Tag Archives: employer fraud

Employee Workers’ Compensation Fraud? No – Employer Fraud Rampant.

Posted on May 10, 2018 by Rod Rehm

Attorney Leonard Jernigan compiled a list of the biggest workers’ compensation frauds

Today’s post comes from guest author Thomas Domer, from The Domer Law Firm.

My friend and colleague Len Jernigan has again compiled the Top 10 Workers’ Compensation Fraud Cases for 2017.

His results emphasize a theme that has been present for the last dozen years during which he has been compiling a “Top 10” list. This year the Top 10 non-employee fraud cases resulted in fraud totaling just under $700 million. Employee fraud cases resulted in zero fraud. Seven of the Top 10 cases were from California, two from Texas, and one from Tennessee.

The cases involve health care fraud, where doctors prescribed inappropriate medications to pharmacies they operated, overbilling schemes for durable medical equipment, mail fraud, kickback schemes, referral of patients for unnecessary care, and prescribing unnecessary treatment.

A recurring theme, falsifying documents and under-reporting payroll to workers’ compensation insurance companies also appeared in the Top 10. In one notorious case, the owners of a hotel hid the existence of 800 housekeeping and janitorial workers to avoid paying workers’ compensation insurance rates and payroll taxes. The list also contains references to dishonest employers misclassifying more and more workers as independent contractors. This misclassification is a fraud that wrongfully denies these employees workers’ compensation when injured, denies the government millions of dollars in payroll taxes to support Medicare, Social Security, Unemployment Compensation, and the fundamental rights of the workers. Simply put, this misclassification is another employers shift the cost of accident and injury to the taxpayers and the fraud continues.

Roofing Company Owner Faces Felony Charge for Not Paying Workers’ Comp

Posted on September 14, 2015 by Jon Rehm

This recent situation in Washington state was written about by guest author Kit Case from Causey Law Firm in Seattle. It is important to keep in mind now because with all the storm damage in Nebraska and Iowa this summer, many roofs will continue to be repaired through the fall season. Though workers’ compensation systems vary from state to state, when businesses are expected to have workers’ compensation insurance and don’t, the results are stark for injured workers and their loved ones. In addition to creating an unfair advantage for the business that’s not paying for the insurance, taxpayers often foot the bill when, not if, but when, a worker who thought he or she was covered by workers’ compensation faces the challenge of recovering from a work-related injury.

A Mason County, WA roofing contractor faces a criminal charge for allegedly failing to provide workers’ compensation insurance for his employees while they were on the job.

The Washington State Attorney General’s office has charged Peter Daniel Yeaman, 55, with unregistered contracting and doing business when his workers’ comp coverage was revoked.

The latter charge is a felony with a penalty of up to five years in prison and a $10,000 fine. Yeaman is scheduled for arraignment in Kitsap County Superior Court today, July 23.

The case resulted from a Department of Labor & Industries (L&I) investigation into Yeaman and his company, Southgate Roofing, of Belfair.

Unfair business advantage

“When contractors skip out on workers’ comp, it’s illegal and it’s incredibly unfair to legitimate contractors who pay their fair share and get underbid by these lawbreakers,” said Annette Taylor, deputy assistant director of L&I’s Fraud Prevention & Labor Standards.

“Workers’ comp premiums for roofers are among the highest in building construction and the trades, based largely on the safety risks those workers face.”

State law requires employers to provide their employees with workers’ compensation insurance. The coverage provides medical care and other financial support if employees are injured on the job.

Construction contractors also must register with L&I. The department confirms they have liability insurance and a bond and that, if they employ workers, they’ve paid their workers’ comp premiums.

At least six roofing employees

L&I suspended Southgate Roofing’s contractor registration in November 2012 for failing to pay workers’ comp premiums, and later officially revoked the company’s workers’ comp coverage.

Nonetheless, according to the charges, L&I found two consumers in Silverdale who had work done by the company in May 2014 and in August 2014.

During the August job, six workers told an L&I inspector they worked for Southgate Roofing. Yeaman himself told the inspector he needed to pay a bill before he could register as a contractor, charging papers said.

Eight previous infractions

In addition, the charges say that between October 2013 and September 2014, the company bought roofing materials numerous times from a Bremerton supplier and made numerous trips to a Bremerton disposal site.

Apart from the criminal charges, L&I has cited Yeaman with six unregistered contracting and two permit-related infractions since 2013, and several safety violations in 2013. L&I currently lists him as ineligible to bid or work on public works projects. He owes the department more than $28,000 for the unpaid fines and more than $131,000 for unpaid workers’ comp premiums, penalties and interest.

