A decision issued this week, on 5/1/12, “Zamora v Neurologic Assn.”, has removed a presumption that people no longer working after an accident were presumptively disabled by the accident. This gave the employer the burden of convincing the Board that entirely different factors were at work.
To put it plainly, the employers had so little chance of success that carriers, lawyers, judges and commissioners paid little attention to agruments that a worker no longer was attached to work and had voluntarily retired. By the late 1980s, the situation had come to the point where “retirement injuries”, i.e., small incidents, were filed as comp claims and used as the basis, years later, for reopening the claim and receiving substantial tax-free supplements to retirement and Social Security payments.[WCx]
The decision, in which benefits were halted, will not be the last word quite yet. It was a narrow split decision and both labor and industry will presumably lobby for slight, but significant, changes in the law.
However, an employer with a well structured program for assistance in Return To Work, not just for workers comp but for disability in general, will benefit the most. Many of the recent decisions involve workers searching for jobs without any assistance from the employer. But an offer of a job, or assistance in finding one, can no longer be ignored by a worker without risk of consequences.[WCx]
Although the role of the employer is not central in the “Zamora” decision, that does not mean that it is not necessary for higher probability of success. Return to work begins, shortly after disability starts, with communication from the employer. The “Zamora” decision involved “presumptions”, but active participation by the employer quickly turns the discussion to facts rather than speculation.
Author: Attorney Theodore Ronca is a practicing lawyer from Aquebogue, NY. He is a frequent writer and speaker, and has represented employers in the areas of workers’ compensation, Social Security disability, employee disability plans and subrogation for over 30 years. Attorney Ronca can be reached at 631-722-2100. medsearch7@optonline.net
WORKERS COMP MANAGEMENT MANUAL: www.WCManual.com
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.
The New York State Workers Compensation Board has announced that it will transition from a paper to an electronic employer report of injury system by adopting the IAIABC (International Association of Industrial Accident Boards and Commissions) Claims Electronic Data Interchange (EDI) Standard Release 3.0. Founded in 1914, the IAIABC is a not-for-profit trade association representing government entities who administer workers comp systems.
Currently, the Board accepts New York-specific claims information from employers and insurance carriers through paper submission. Beginning in early 2013, these submissions will be required to match the IAIABC standard and be made electronically. .[WCx]
"Electronic filing will reduce system waste and increase efficiency, meaning businesses will save while injured workers will receive their benefits faster," the Board’s Executive Director Jeffrey Fenster said. "We are working closely with employers and insurers in the workers compensation industry to ensure a seamless transition to electronic filing."
More than 30 states currently use or are planning to use the IAIABC EDI standard for claim submissions. Most national insurance carriers already utilize this standard. The technology is recognized as the national best practice for workers comp injury reporting. The Board will implement the mandate of electronic reporting in phases beginning with those national carriers that use IAIABC EDI in other states. .[WCx]
Based on the experience of other states that have implemented the IAIABC standard, the Board anticipates that its adoption in New York will yield significant benefits, including:
- Improving the timely delivery of benefits to injured workers.
- Providing a single, consistent data format.
- Reducing waste, abuse, and delay in the system.
- Reducing paper handling costs to system participants outside the Board, i.e., handling, completing, and shipping.
- Reducing high costs to the Board for handling, processing, and scanning paper documents as well as certain data entry costs.
- Reducing duplicative claim form filings.
- Increasing the quality and timeliness of information received by the Board.
- Improving data collection for system oversight and policy making.
Mario Cilento, president of the New York State AFL-CIO, noted, "The heart of the workers compensation system is delivering benefits to injured workers when they need them. Labor supports implementing the new paperless standard, which will quicken the delivery of benefits. Anytime we can streamline that process without compromising the integrity of the system, injured workers are better served. The data collected will also lead to improved information for policy-making in the future. We appreciate the Board's efforts to improve the delivery of service in this area."
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.
Data, being released and discussed, shows that assessments for operating expenses made by the NY WCB against carriers (and passed on to employers) are five times higher than the national average for all states.
Why?
