In the previous post on this topic, I outlined the problem of employer fraud (as opposed to employee fraud) in the workers’ compensation system. In this post, I will examine some real life examples of employer fraud and discuss what is being done to combat this problem.
First, let’s consider a few real-time examples of employer fraud:
- On January 25, 2010 a judge ordered a staffing firm in Bellflower, California to pay 20 million dollars in restitution after a plea bargain was reached in a workers’ compensation fraud case.
- The owners of a roofing company in Orange County, California were arrested on 106 felony counts and charged with $38 million dollars in workers’ compensation fraud. Investigators seized $500,000 in jewelry from their home, as well as two Ferraris, a Bentley and a Range Rover.
- The president and vice-president of a security firm in Los Angeles were charged with failing to pay $9.5 million dollars in premiums. They claimed they had only 20 employees, but it was revealed they had over 1,500 workers.
- The owner of a drywall company in Marysville, Washington entered a guilty plea to theft of sales tax and workers’ compensation fraud in November, 2009 and agreed to pay more than $2.1 million in restitution.
- On July 10, 2007 the owner of a gutter business in New York State entered a guilty plea to workers’ compensation fraud. By falsely claiming he only had two employees, when he actually had 15, he avoided $519,907 in workers’ compensation premiums.
The list goes on and on. For a top ten list of employer fraud cases for 2009 and 2010 go to my firm’s website.
There is some good news. Various government agencies are waking up and fighting back. New York conducted a study to determine the seriousness of the problem and on January 25, 2007 the
Non-compliance increased premiums and shifted the cost of medical care of injured workers to taxpayers and other employers.
Fiscal Policy Institute Report concluded that 25-30% of all companies in New York were not purchasing workers’ compensation insurance, and that this failure to comply was a growing problem. Non-compliance increased premiums and shifted the cost of medical care of injured workers to taxpayers and other employers. It also concluded that between $500 million and $1 billion dollars was being lost to the system annually. New York then authorized its compliance officials to issue stop work orders if a construction site did not have verification of workers’ compensation coverage. Within the first fourteen months there were over 1,000 stop orders executed, resulting in fines of $5.49 million dollars. In 2008 its fraud prevention program accounted for more than $20 million dollars in total savings.
On March 12, 2008 the governor of Massachusetts entered an Executive Order creating an inter-agency task force to attack the problem. Colorado, Delaware, Illinois, Louisiana, Maine, Maryland, Michigan, Missouri, Nebraska, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island, South Carolina, Vermont, Virginia, and Wisconsin have taken similar steps to crack down on misclassification and other employer fraud. Texas, California, and Florida have been particularly aggressive in attempting to go after employer fraud.
At the federal level, on February 4, 2009 the Treasury Inspector General for Tax Administration issued a report (based on a preliminary analysis of fiscal year 2006) which found that underreporting attributable to misclassified workers is likely to be markedly higher than the $1.6 billion dollars that was estimated in the tax year 1984, the last time a similar study was conducted. The IRS is looking at a new definition of independent contractor, and on April 22, 2010 Senator Sherrod Brown, D-Ohio and Representative Lynn Woolsey, D-California introduced a bill to get tough on companies that misclassify employees as independent contractors. The Secretary of Labor, Hilda Solis, has created a broad based initiative which will use $25 million to fight misclassification.
…if you happen to know some people who work for Nestlé U.S.A., a company that employs nearly 25,000 people, ask them to tell the risk management department to get the facts straight the next time they address the issue of workers’ compensation fraud.
The United Brotherhood of Carpenters and Joiners of America have an excellent video called 1099 Misclassification: It’s Time to Play by the Rules. Every government official who wants a brief summary of the problem should review this ten minute video. In fact, if you’ve read this far, take a few minutes to watch the video yourself, and the next time you hear someone complain about employee fraud in workers’ compensation, ask them to watch it too. Finally, if you happen to know some people who work for Nestlé U.S.A., a company that employs nearly 25,000 people, ask them to tell the risk management department to get the facts straight the next time they address the issue of workers’ compensation fraud.
1 The Associated Press, 3 Plead Not Guilty to Bilking $9M In Worker Fraud (accessed April 29, 2010). (http://losangeles.cbslocal.com/local/worker.fraud.Ousama.2.988253.html)
2 New York State Workers’ Compensation Board Press Release, Suffolk County Businessman Pleads Guilty to Insurance Fraud (accessed April 29, 2010). (http://www.wcb.state.ny.us/content/main/PressRe/2007/SuffolkCo_InsFraud.jsp)
3 ClaimsJournal.com, New York State Insurance Fund: Anti-Fraud Efforts Saved $20.7M (accessed Feb. 24, 2009). (http://www.claimsjournal.com/news/east/2009/02/18/90002.htm)
4 ClaimsJournal.com, New York State Insurance Fund: Anti-Fraud Efforts Saved $20.7M (accessed Feb. 24, 2009). (http://www.claimsjournal.com/news/east/2009/02/18/90002.htm)