Photo credit: davidwilson1949 / Foter / CC BY

A Real Mess

Posted on April 7, 2014 by Rod Rehm

Today’s post was shared by Gelman on Workplace Injuries and comes from daviddepaolo.blogspot.com

Does fraud really matter?

Respected colleague Leonard Jernigan from North Carolina writes a yearly blog post about fraud in workers’ compensation. His current record over the five years he’s written this post is that for each top 10 list, the largest dollar amounts stolen are in the category of employer fraud, except for one employee incident, which happened this last year, so the record is 49 employers, 1 employee.

The very complicated article below definitely falls into the employer fraud category. David DePaolo writes about an incredibly complex situation that affected workers, employers and the greater society in a number of states, including Oklahoma, which made a major change to the workers’ compensation system last year.

“And who knows how much of the failure of Park Avenue and Imperial Casualty and Indemnity Co. contributed to that state’s abysmal rate work comp insurance cost ranking leading up to last year’s historic opt-out legislation,” he wrote in the article.

My point is that when anyone commits fraud in a workers’ compensation system, regardless of the state, there can be far-reaching consequences for society being stuck with the bills of that fraud and for injured workers and also employers who play by the rules. In addition, absorbing the cost of that fraud can also be far-reaching, even potentially contributing to changes to an entire workers’ compensation system.

Just ask Oklahoma.

Corporate fraud is a major problem in the workers’ compensation system. Today’s guest post authored by David DePaola is shared from http://daviddepaolo.blogspot.com and highlights a very serious problem with the nation’s workers’ compensation system.

What do Oklahoma, New York, Washington, Kentucky and Florida have in common?

If it’s workers’ compensation, then the connection is a far reaching scheme involving millions of dollars, failed insurance companies and professional employer organizations.

A federal grand jury in New York back in October 2012 indicted Wilbur Anthony Huff, principal behind a couple of professional employer organizations, Matthew Morris, Park Avenue Bank’s former senior vice president, and Allen Reichman, the former director of investments at New York investment house Oppenheimer & Co.

that Huff and Morris engaged with former bank president and Chief Executive Officer Charles Antonucci in an elaborate conspiracy to plunder Park Avenue Property and Casualty, formerly known as Providence Property and Casualty Insurance Co., and its subsidiary, Imperial Casualty and Indemnity, and artificially inflate the bank’s assets to secure funding from the federal Troubled Asset Relief Program.

U.S. Attorney Preet Bharara said in a press release that Huff, who secretly controlled South Florida PEOs O2HR and Certified HR Services, was at the “vortex of fraud” in a series of schemes involving more than $100…

[Click here to see the rest of this post]

Dirty Tricks Employers Use To Keep You From Getting Benefits

Posted on March 26, 2012 by Rod Rehm

Tom’s post on how to protect your rights is crucial for every worker to read before they get hurt at work. Know your rights, and beware these dirty tricks that employers use to keep you from getting your benefits.

——————–

Today’s post is by our colleague Tom Domer from Wisconsin.

Over the course of 35 years representing injured workers, I have heard some whoppers – Employers’ questionable tactics that make even my jaw drop.

With all the insurance company generated blather about “employee fraud”, incidences of employer fraudulent tactics abound.

Workers beware of the following:

Recorded statements taken by worker’s compensation carrier adjuster while employee is under medication or in the hospital still suffering from the injury. Questions such as “It’s true you had (low back pain, arm pain, fill in the blank pain, etc.) before your work injury, correct? You’ve had lots more pain from (your motor vehicle accident, sports injury, etc.) than you’re experiencing from your work injury, correct?”
Employer “channeling” a worker to its “Return to Work Clinic” (doctors on company payroll whose opinion is “like some athletic coaches, ‘rub some dirt on it and get back in the game’.”
Telling employees to take sick leave rather than claim worker’s compensation.
Telling employees to file medical bills under their group insurance, not worker’s comp.
Nurse Case Manager who initially befriends the employee, but later makes every attempt with the worker’s doctor to prematurely return the worker to the job before a healing occurs. Continue reading →

Workers' Compensation Watch

Published by Rehm, Bennett, Moore & Rehm

Published by:

Tag Archives: employer fraud

Employee Workers’ Compensation Fraud? No – Employer Fraud Rampant.

Roofing Company Owner Faces Felony Charge for Not Paying Workers’ Comp

A Real Mess

Dirty Tricks Employers Use To Keep You From Getting Benefits

Share this:

Share this:

Share this:

Share this: