and $430,000 to the California Department of Toxic Substances Control (DTSC) for investigative expenses and enforcement tools.
 
 
Among others who will benefit are the College of Engineering at the University of California, Davis, slated to receive $100,000 to support aerosol studies; the Coalition For A Safe Environment, which will receive $75,000 for select projects; and 11 San Pedro Bay marina owners and operators, who will share $165,000 to target water and sediment pollution sources. (WCxKit)
 
 
SA Recycling shreds and sorts recyclable metal materials. The process, ultimately, generates auto shredder residue (ASR) which is treated to reduce solubility of any remaining metals.
 

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.

EMPLOYER WORKERS COMP MANUAL:  www.WCManual.com
 
 

 

WORK COMP CALCULATOR:  www.LowerWC.com/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.
 
©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.

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