Friday, May 30, 2014

Intentional Fraud

All fraud is not actionable in workers' compensation. It is similar to discrimination action actions under the workers' compensation act. There is much talk, but few claims succeed, since they are based upon the element of intent.

This case caught my eye because of David DePaolo's recent blog post highlighting the recent, as David calls it, "Truly Imaginative" behavior of an individual playing two sides of the plot line.

The fraud issue struck a note for me as I have been reviewing cases for an upcoming seminar on workers' compensation issues. The decision of Bellino v Verizon, 2014 WL 10301786 (NJ App Div 2014) is a factual situation that seem to draw the ire of many insurance companies and employers. The injured worker failed to disclose some past medical information during a proceeding. The Court held that the element of intent was not proven.

Cases involving fraud are especially fact sensitive. Rarely does someone play both sides of the story line in perpetrating an intentional workers' compensation fraud scheme. Carlos Perry in West Virginia did so as the US Justice Department reports:

Knoxville Man Sentenced To Twelve Years Imprisonment For Workers' Compensation Fraud

Carlos Perry Found to Have Defrauded Six Insurance Companies Out of $401,649 in Benefits

FOR IMMEDIATE RELEASE

May 20, 2014

ABINGDON, VIRGINIA – United States Attorney Timothy J. Heaphy announced today that Carlos Perry, 58, Knoxville, Tenn. was sentenced last week in the United States District Court for the Western District of Virginia in Abingdon to twelve years in federal prison.

Perry was also ordered to pay restitution in the amount of $324,914.70. Perry had previously pleaded guilty to one count of mail fraud.

According to evidence presented at the sentencing and guilty plea hearings by Assistant United States Attorney Zachary T. Lee, between January 2011 and February 2014, Perry developed a scheme in which he defrauded six different insurance companies of workers’ compensation benefits using false business and fictitious employees. An investigation by the United States Secret Service determined that Perry’s scheme entailed Perry impersonating an owner of six fictitious businesses located in Wise, Va., Johnson City, Tenn., Bristol, Va., and Abingdon, Va., in order to obtain workers’ compensation insurance. Perry then filed false injury claims on behalf of the fictitious employees.

Perry received the checks sent by the insurance companies and impersonated the fictitious employees at doctor’s visits and in communications with the insurance companies. The United States Secret Service discovered that Perry utilized nineteen fictitious identities in the course of his scheme and used the social security numbers of numerous real persons to execute his fraud. On January 29, 2014, Perry was arrested by the United States Secret Service and the United States Marshals Service at a doctor’s office in Kingsport, Tenn., where he was impersonating one of the fictitious employees. As a result of Perry’s scheme, six separate insurance companies sustained a combined loss of $401,649.66.

The investigation of this case was conducted by United States Secret Service, United States Marshals Service, and the Virginia State Police. Assistant United States Attorney Zachary T. Lee is prosecuting the case for the United States.

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Thursday, May 29, 2014

Reports of Worker Fatalities during Flowback Operations

John Snawder, Ph.D, DABT; Eric Esswein, MSPH, CIH; Bradley King, MPH, CIH; Michael Breitenstein, BS; Marissa Alexander-Scott, DVM, MS, MPH; Kyla Retzer, MPH; Max Kiefer, MS,CIH and Ryan Hill, MPH.

Although worker safety hazards in the oil and gas extraction industry are well known, there is very little published data regarding occupational health hazards (e.g., types and magnitude of risks for chemical exposures) during oil and gas extraction operations. To address the lack of information, NIOSH requests assistance from oil and gas stakeholders in further characterizing risks for chemical exposures during flowback operations and, as needed, develop and implement exposure controls. This blog briefly describes flowback operations and addresses reports made known to NIOSH of recent worker fatalities related to or located at flowback operations.

Worker Fatalities

NIOSH learned about several worker fatalities associated with flowback operations through media reports, officials with the Occupational Safety and Health Administration (OSHA), and members of the academic community. According to our information, at least four workers have died since 2010 from what appears to be acute chemical exposures during flowback operations at well sites in the Williston Basin (North Dakota and Montana). While not all of these investigations are complete, available information suggests that these cases involved workers who were gauging flowback or...

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Median CEO Pay Tops $10 Million For The First Time

Wage inequality impacts workers' compensation. Benefits are calculated upon wages earned at the time of the accident. Many workers hold two jobs and rates are calculated only upon one job. Today's post was shared by Steven Greenhouse and comes from www.npr.org

Leslie Moonves of CBS received $65.6 million in total compensation in 2013, an increase of 9 percent. CBS stock rose nearly 70 percent last year.

