Tag Archives: fraud

Why an Obscure Securities Law Case Could Affect SSDI

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Securities and Exchange CommissionSocial Security Disability Insurance (SSDI) cases are largely decided by administrative law judges (ALJs). A decision questioning the role of ALJs in another area of the law could cause some major complications for SSDI applicants and SSDI beneficiaries.

The 10th U.S. Circuit Court of Appeals recently set aside a conviction for securities fraud by the Securities and Exchange Commission (SEC) because the ALJ who decided the case should have been appointed under the Appointments Clause rather than hired by the SEC. The 10th Circuit’s decision directly conflicts with a recent decision made by the District of Columbia  Circuit Court of Appeals, which means the U.S. Supreme Court could take up the issue.

This matters to SSDI applicants, their attorneys and even present SSDI beneficiaries because the vast majority of administrative law judges, roughly 1,200 of 1,400, have been hired by the Social Security Administration to hear Social Security Disability appeals. Similar to ALJs from the SEC, ALJs who hear SSDI appeals are hired on merit and are federal employees.

If the U.S. Supreme Court followed the recent 10th Circuit decision and applied it to ALJs who heard Social Security Disability appeals, at least 1,200 ALJs would have to be appointed by the president and confirmed by the Senate. This could lead to further delays and uncertainty related to SSDI appeals. If the 10th Circuit decision were applied to SSDI judges, it is uncertain as to whether awards of disability would still be valid if they were made by unconstitutionally chosen ALJs. In 2014, in National Labor Relations Board v. Noel Canning, the Supreme Court held that the NLRB’s decision made by commissioners who were appointed by constitutionally invalid recess appointments was invalid.

The Social Security Administration has recently moved to abolish the treating physician rule in an effort to decrease claim payments. Uncertainty over whether the awards of SSDI benefits are constitutional would add additional hurdles to those needing SSDI benefits. If you are applying for Social Security Disability or thinking about it, contact an experienced attorney. Also, contact your lawmakers to express your concerns about the SSDI system to them.

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in Courts, employment law, social security disability and tagged , , , , , .

Workers’ Compensation Basics: Are You an Employee?

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Here’s the second blog post in a series on the basics of workers’ compensation.

As its name suggests, workers’ compensation compensates employees for on-the-job injuries. About 95 percent of time, the question of whether an injured worker is an employee is a simple “yes.” If you are paid a regular salary or by the hour via a regularly scheduled paycheck where your employer takes deductions out for Social Security, unemployment, Medicare, etc., you are most likely an employee.

But sometimes the issue of whether you are an employee isn’t as simple. Some states may exclude household and farm workers. Some states may exclude employees performing work for the business outside of the regular course of business hours. An employer might try to exclude an employee from workers’ compensation benefits by alleging the employee is an independent contractor.

If you are hurt on the job and your employer or their insurance company is claiming that you aren’t covered by workers’ compensation, you need to contact an experienced workers’ compensation attorney. Laws about which employees are covered by workers’ compensation are very specific and vary by state. You need an attorney who can tell you whether you are in fact covered by workers’ compensation, and, if not, what other possible ways there would be to compensate you for your injuries.

Read the first blog post in the series by clicking on this link: What is Workers’ Compensation?

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in Fraud, Workers' Compensation and tagged , , , , .

Workers Can’t Wait to Cash In?

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Worplace-Safety-Workers-Compensation-Worker-Injury-ConstructionIt’s not uncommon in the workers’ compensation arena that we hear allegations of malingering or workers being hurt on purpose to reap the monetary rewards of a work injury. Some employers refuse to settle a case as long as the worker is still employed by the company, fearing a large monetary settlement will encourage other workers to get injured.  The limited benefits of a workers’ compensation claim make these assertions ridiculous.  Specifically, no benefits are paid for the pain and suffering.  Additionally, the reality is that many states compensate a permanent injury for only a matter of weeks or years.  The worker and his or her family are left to deal with the ongoing effects of these injuries for the balance of their lifetime.

The Insurance Journal listed the top 10 leading causes “of serious, nonfatal workplace injuries” from “2012 claims data for injuries lasting six or more days and ranked the injuries by total workers’ compensation costs,” according to a recent article.

Not surprisingly, horseplay or purposefully getting injured was not among them. In fact, the leading cause of workplace injuries is ironically enough – overexertion! Overexertion and other exertion-related injuries made up almost a third of all workplace injuries. So much for the theory of money-hungry workers playing around or purposefully getting injured. Falls comprise two of the top 10 leading causes of workplace injuries, making up a total of just over 24 percent of all injuries.  Being struck by or striking objects combined for around 15 percent. Motor vehicle accidents (5.3 percent) and repetitive movements (3.1 percent) round out the top 10 list. The full list is detailed below. In total, the 10 most common work injuries accounted for almost 84 percent of all injuries.

