Worker's Compensation is a service that provides reimbursement for lost wages to employees who have sustained injuries from work or work-related tasks. It is also one of the services that is most often the victim of fraud. Each of the three types of fraud, claimant, employer, and provider, is defined by the same characteristics, outlined by the Ohio Board of Workers Compensation:
Receiving workers' compensation benefits that are not entitled to the claimant;
Making false or misleading statements with the purpose of securing goods or services under the Workers' Compensation Act;
Altering, falsifying, destroying, concealing, or removing records needed to assess claim validity or establish the nature of goods and services for which reimbursement is requested;
Entering into an agreement for conspiracy to defraud the BWC or a self-insuring employer by making false claims for disability benefits.
The public and many enforcement agencies tend to dwell on claimant fraud, as it is the most widely publicized (Beck). The fixation on claimant fraud has distracted the public and these enforcement agencies and policy-makers from growing evidence of the real problem: millions of dollars in employer and provider fraud.
Claimant fraud is very serious, but has more than its share of attention in the media, completely blowing the problem out of proportion. The Press Democrat found that, "While some insurance companies claim one out of three workers lie about their injuries, or 33%, the actual number of fraud cases sent to prosecutors is less than one out of one hundred, or less than 1%." In New York, for example, over $6 million in insurance fraud was documented, less...
... middle of paper ...
...rat 11 May 2000.
Helvacian, Mike and Kyumin Shim. "Gender in Workers Compensation Claims." 1998 NCIC Issues Report. Boca Raton: NCIC. 1998.
"Insurance Department Fraud Investigations Net 12 Arrests." NY State Insurance Department: Press Releases 1998. NYC: NYSID Publications. 2 Feb. 1998.
"Insurance Fraud Arrests Up 140% During Pataki Administration." NY State Insurance Department: Press Releases 1998. NYC: NYSID Publications. 7 Jan. 1998.
Lorenz, Jonna. "Worker's Compensation Fraud Claims Climbing." Capitol-Journal Online Business News 26 Jan. 1999. 20 Oct. 2000. .
United States. Department of Labor and Industry. Guidelines and Definitions. 95th edition. Washington. 1999.
"What is Fraud?" BWC Online. Date accessed 17 Oct. 2000. .
"Workers Compensation Fraud." Minnesota Department of Labor and Industry. Date accessed 17 October 2000. .
Need Writing Help?
Get feedback on grammar, clarity, concision and logic instantly.Check your paper »
- Workers’ compensation is meant to protect employees from loss of income and to cover extra expenses associated with job-related injuries or illness. Accidents in which the employee does not lose time from work, accidents in which the employee loses time from work, temporary partial disability, permanent partial or total disability, death, occupational diseases, noncrippling physical impairments, such as deafness, impairments suffered at employer-sanctioned events, such as social events or during travel to organization business, and injuries or disabilities attributable to an employer’s gross negligence are the types of injuries and illnesses most frequently covered by workers’ compens... [tags: essays research papers]
787 words (2.2 pages)
- Coleen Colombo and Colleagues Resist Mortgage Fraud Synopsis: Coleen Colombo began employment with BNC the Sacramento California Concord branch in 2003. The Concord office was part of a regional group that subsidized $1.2 billion of loans a month. Coleen was hired as a senior underwriter for the Concord branch. Initially Coleen thrived in her position during one of her performance evaluations; she achieved a top rating of “exceed expectations.” It’s easy to say that Coleen loved her job with BNC, at is before the bottom fell out of the subprime lending market.... [tags: Abuse, Harassment, Bullying, Psychological abuse]
1556 words (4.4 pages)
- When considering workers compensation insurance for your construction business, it’s important to keep in mind the risks associated with the concrete industry. Some of the ways to protect your company from these risks include: • Securing insurance coverage for all employees based on their job description or class code • Ensuring that independent or subcontractors have their own workers comp coverage in place • Understanding your policy limits and whether the policy completely covers your risk. No matter how big or small the construction firm, if it has employees and works with the public, there are inherent liabilities each business owner faces.... [tags: Insurance, Workers' compensation, Employment]
824 words (2.4 pages)