Are you getting rich off the rising stock market? America's CEOs are.
Median compensation for the chief executive of a Standard & Poor's 500 company was $10.8 million last year, according to a study by The Associated Press.
That represents an 8.8 percent increase over 2012 and marks the first time that median compensation crossed the eight-figure mark.
Much of the increase was due to performance cash bonuses, stock awards and options. The S&P 500 index rose 30 percent last year, while earnings per share increased by more than 5 percent, lifting CEO compensation, which is generally tied to such indicators.
Bankers got the biggest raises, with total compensation on Wall Street rising 22 percent — matching the 22 percent they'd received a year earlier. Media industry CEOs also did nicely, with the top officials of CBS, Viacom, Walt Disney and Time Warner each pulling in more than $30 million
All told, more than two-thirds of CEOs got a raise, according to the study, which AP and the executive pay research firm Equilar conducted using federal filing statements.
Women CEOs made more than men — $11.7 million, compared to $10.5 million. But that applied only to the dozen women who were included in the sample, compared to 325 male CEOs.
Last year was the fourth in a row in which CEO compensation increased, following a dip with the Great Recession. "The median CEO pay package climbed more than 50 percent over that stretch," according to the AP. "A chief...

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How Tech Companies Tricked A Generation Into Working For Free

Today's post was shared by Steven Greenhouse and comes from www.forbes.com

Last month Apple announced it would open beta testing access for its soon-to-be-revealed version of OS X to anyone with a compatible computer. Once a process reserved for a limited number of developers operating under non-disclosure agreements, the ability to have early access to new software from one of the most desirable companies in the world feels like an unexpected gift. The labor necessary to test software as complicated and widely distributed as an operating system is hard to calculate, but, like all forms of software testing, there is a point where the expense of paying workers is no longer economically feasible. But because Apple has cultivated an image of unattainable desirability for its products, this structure of uncompensated labor becomes a happy privilege, an opportunity to contribute to the ongoing evolution of a brand they love as an echo of themselves.
These voluntary forms of unwaged labor have become endemic as work has increasingly shifted toward the production of digital metaphors like apps, operating systems, and analysis. As the economy has continued to create its divine mirage of growth, workers have come to seem like profit deterrents whose need for sleep, food, play, and security drag down the system. Central to this shift has been the mass distribution of computers, the uses of which have become so frictionless and pleasing they encourage the subconscious guilt of the average worker, who begins to suspect that spending her day telecommuting in...

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Will the Supreme Court Kill Public-Employee Unions?

The Labor movement was a catalyst for the America's workers' compensation movement. Are they both going extinct? Today's post was shared by Steven Greenhouse and comes from www.motherjones.com

Forget Wisconsin Gov. Scott Walker and his fellow union-bashing governors. Forget the partisan Republican attacks on organized labor. The gravest threat today to public-employee unions—which represent cops, firefighters, prison guards, teachers, nurses, and other city and state workers—is a Supreme Court case named Harris v. Quinn, which could be decided as early as this Tuesday. And, strangely enough, it is the court's most sharp-tongued conservative, Justice Antonin Scalia, who could ride to organized labor's rescue.
The case pits several of the nation's mightiest labor unions, such as the Service Employees International Union (SEIU) and the American Federation of State, County, and Municipal Employees (AFSCME), against their longstanding foe, the National Right to Work Legal Defense Foundation, which helped bring the case. National Right to Work is funded by some of the biggest names in conservative philanthropy: the Bradley family, the Waltons of Walmart, Charles Koch, and DonorsTrust and Donors Capital Fund, two dark-money ATMs. Labor officials see Harris as an effort by the deep-pocketed conservative movement to wipe public-employee unions off the map—and to demolish a major source of funding and support for the Democratic Party. "This is an attempted kill shot aimed at public-sector unions," says Bill Lurye, AFSCME's general counsel.
The origins of Harris date to July 2003, when the Illinois legislature passed a bill recognizing certain...

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Wednesday, May 28, 2014

The Documents You Need, When You Need Them

A screen shot of the new smartphone app from the American Bar Association that is intended to help users save and transmit health care documents.

Today's post was shared by The New Old Age and comes from newoldage.blogs.nytimes.com

Few things drive an emergency room staff quite as nuts as a patient who has, yes, carefully considered her preferences, designated a health care decision-maker should she become incapacitated, and documented all that information in an advance directive — which is sitting in a locked safe deposit box or stashed in an bureau drawer at home.

A screen shot of the new smartphone app from the American Bar Association that is intended to help users save and transmit health care documents.
But as we’ve discussed before, that’s hardly an uncommon scenario. In fact, the president of the American Bar Association, Jim Silkenat, told me that until recently, his own advance directive wasn’t easily accessible.
“It was in a file here in my office” in Midtown Manhattan, he said. “My kids knew about it, but they had no idea where it was. Nobody had really focused on it.” Fortunately, since his children live in Scotland and Arizona, Mr. Silkenat hadn’t encountered an emergency requiring them to show up at a hospital with the document.
But enough people do find themselves in that quandary that the association’s Commission on Law and Aging has developed a smartphone app, My Health Care Wishes, that allows you to store your own advance directive or family members’ on your iPhone or Android phone. When you need them, the app lets you present such documents — and other health information and contacts — via email or...

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