Well, the number of people employed by the NYWCB is greater (1500+) than the number of people employed by all comp boards east of the Mississippi (if Florida is excluded). By 1990, the NYWCB had 650,000 workers comp hearings per year, a number so large and anomalous that a major comp research institute studying New York twenty years ago at first thought that a zero had been added by mistake. [WCx]
In addition, NY has had for decades far higher assessments for second injury funds. (One eastern state has a second injury fund law that, for several decades, had only a single claim which qualified for reimbursement.)
The reasons for the New York anomaly can be traced back to a highly broad interpretation of a requirement that no claim for workers comp could be closed without affording the parties to a hearing. It did not say that more than one hearing was required, nor did it say that a hearing had to be automatically scheduled if no one requested it.
However. New York gradually drifted into the practice of automatically scheduling at least one hearing on every claim. If any party (claimant, carrier or an attorney) for some reason failed to attend, an adjournment was automatically granted. Lawyers, whose fees were, and are, proportional to the number of hearings, were never heard to complain about such policies.
By the 1980s, some claims were breaking all records for administrative tolerance. In one claim (and probably a lot more) a claimant was granted eleven consecutive “final opportunities for the claimant to appear. In 2009, a case was reported where two law firms, and the Board, required seven years of hearings and two years of court appeals to decide which of two carriers was responsible for a claim. (A board clerk had made a key stroke error which placed the wrong carrier on notice for the first hearing. No one ever thought to contact the Compliance Bureau.)
The message for employers is to avoid thinking that others (carriers and the Board) will be the first to limit unnecessary costs on claims. A principal reason (more likely, an excuse) for hearings is that necessary information is not in the carrier’s claim file or the WCB e-file. Yet much of the information (payrolls, lost time information) is obtained from the employer.
An employer can reduce the costs on claims by submitting as much information as possible prior to the first hearing. The itemized payroll for the year prior to the accident, for example. That information will be required on all claims with significant lost time (more than a week) and a substantial percentage of all adjournment is to “obtain a payroll prior”. [WCx]
The above suggestion can reduce hearing costs by 10-20% on a claim. Many other suggestions can do the same, but that should do for a start.
Author: Attorney Theodore Ronca is a practicing lawyer from Aquebogue, NY. He is a frequent writer and speaker, and has represented employers in the areas of workers’ compensation, Social Security disability, employee disability plans and subrogation for over 30 years. Attorney Ronca can be reached at 631-722-2100.
medsearch7@optonline.net
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.
OSHA recently cited Navillus Contracting Tile Inc. for alleged repeat and serious violations of safety standards at a work site in Brooklyn, New York.
The Manhattan-based masonry contractor was cited following an incident in which an employee fell 80 feet to a lower level from the top of a 118-foot-high scaffold. [WCx]
"This employee is fortunate to have escaped death, but what is unfortunate is that this fall occurred in the first place," said Kay Gee, OSHA's area director for Brooklyn, Manhattan, and Queens. "It is effective scaffold maintenance, work practices and fall protection – not luck – that are essential to protecting workers against life-threatening falls."
An inspection by OSHA's Manhattan Area Office found that the scaffold platform was not fully planked and lacked guardrails, an aluminum access platform was not secured against displacement, another worker was not tied off to a safe anchorage point, and employees accessed work areas by climbing up and down the scaffold frames. These conditions resulted in citations for six serious violations, with $36,000 in proposed fines. A serious violation occurs when there is substantial probability that death or serious physical harm could result from a hazard about which the employer knew or should have known.
One repeat violation with a proposed fine of $38,500 involves a lack of guardrails. A repeat violation exists when an employer previously has been cited for the same or a similar violation of a standard, regulation, rule or order at any other facility in federal enforcement states within the last five years. OSHA cited Navillus in 2008 for a similar hazard at a Bronx work site. .[WCx]
"To prevent hazards such as these, employers should implement effective illness and injury prevention programs in which they work continuously with their employees to identify and eliminate hazards," said Robert Kulick, OSHA's regional administrator in New York.
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.
In NY workers comp, “return to work” measures (RTW) can achieve unprecedented savings – for the employer and the employee but only if the employer takes the initiative. Employer involvement is many times more effective than what a carrier, TPA, consultant, etc. can provide especially with restoring a worker to employment.
Recently in NY, new court decisions point to a recognition that a worker collecting wage loss benefits cannot lightly refuse a job offer without risking reduction of benefits. But the cases involve claims where the original employers made the offers. Those employers, of course, were in a far better position to know what offer would be within the capabilities of one of their employees. (WCxKit)
Many employers have ignored the advantages of proactive job offers. The reasons lie in the fact that any program will fail sometime, in someplace, for many reasons. But that is no reason to balk. What is not tried will ALWAYS fail. If the employer will not make the effort, who will?
This will be the opening of a series which will outline the steps for an employer-initiated return to work program. A series has to begin somewhere and the starting point must be to stress that the employer’s role is central and cannot be delegated. The employer alone has the knowledge of the person, the job, the requirements and the ability to make essential modifications often necessary for success.
Editor's Note: The next part of our Tips from Ted, will deal with pre-incident planning.
Author: Attorney Theodore Ronca is a practicing lawyer from Aquebogue, NY. He is a frequent writer and speaker, and has represented employers in the areas of workers’ compensation, Social Security disability, employee disability plans and subrogation for over 30 years. Attorney Ronca can be reached at 631-722-2100. medsearch7@optonline.net
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 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.
“Return to Work” (RTW) will achieve unprecedented attention in the coming year, largely due to a series of recent decisions and an upcoming argument in the state’s highest court, the Court of Appeals. The issue will be defining better the standards for “voluntary withdrawal” from the labor force. Such withdrawals can result in halting of future payments.
If an employer makes a job offer a return to work is far more likely to result in success than if a worker tries to find a job. To help employers implement a RTW program, the Board has on its website an outline of an RTW program. One of the sections deals with “partners” in the return to work process. Nine people and entities are listed, but the most important is not present on the list. Who might that be? The SPOUSE!
In order to appreciate the role and importance of the spouse in managing disability it helps to have been as close to the problem as possible, but with professional expertise. That means being the treating doctor or the lawyer representing the worker. Only in that way are you likely to witness first hand the role that is played by the spouse.
People who have become cynical and jaded by the administrative handling of comp claims would be surprised to learn that the spouse is the person least likely to favor extended disability, no matter what the final settlement figure might be. The spouse, above all others, knows, and lives with, the consequences of extended absence from work. Even the children, who share the consequences, can only guess at the downside nature of disability though they quickly learn what it is like to have an additional parent commenting on their every move.
Why would the Board outline omit all references to a spouse? Perhaps because the very nature of the relationship is private and beyond the Board’s comment or control. But that is no reason for others to fail to involve that most important person.
In any enlightened RTW program by the employer a face to face discussion with the employee should be had as quickly as possible. The spouse should be present and participating in the discussion with, of course, the permission of the worker.
There is a good chance that the employer already knows the spouse, which makes the efforts far more effective. Leaving the efforts to a carrier or administrative board makes for a poor communication network which usually omits family members from the process. But the employer has an excellent functioning, and supportive, network when the family is directly involved.
A RTW discussion should not focus on the claim. The effort is part of the employer/employee relationship and such discussions can, and often are, had even in the absence of any kind of claim. Having such discussions when no claim has been filed will often result in lowering claims in the future. (Many disability claims – comp, LTD, Social Security disability – are triggered by uncertainty about future earnings or medical payments. A sooner, rather than later, meeting with the employer will greatly reduce that uncertainty.)
In short, the employer participates not as a surrogate for the carrier but as the other major player in the family’s security. (WCxKit)
The first rule of disaster management and control is to maximize the immediate use of all available tools. Do not wait for a third-party to appear with another tool, which is seldom as effective as those already in place and not nearly as timely.
Author: Attorney Theodore Ronca is a practicing lawyer from Aquebogue, NY. He is a frequent writer and speaker, and has represented employers in the areas of workers’ compensation, Social Security disability, employee disability plans and subrogation for over 30 years. Attorney Ronca can be reached at 631-722-2100.
medsearch7@optonline.net
One of our readers, Tom Gassaway of Arthur J. Gallagher, found this article of particular interest and offered this example.
