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Fingers Pointed at Those Responsible For Compensation Scam

BY: korey saulters | Category: Health | Submitted: 2011-01-20 21:04:16
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Article Summary: "People who know about the system used in compensating workers agree that its full of problems and that these problems are always the fault of someone else. Employees, employers, and insurance companies are accused of fraud..."

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Those involved in workers' compensation all agree that the system is problematic and that it's the fault of someone else. Blame is shifted from one employee and employer to another. The bosses are the targets of the California Department of Insurance.

Worker's compensation insurance involves employer fraud. An employer who underreports the payroll or who classifies an employee wrong is committing fraud. The top insurance regulator of the state has a different viewpoint. A California insurance commissioner states that there are people who abuse the workers' compensation insurance, but are being paid huge amounts by the employers.

Groups involved in the current crisis are not exempt from blame, an attorney who knows about workers' compensation issues says. He will make sure the workers get the strongest defense. Very little cases of fraud done by workers is known. From the years 1993 to 1998, a very small number of arrests were made from the millions of injuries reported, according to the California applicants' attorneys association Web site.

He thinks employers and employees need to get it in their heads that they still have insurance companies to worry about. Insurance costs began to fall a few years after deregulation of the insurance industry happened. The insurance companies made big profits through the investments of insurance premiums in the stock market when the number of claims went down.

What happened in 9/11 added to the problems. Insurance companies closed business because of these terrorist attacks, in addition to losses in the industry that amounted to $40 billion. He supports any legislation that would make the 235 private insurance companies offering workers' compensation coverage in California.

Rates don't change when no claims are made, but rates go up when there are claims. Those employees who are free from claim would be rewarded if Senate Bill 191, which he supports, were to be implemented.

A physical therapist is reminded of the Latin word compitis when he describes his patients' conditions. The recovery time needed for non work related injuries will be noticeably different from the recovery time needed for work related injuries, this man said.

Work related injuries, he said, will not recover as fast as injuries that take place outside of work. He said the streamlined system of payment also encourages doctors, physical therapists and other health care providers to keep workers' compensation patients on their books.

Treatment is seldom queried, he said, and once the paperwork is submitted the health professionals can expect a check virtually by return post. You can see obvious differences between this and HMO, which would usually leave negative impressions.

A particular chiropractor for about 13 years, half that time with his own practice said he estimates that 15 percent of his patients are on workers' compensation and says for some chiropractors that figure would be closer to 40 percent. Providing a lot more services and therapies than necessary is how chiropractors take advantage of the system. He knows what form of abuse the system gets from patients. Though patients will sometimes fake injuries, tests can be done to detect who are malingerers.

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