- The New Deal and the Great Depression: The Social Security Act. Primary Sources Landon, Alf, History Maters: The U.S. Survey on the Web, I Will Not Promise the Moon”: Alf Landon Opposes the Social Security Act, 1936 by Alf Landon, (October 15, 1936), Accessed January 16th, 2014, http://historymatters.gmu.edu/d/8128/ As Governor of Kansas, the author was best known for balancing the budget and reducing taxes. On a national level, Landon was known for his opposition to the Social security Act of 1935, but perhaps best known for losing the election of 1936 to Franklin Delano Roosevelt in a landslide victory.... [tags: fraud, taxes, financial]
766 words (2.2 pages)
- Workers’ compensation is designed to protect both employers and employees. The words workers’ compensation can carry negative connotations. For example, the thought that the employer has the right to pick a pool of medical providers for the injured employee to choose from could have some employees crying foul. The reason, though is to protect the employer from medical providers who would seek to side with the employee, otherwise known as bias. The other reason is to protect the employee from medical providers who are unfamiliar with the workers’ compensation process.... [tags: Employment, Occupational safety and health]
1152 words (3.3 pages)
- Compensation philosophy is basically official statement recording the organization position about employee compensation. This explains the “why” of employee pay and produces a framework for stability. Employers can benefit from this if open about their compensation philosophy and having a proper pay strategy (SHRM, 2015). The executive team and the human resources department are the ones that usually develop the compensation philosophy’s. The compensation plan is based on different factors, for example, the organizations financial position, the salary information, the size of the company, and the level complexity in discovering qualified people based on the economy.... [tags: Employment, Employment compensation, Insurance]
782 words (2.2 pages)
- Working within the workers’ compensation (WC) structure in cost and billing is different than the Affordable Care Act (ACA) reimbursement system. Prior to taking the Healthcare Business Dynamics class, I understood the different WC medical care pay schedules according to each state; albeit, participating in the strategic planning of a business plan, I have a better understanding that Medicare, Medicaid, and group insurance is reimbursed at a lower rate causing concern that the AFA may cause financial distress on the healthcare institutions (Aldhizer & Juras, 2015).... [tags: Health care, Medicine, Public health, Insurance]
1263 words (3.6 pages)
- Question Presented: Under Californian workers’ compensation law can a worker receive workers’ compensation and when the injury was self-inflicted, and when their participation in the activity was voluntary, and when the activity took place after the work day and when the worker did not want to say no to their supervisor and when they were anxious to get on their boss’s good side and while during the activity business was discussed and when the company built the court for a director of sales, and when the director believed that inviting employees to play was a great way to get to know their employees, to increase morale and camaraderie at the company but when at the activity the employee’s in... [tags: the case of Lance Baldwin]
2237 words (6.4 pages)
- Incentive based compensation plans are one of the most conversed topics organizations that have been dealing with for quite some time. There have been several philosophies, formulas, and plans used but in the end, each type of plan has created unfavorable and optimistic results. The questions have always been whether the positive that comes from incentives plans are worth the challenges they create. In examining some of the plans that offer individuals, team based, and long-term incentives, they all vary in different ways that they are applicable, administered and designed, and beneficial to the organization’s objectives.... [tags: planning, financial performance, compensation]
586 words (1.7 pages)
- Worldcom Fraud TABLE OF CONTENTS WORLDCOM MISSION STATEMENT..........................................PG. 3 THE ETHICAL PRINCIPLES AND TENETS OF WORLDCOM ............PG. 4 THE BEHAVIOR OF WORLDCOM ADMINISTRATORS ....................PG. 5 WAS CYNTHIA COOPER A HERO?.............................................PG. 6 WHAT WORLDCOM DID NOT RECOGNIZE .................................PG. 7 THE CONCLUSION..................................................................PG. 8 WORKS CITED.......................................................................PG.... [tags: Business Fraud Fraudulent]
1456 words (4.2 pages)