  1. Overexertion 25.3 percent
  2. Falls on same level 15.4 percent
  3. Struck by object or equipment 8.9 percent
  4. Falls to lower level 8.6 percent
  5. Other exertions or bodily reactions 7.2 percent
  6. Roadway incidents 5.3 percent
  7. Slip or trip without fall 3.6 percent
  8. Caught in or by equipment or objects 3.5 percent
  9. Repetitive motions 3.1 percent
  10. Struck against object or equipment 2.9 percent

The Occupational Safety and Health Administration (OSHA) reports that workplace deaths have decreased from 38 per day in 1970 to 12 per day in 2012, according to the article. Additionally, OSHA reports occupational injury and illness rates have declined 67 percent since 1970, all while employment has almost doubled.

Despite these accomplishments, insurance companies and large employers continue to lobby state legislatures about the injustice and cost of workers’ compensation benefits. In reality, workers and their families continue to bear the real burdens of workplace injuries.

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in Disability, employer fraud, fighting fraud, Fraud, Work Injury, Workers' Compensation, Workplace Injury, Workplace Safety and tagged , .

Misclassification – Department of Labor Recovery

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department_of_labor

 

Today’s post comes from guest author Leonard Jernigan, from The Jernigan Law Firm in North Carolina. Employer fraud happens more than businesses would like folks to think, and Mr. Jernigan writes a “Top 10” list at the end of each year talking about this problem. His list in 2012 was called “$97 Million In Fraud: 2012′s Top 10 Workers’ Compensation Fraud Cases.” That blog post includes an example of labor violations when a company in Massachusetts misclassified employees as subcontractors. The article that was the focus in last Monday’s blog post, “Connecticut Employers Shut Down For Not Paying Workers’ Compensation Insurance,” also talked about misclassification as a form of employer fraud. Although it appears to happen in construction a lot, this type of fraud can occur in other industries, too. And as can be seen in just the article below, misclassification fraud isn’t limited to specific states but can happen anywhere. It is helpful to see some action occurring, both in the courts and legislatively.

The U.S. Department of Labor has recovered more than $1 million in back wages and liquidated damages for 196 employees of Bowlin Group LLC and Bowlin Services LLC out of Ohio and Kentucky. Bowlin Services installed cable for Insight Communications, a cable, telephone and Internet provider in Kentucky. The defendants misclassified 77 employees as independent contractors and violated the Fair Labor Standards Act (FLSA) by denying these workers access to critical benefits, including minimum wage, overtime, family and medical leave, unemployment insurance, workers’ compensation and failing to maintain accurate payroll records.

Misclassifying employees negatively impacts our economy, generating losses to the U.S. Treasury, Social Security and Medicare funds, state unemployment insurance, and state workers’ compensation funds. It also leads to unfair competition because businesses that play by the rules are at a disadvantage.

This problem has become so acute in Tennessee that last month the legislature passed Senate Bill 833, which has been signed into law and imposes penalties on construction companies for misclassifying workers in an attempt to evade workers’ compensation premiums. A Tennessee study in 2012 revealed losses of up to $91.6 million in workers’ compensation premiums. North Carolina has identified the problem but has yet to take any action. Until states aggressively prosecute misclassification, this fraud will continue.

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in Employee Misclassification and tagged , , , , .

Insurance Company Broker Caught Cooking the Books

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Today’s post comes from respected colleague Jon Gelman from Jon Gelman, LLC – Attorney at Law in New Jersey. It is pretty common to hear about fraud when it comes to workers in workers’ compensation. But the fraud can also come from different cogs in the wheel of the workers’ compensation process, an issue that isn’t always covered as thoroughly unless it involves a lot of money, like this situation. This insurance company employee stole millions of dollars instead of buying insurance policies for “trucking, hauling, waste management, moving, and recycling businesses located in New Jersey and New York,” according to the post. So the insurance companies didn’t get their money, the businesses didn’t get their insurance policies, and this fraud violated the trust of the insurance broker itself. At the time of his original blog post, Mr. Gelman wrote that the prosecution anticipated the sentence would include jail.

NJ Attorney General Jeffrey S. Chiesa announced that an employee of a former Morris County insurance brokerage company pleaded guilty today to stealing several million dollars entrusted to her employer. These funds had been entrusted to the insurance brokerage for the purpose of purchasing insurance policies for small and medium-sized businesses in New Jersey and New York.

Kelly Roetto, 45, of Bedminster, pleaded guilty to an accusation charging her with second-degree theft by unlawful taking, second-degree issuing bad checks, and second-degree misconduct by a corporate official before Superior Court Judge Thomas V. Manahan in Morris County.

Judge Manahan scheduled sentencing for Dec. 19.Under the plea agreement, the state will recommend that Roetto be sentenced to nine years in state prison. In addition, Roetto will be ordered to pay restitution and will agree to never again obtain an insurance license in the State of New Jersey.

This defendant used her position of trust within this insurance brokerage firm to divert millions of dollars

“This defendant used her position of trust within this insurance brokerage firm to divert millions of dollars,” Attorney General Chiesa said. “My office will continue to work with the insurance industry to root out corrupt insurance brokers.”

“This crime attacked the integrity of our insurance system by Continue reading

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in Fraud and tagged , , , .

