subject: A Situation Where Fingers Are Pointed [print this page] Everyone agrees that the system used for worker's compensation is full of flaws and this is because of someone else. Professionals, insurance companies, employers, and employees are all accused of fraud. The California Department of Insurance, for example, draws a bead on the bosses.
Employer fraud happens whenever workers' compensation insurance is being talked about. The different kinds of fraud may be in the form of underreporting the payroll or misclassifying the employees. The state's top insurance regulator sees this from a different angle. Workers' compensation insurance is being abused by employees paid large amounts of cash by employers, the California insurance commissioner.
Not one group can be excused from blame for this current problem, an attorney who deals in workers' compensation issues. But he saves his strongest defense for the workers themselves. He says fraud by workers is not very frequent. The Web site of the California applicants' attorneys association reveals that very few people were arrested and convicted from the millions of injuries reported between 1993 and 1998.
He wants employers and employees to see that they are both still facing against insurance companies. He said for five years after deregulation of the insurance industry took effect in 1995, insurance costs fell. Since the number of claims was low, insurance companies invested the premiums in the stock market and made huge profits.
The incidents during 9/11 have added to the problems. These terrorist attacks caused a $40 billion blow on the insurance industry, resulting also in many companies to go out of business. But he says there are still 235 private insurance companies offering workers' compensation coverage in California and he supports proposed legislation that would post the top 50 of them, together with their rates, on a state Website.
A claim would result in a rise in rate, but no claim would result in no change in rate. Those employees who are free from claim would be rewarded if Senate Bill 191, which he supports, were to be implemented.
A physical therapist uses the word compitis as a description for the patients he usually treats in his office. The recovery time for work injuries is different from the recovery for non work injuries, this gentleman says.
A person with a sport related injury will most likely recover faster and be back at work sooner than someone who got injured from a work mishap. 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.
Submission of the paperwork ensures that the check will be sent to the health professional promptly. This is very different from the inconvenience one would usually experience with an HMO, which uses a time consuming, expensive, and difficult system.
Those who make use of workers' compensation among this chiropractor's patients number to about 15% of his entire patient population. To take advantage of what they can get from the system, some chiropractors would make use of services, therapies, and machines they don't normally use. He knows what form of abuse the system gets from patients. Patients fake injuries, but they can be detected through certain tests.
