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adjustercom.net - FraudFromInsideAndOutsideTheCourtroom

 


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Sick Of Workers' Compensation Fraud. Can You Analyze This?
By Lonce LaMon - July 31, 2012

I’ve become so bored reading and hearing about workers’ compensation fraud that I think I’d like to scream!  I know that sounds bad.  Like I don’t care.  But I truly do care.  Deeply.  But I’ve become bored with the subject and I feel like I just don’t want to publish another article about God-damned fraud.  So, we need to just eradicate it finally and forever...

I like newness.  And I'm burned out.  Boring!  Yawn!   Let's kill it…

Perhaps I have ADD and simply need a new subject or distraction.  It’s possible.   But fraud just isn’t interesting to read about or write about any more.   It’s become an old worn out saw.  It’s the same old crap.  At least, that’s how I’m feeling about it in this moment. 

Back in the 1980s, I don’t remember hearing about it.  Oh, sure it was around; it occurred.  A claimant would fake an injury and a slimey doctor would pop up here and there. 

But it truly was no big deal.  I was alive and well in those days and was constantly talking to workers’ compensation claims adjusters, supervisors, and managers, and I don’t remember anybody being too preoccupied with fraud.

I had my ears open and I remember what was often discussed.  The passionate subject seemed to be that defense attorneys would throw lavish parties during the Christmas season and we all could get together and celebrate.  We all seemed to get by honestly and very well.  Nobody talked about fraud.  It was as if it didn’t exist.

I read in a Press Release today that according to Deputy District Attorney John Morris, who is in charge of the Health Care Fraud Division in Los Angeles County, criminal filings related to workers' comp cases have more than tripled over the last two fiscal years.

It seems unreal...

...according to Deputy District Attorney John Morris.... criminal filings related to workers' comp cases have more than triped over the last two fiscal years.

Fraud first really came to my attention in the early 1990s.   I’m going to say 1993.   There was a big crack-down on “medical mills” in California and the district attorneys’ offices started raiding offices right and left.  One mill after another and another was raided and shut down.  Then the numbers accelerated and the names began to blur together into memory loss.  Information overload. The names changed but the game seemed quite the same.

What caused this sudden happening?

Had these mills been around all throughout the 1950s, 60s, 70s, 80s and nobody ever took notice?  Or did they just become the creative new thing of dishonesty in the 90s? 

What causes a creative criminal invention to occur during one time period and not another?  Why is there so much more fraud now than in the old days?

Why was the big Mafia racketeering business about bootlegging in the 1930s, and then later about gambling and prostitution, when now organized crime is in love with insurance fraud? 

Fraud has been around.   But it ebbs and flows with different businesses it infiltrates.   But why now insurance fraud?  Why now so specifically workers’ compensation fraud?

There have always been crooks.  They’re written about in the Bible.

What are the causes? Why workers’ comp fraud now? And why wasn’t it like this in the 1950s?

Thieves have been around since cave days, to be sure.

But what I want to know, is why this is the period of rampant workers’ compensation fraud, and why it’s now so radical?  

I love to analyze everything, and now I want to know so I’m asking the question.


  
What are the causes?    Why workers’ comp fraud now?   And why wasn’t it like this in the 1950s?

Is it a spiritual break-down?  The degeneration of Christian values?   Is it the Recession?  An increase in narcissism?   Alcoholism and drug addiction?  Is the problem with the system itself that makes it too easy to abuse?

Is it the high cost of medical care?  Is it because most medical care is now paid by insurance, as opposed to by cash from the individual like in the 1960s, and insurance is now the target?
 
I so remember that sign at the doctor’s office window during the 1960s:  Payment is due upon services rendered.
 
Few people can afford their own medical expenses today without insurance.  
Rising medical costs have become a cliché.   Diagnostic testing is prodigiously expensive. 

So there’s rampant provider fraud.  Claimant fraud.  People trying to cheat the system.

So, what are all the reasons?  What’s the biggest reason?   I want you, my valued reader, to write to me asap and give me your opinion.  I want answers that I can publish. What do you think is the reason or reasons for so much workers’ compensation fraud today?  What has changed from the 1980s and prior decades, and why has workers’ comp fraud avalanched like never before into what it is now?

Are people in general just more dishonest than they were 30 years ago?  If so, why?

Please give me your thoughts and opinions.  I am going to publish a consensus of my readers’ thoughts and ideas in response to this question.

Thank you!

Write to me now at: lonce@adjuster.com

 

 
 
 

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