I received your newsletter this morning and found one article that I felt was long overdue. The article was “The Spouse Might Be the most Important Partner in NY Workers Comp.” I spent 17 years working at Liberty Mutual and remember hearing this mentioned, for the very severe cases, as far back as 1978. I was told they need to be involved in the psychological and emotional recovery from an accident, no matter in what state the accident occurred. I even saw it used for a claim involving one of my insureds.
The claim involved a worker who lost both hands in a punch press accident. He was due to be married within a few months of the accident and the obvious questions arose:
Would the wedding even take place?
Would the future spouse still want him?
Would the future spouse be able to assist with all of his needs?
What about income and medical bills?
Liberty immediately got him to their rehabilitation center in Boston and started to work on this whole process. Somewhere along the way the fiancé was asked to take part. The good news was she was agreeable and it went well. She was there through the fitting of the “hooks” for hands and other key milestones. The good news was they were able to be married on time and the they returned to Boston after the wedding to finish the rehabilitation. Overall, it was a good outcome and I heard later they even had two children.
Thanks for the article.
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.
Two recent decisions, and an outline posted on the WCB website, indicate that there is a shift in New York workers comp towards employer return to work offers.
The court decisions “Browne v Medford Multicare” and “Smith v TWA, Inc” dealt with workers who refused return to modified work. (WCxKit)
The refusal of the offers was treated in both cases as voluntary withdrawal from the labor market – a conclusion that would have been unthinkable years ago. In addition, the Board has posted a return-to-work guide for employers on its website, another departure from past practices.
The decisions point to the emergence of a very different comp system. In the past, a claimant could refuse all offers of work without jeopardizing further compensation, which led to the final settlements which accounted for 60% of all attorney fees. The new model will substantially reduce comp costs and xmods for proactive employers.
The Board outline of return-to-work proposals makes it clear that, in the future, the worker’s attorney is expected to support prompt return to work even if a settlement fee is lost in the process. Hopefully, the Board will find a way to award fees for cooperating with a return-to-work program. Such cooperation, in the past, has been viewed as worth less than service which led to protracted disability.
Tellingly, the Board sites statistics in its RTW outline which claim that successful work rehabilitation has only a 1% chance of success for an injury which has resulted in two years of lost time. In the past, only disabilities resulting in two years lost time were considered for lump sum settlement. The Board construed years of lost time as a perversely positive result.
But all this is a potential reform. It is only as inevitable as the willingness of employers to become involved and do it right. All the decisions will mean nothing to an employer who imagines that, somehow, a carrier or the Board will do the heavy lifting for it. (WCxKit)
Will all, or even most, employers become “return to work” conscious? No. Certainly not. The chances that a claimant, chosen at random, will work for an employer diligently pursuing ways to reduce employee lost time will be substantially less than 50%, perhaps much less. Even so, the playing field is different. The employer making the effort will achieve the savings. And its workers will share in those savings in a wide variety of ways.
Author: Attorney Theodore Ronca is a practicing lawyer from Aquebogue, NY. He is a frequent writer and speaker, and has represented employers in the areas of workers’ compensation, Social Security disability, employee disability plans and subrogation for over 30 years. Attorney Ronca can be reached at 631-722-2100. medsearch7@optonline.net
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.
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.
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.
The Clinton County (New York) District Attorney’s office recently announced an arrest associated with workers compensation and insurance fraud.
Robert Deyo, 34, of Plattsburgh was arrested and arraigned in Plattsburgh City Court before the Honorable Penelope Clute and charged with one count of Perjury in the First Degree and one count of Committing a Fraudulent Practice. (WCxKit)
The charges stem from allegations that Deyo was receiving workers comp benefits he was not entitled to by continuing to work as a contractor, and not reporting that fact to his employer or the insurance carrier.
“Workers compensation fraud takes hard-earned money from honest businesses, workers and consumers alike,” said New York State Insurance Fund Chief Executive Deputy Director Dennis Hayes. “Through the assistance of local law enforcement and cooperation with our partner agencies, NYSIF has and will continue to aggressively fight workers compensation fraud.”
Deyo was remanded to the Clinton County Jail in lieu of $2,000 bail – $4,000 bond.
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.
Posted in
Legal Doctrines, NY Workers Comp Issues, Return to Work and Transitional Duty |
