Filed Under:Claims, Loss Litigation

Thanksgiving, Fraud, and Things to Remember

Editor's Note: David Langham is the deputy chief judge of Compensation Claims for the Florida Office of Judges of Compensation Claims and Division of Administrative Hearings. This blog originally appeared at: http://flojcc.blogspot.com/2012/11/thanksgiving-fraud-and-things-to.html

This morning's headlines are loaded with workers' compensation fraud of all kinds:
 
"NJ Broker to Serve 135 Months for Bribing School Superintendent"
 
"TN Safety Manager Convicted of Falsifying Injury Statistics"
 
"NY DOT Millwright Receives Probation for Comp Fraud"
 
"OH Double Dipper Must Pay $25k Restitution to BWC"
 
The New Jersey broker will go to jail for 11 years. Over an eight-year period, the broker and others paid millions of dollars in bribes to assure that the school district would obtain their insurance from specific providers/vendors. They agreed, and I quote "to use middlemen, shell companies, sham consulting contracts and third-party payments to secretly pas hundreds of thousands of dollars in cash and bribes...." Not content with bribery, the superintendent that accepted the bribes has already pled guilty to mail fraud and conspiracy to defraud the IRS. He was fined $100,000.
 
Twelve days of trial result in a conviction, and possibly a long prison term for a safety manager who maintained a fine safety record at the Shaw Group in Tennessee and Alabama. He merely elected not to record a few (80) minor injuries such as "broken bones, torn ligaments, hernias, lacerations, and  shoulder, back and knee injuries." The employer obtained more that $2.5 million in safety bonuses from the Tennessee Valley Authority because of their resulting safety record. The employer previously repaid double the safety bonus money, in settlement of a civil suit against them related to this malfeasance. 
 
The U.S. Department of Transportation millwright will serve three years probation. He received about $85,000 in benefits while he simultaneously ran his own company. While running that company, he submitted documents in support of his claims for benefits, and claimed he was not working. Now he is paying the money back, serving six months of house arrest, and performing 100 hours of community service. 
 
Similarly, the Ohio worker collected workers' compensation benefits while simultaneously working for a local real estate company. Turns out that this is a felony in Ohio. He was ordered to pay over $25,000 back to the Bureau of Workers' Compensation. However, his sentence to twelve months in jail was suspended. 
 
Each instance is troubling. Of course, these are the examples that make headlines. The vast majority of injured workers, employers, and others in these systems are not engaged in these behaviors. Unfortunately, most of the time the public only hears about workers' compensation when these negative stories break. They give us all a black-eye, and likely serve to fuel perceptions that fraud is rampant. As we pause this week to give thanks for all that is worthy in our lives, I am thankful for this system that is workers' compensation.
 
First, I have earned a reasonable living through my interest in and therefore practice of workers' compensation. I have been privileged to represent some fine people along the way. I have enjoyed being on the same side, opposing side, and a few times in between some exceptionally dedicated, realistic, and professional attorneys. I learned a great deal years ago from a Claimant's attorney I caught in a legal snare. I knew he could escape and, jadedly, fully expected him to escape. All he had to do was lie; my faith in human nature assured me that he would. He did not, my client won, he reported it to his malpractice carrier. Shawn Hideyoshi Pope was fifty when he passed on Halloween 2012. He reminded me much about honor and professionalism one time. I had not talked with him in several years, but I will miss him. 
 
Second, after transitioning to the bench, I have been privileged to learn a great deal about people. Good and bad. I have worked with some of the best people in Florida, on building a better adjudication process and modernizing the OJCC. There are too many to name, but Jeff Jacobs, Jake Schickel, Jim Fee, Rosemary Eure, and Richard Chait spring to mind from the Claimant's side of the table. Tom Conroy, Richard S. Thompson, Allison Hauser, and Dawn Traverso likewise, from the Defense side. There are so many more, but there is so little space. The many fine judges and mediators would require far to much space to list.
 
Third, I have learned that the old colloquialisms and jokes about state employees are, as with many stereotypes, blatantly false. I am proud to be associated with a group that is highly dedicated, motivated by high ideals, and hard-working. Certainly, there are some OJCC employees who are still looking for their chance to shine, and a very few remain that perhaps will never shine; I am convinced that this is an exceedingly small minority. The majority of our judges, mediators, and staff are dedicated to the delivery of public service, and they are acutely aware that our role in society affects people's lives, daily, markedly, and persistently. Their patience and dedication is a tribute to their humanity.

Fourth, I have had the chance to witness the formation of an organization dedicated to the development of collegiality between the nations' adjudicators of workers' compensation, the National Association of Workers' Compensation Judiciary. The dedication and commitment, to the formation and growth of this group, of John Lazzara, James McConnaughhay, and Steve Rissman cannot be overstated or ignored.

Finally, having reflected upon those things that make me thankful this season, I sit typing in the dark this Thanksgiving eve. I hope I have reminded you that things are troubling, that there are bad actors in the world, but that they do sometimes get what is coming to them, and that there is far more for which we should be thankful than about which we should complain. I hope this message finds you well, and that we are all together when I ink the next one for Thanksgiving 2013.

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