Private Investigators in Workers’ Compensation

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Corporations sometimes hire private investigators to verify that your claim is not fraud

Corporations sometimes hire private investigators to verify that your claim is not fraud

Today’s post comes from respected colleague Leonard Jernigan from The Jernigan Law Firm in North Carolina. Unfortunately, being followed by a private investigator is also very common in Nebraska and Iowa. Attorneys at our firm give clients specific instructions about dealing with private investigators, as should most attorneys that work with personal injury and workers’ compensation cases. I recently saw this blog post from www.workerscompensation.com that gives employers that hire private investigators tips on being more effective at catching someone “violating their medical restrictions by shoveling out their driveways or partaking in a winter recreational sport.” And although there probably isn’t much skiing going on in our part of the Great Plains, it bears in mind that a private investigator may see someone being active but won’t know the ramifications of that activity upon that person for the next few days, like cutting back on doctor-approved activity because of soreness. So be sure to follow the restrictions laid out by your doctor to make the private investigator’s job that much harder!

As a workers’ compensation attorney I find it interesting that many people in the public question the disability status of injured workers. Let’s assume for the moment that you have sustained an injury on the job and you’ve been out of work for 5 months after back surgery. When you are unable to return to work quickly, the insurance industry has a lot of tools at its disposal to verify your disability status. They can pour over your medical records, pre- and post-injury, looking for any piece of evidence to deny your claim. They can send your file to lawyers who review medical records and recorded statements to potentially attack your credibility and honesty. They can hire a nurse to attend your appointments and speak with the physician and the staff, as well as obtain information directly from you. They can do background searches on you to see if you have a criminal or civil record. Obviously they will check to see if you ever filed a workers’ compensation claim before. They will also do social media and Internet searches on you and your family members (Facebook, Twitter, LinkedIn, etc.). They also can hire private investigators to follow you and your family around and take video recordings of your activities. With all these resources at the disposal of the insurance company, it’s hard to believe that many cases of employee fraud slip through the system.

A private investigator pretended to be a potential buyer and spent an hour or more going through the house.

We have one client recently who was followed by several private detectives for more than a year. They not only followed him around, but also followed his wife and son, who have no workers’ compensation claim. Another client had to sell his house because of his disability. A private investigator pretended to be a potential buyer and spent an hour or more going through the house. Does the concept of “Big Brother” come to mind? Are you concerned about invasion of privacy, particularly for family members, friends, and others who may be seen in such videos? We always tell our clients such activity may occur so don’t be alarmed by it, but that isn’t too comforting to people who are struggling through health issues, who have depression and anxiety problems, and who are sensitive to privacy concerns.

It would be interesting if the roles were reversed and employers who underpay premiums by misclassifying the status of their employees, who fail to purchase insurance required to protect their workers, and who don’t follow proper safety regulations that cause injury, were followed this closely by employees or regulators who administer the workers’ compensation program. I have no doubt that these employers and insurance representatives would be outraged.

 

 

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in insurance regulation, private investigator and tagged , .

NIOSH To Review Underreporting of Occupational Injuries and Illnesses by Workers

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underreporting injuryToday’s post comes to us from our colleague Jon L. Gelman of Wayne, New Jersey. We encourage all  workers to report their injuries to the appropriate person within their company, and if the proper reports are not filed, to seek legal representation. We are concerned about workers being discouraged from reporting injuries on the job. Mr. Gelman, one of the nation’s leading commentators on workers’ compensation, points out this is potentially a national problem.

The National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC) has proposed a project to review the Underreporting of Occupational Injuries and Illnesses by Workers.

“In 2008, the Congressional Committee on Education and Labor released the report, “Hidden Tragedy: Underreporting of Workplace Injuries and Illnesses,” indicating “that work-related injuries and illnesses in the United States are chronically and even grossly underreported.” Based in part on the report’s results, Congress allocated funds for NIOSH to conduct a follow-up study using NIOSH’s occupational supplement to the National Electronic Injury Surveillance System (NEISS-Work) to estimate underreporting among individuals who seek care at an emergency department (ED) for an occupational illness, injury, or exposure.

“Objectives for this project are to (1) assess the reporting behavior of workers that are injured, ill, or exposed to a harmful substance at work; (2) characterize the chronic aspects of work-related injuries or illnesses; and (3) estimate the prevalence of work-related chronic injuries and illnesses among United States workers treated in EDs. Particular attention will be paid to self-employed workers, workers with work-related illnesses, and workers with chronic health problems.
“Data collection for the telephone interview survey will be done via a questionnaire containing questions about the respondent’s injury, illness, or exposure that sent them to the ED; the characteristics of the job they were working when they were injured, became ill, or were exposed; their experiences reporting their injury, illness, or exposure to the ED and their employer (if applicable); the presence of an underlying chronic condition that was associated with their ED visit; and the nature of any other work-related chronic conditions they have experienced. The questionnaire was designed to take 30 minutes to complete and includes a brief series of questions to screen out individuals who were not seen in the ED for a work-related injury, illness, or exposure; who are younger than age 20 or older than age 64; who do not speak English or Spanish; or who were working as volunteers or day laborers when the injury, illness, or exposure occurred or was made worse.

The offices of Rehm, Bennett & Moore, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

This entry was posted in Fraud, Government and tagged , , .