Thursday, February 27, 2020

It’s A Sign of Fraudulent Times

According to the National Academy of Social Insurance, employer costs for workers’ compensation totaled more than $96.5 billion in 2016. While most workers’ compensation claims are considered to be legitimate, the Department of Labor estimates that between one and two percent of all workers’...

Deliberate

Fraud is any deliberate act to take property or money by deception from a victim. In other words, it’s an intentional act to deceive for the purposes of unlawfully or unfairly gaining something. (It’s driven by a fraudster’s need to become wealthy without having to actually...

Piece of the Fraud Pie

Many workers’ compensation fraud schemes involve supposedly injured workers who claim they are unable to work, when they actually can. Sometimes they are caught on surveillance video performing physical activities that their workers’ compensation forms claim they cannot do. Today’s fraud case is a...

Everything is Bigger in Texas

So they say “everything is bigger in Texas,” but did you know that: Texas' total area is twice the size of Germany. If Texas was its own country, it would have the 13th highest GDP in the world. The King Ranch in Texas is...

Impaired Thinking

There are lots of things that can cause impaired thinking – sleep deprivation, alcohol and drug use, certain medications or diseases, and then there’s just plain stupidity. Two Texans, who worked for a company that determined workers’ compensation benefit eligibility, weren’t thinking logically when...

Tightly Knit

Families who are tightly knit do lots of things together such as run marathons, take nice vacations, and even start businesses together. Today’s fraudster, who was an attorney from Grand Prairie, Texas, opened several businesses with family members with the sole intent to defraud....

Pruned

Individuals who work in the landscaping business have lots of opportunities to injure themselves while on-the-job. The Centers for Disease Control and Prevention (CDC) reports that landscaping is one of the highest hazard industries with a fatality rate of 25.1 per 100,000 workers. (The...

Self-directed Fraud

When an on-the-job injury occurs that warrants workers’ compensation benefits, the injured worker is required to visit a licensed physical therapist or chiropractor, who is under the direction of a medical doctor, to participate in a rehabilitation plan that will get them back to...

Fraud Pyramid

Just as pyramids are wide at the bottom leading to a point at the top, many fraudulent schemes start with a broad base of criminal supporters and lead up to a mastermind. Such is the case for today’s “Fraud of the Day,” where 30...

Fraud Conductor

In 2016, Medicaid paid out $26 million for individuals who were deceased, just in one state alone. The federal-state insurance program, which serves the nation 's most underprivileged citizens, has similar problems in other states as well. A Texas physician jumped on the fraud...
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