Its nice to see the publicizing of the fraudulent WC case in Ohio involving $3,090.01.
What about the thousands of fraudulent WC claims (alleged back problems, accident occurring on a weekend reported on Monday as an on the job injury, etc) that are ongoing that cost the system hundreds of thousands of dollars, not only in Ohio but in every state of the US?
You’ve got to believe something is wrong when employers complain to their WC carrier that a claim is fraudulent and nothing happens but the appearance of an investigation.
Employees, including public employees, out to get the system succeed with such ease (lawyers and doctors assist) and frequency, that WC fruad is probably costing the insurance industry
$20 billion annually.
Not enough is being done to publicize the penalties one receives when found guilty of WC fraud.
I am a WC Adjuster, and I absolutely and totally agree with you, David. The problem is that workers’ compensation is for the “worker”, and the WC Judges/Commissioners, etc are very liberal with their awards and interpretation of the w.c. statutes and case law. Furthermore, when an adjuster is able to attain good video tape of the I/W doing exactly that of which he tells the doctors/attorney/judge he is unable, the judges tend to find a way to ignore the tangible proof (for whatever reason). This is an area of insurance that is very frustrating and most of all liberally interpreted.
For every allegedly “fraudulent” WC claim, there is an unbelievable amount of fraud committed by the insurers. What about refusal to authorize clearly necessary treatment, slow-paying benefits, TTD checks suddely going “off diary”, IMEs by crooked doctors, and the like? That’s not fraud?
Surprise! No one is happy with the WC system. We have 50 WC Acts accross the country and no one seems to be happy with any of them. Employers pay outlandish premiums, employees lie to collect benefits they are not entitled to. Medical providers overtreat and overcharge. Insurers haphazardly “adjust” medical bills and cut off employees income when time off is no longer medically supported. Employees get terminated when they make WC claims or when they don’t.
Are we ready to go back to the pre-WC world? Oh for the days of common law and employers “cardinal defenses”. Let’s repeal those awful WC laws and give those poor injured workers something to really complain about. It’s unfortunate that these 50 sets of statutes are the best our legislators could come up with. No one is happy.
Come on down to Miami and really see where comp needs a break. Some of the files that I have to work are as greasy as oil. There may be laws that are written, but not carried out. What happened to the 3rd degree felony that is suppose to be inforced??
Hail to those who catch fraud and prosecute!
What about the vindictive employer who endsup finding a way to terminate the employee after making a claim. Benefits are terrible, the doctors are terrible, adjusters are worse. The whole system stinks
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Its nice to see the publicizing of the fraudulent WC case in Ohio involving $3,090.01.
What about the thousands of fraudulent WC claims (alleged back problems, accident occurring on a weekend reported on Monday as an on the job injury, etc) that are ongoing that cost the system hundreds of thousands of dollars, not only in Ohio but in every state of the US?
You’ve got to believe something is wrong when employers complain to their WC carrier that a claim is fraudulent and nothing happens but the appearance of an investigation.
Employees, including public employees, out to get the system succeed with such ease (lawyers and doctors assist) and frequency, that WC fruad is probably costing the insurance industry
$20 billion annually.
Not enough is being done to publicize the penalties one receives when found guilty of WC fraud.
I am a WC Adjuster, and I absolutely and totally agree with you, David. The problem is that workers’ compensation is for the “worker”, and the WC Judges/Commissioners, etc are very liberal with their awards and interpretation of the w.c. statutes and case law. Furthermore, when an adjuster is able to attain good video tape of the I/W doing exactly that of which he tells the doctors/attorney/judge he is unable, the judges tend to find a way to ignore the tangible proof (for whatever reason). This is an area of insurance that is very frustrating and most of all liberally interpreted.
For every allegedly “fraudulent” WC claim, there is an unbelievable amount of fraud committed by the insurers. What about refusal to authorize clearly necessary treatment, slow-paying benefits, TTD checks suddely going “off diary”, IMEs by crooked doctors, and the like? That’s not fraud?
Surprise! No one is happy with the WC system. We have 50 WC Acts accross the country and no one seems to be happy with any of them. Employers pay outlandish premiums, employees lie to collect benefits they are not entitled to. Medical providers overtreat and overcharge. Insurers haphazardly “adjust” medical bills and cut off employees income when time off is no longer medically supported. Employees get terminated when they make WC claims or when they don’t.
Are we ready to go back to the pre-WC world? Oh for the days of common law and employers “cardinal defenses”. Let’s repeal those awful WC laws and give those poor injured workers something to really complain about. It’s unfortunate that these 50 sets of statutes are the best our legislators could come up with. No one is happy.
Come on down to Miami and really see where comp needs a break. Some of the files that I have to work are as greasy as oil. There may be laws that are written, but not carried out. What happened to the 3rd degree felony that is suppose to be inforced??
Hail to those who catch fraud and prosecute!
What about the vindictive employer who endsup finding a way to terminate the employee after making a claim. Benefits are terrible, the doctors are terrible, adjusters are worse. The whole system stinks