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May 20, 2012

CDI Unit Active In Utah

     This is from an piece, which mostly concerns allegations of workers compensation fraud, posted by a Utah television station:
People who feign disabilities in Utah can get away with millions of dollars – money you pay into social security and money employers pay to cover accidents on the job. ...
 
Workers compensation is a private insurer that began as a state agency. On the federal level, the Social Security Administration provides disability benefits. 

It has a "Cooperative Disability Investigation Unit" - operating in Salt Lake for roughly a year – which tries to stop fraud before it starts.

In a recent 3 month period, the local CDI unit, as it's called, says it confirmed 42 cases of fraud or "similar fault."

7 comments:

  1. Anyone have any stats on the percentage of "similar fault" cases that actually end up in a prosecution for fraud? It seems to me that most cdiu cases are based on such thin evidence that the could never hold up in a court. Nonetheless, this doesn't stop ssa from denying or ceasing the individual's claim for benefits.

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  2. A large grain of salt should be ingested with any statistic that can be used to justify staffing.The bureaucracy will often mandate referrals on even minor cases to increase the numbers.

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  3. A real problem, but not that reveiling article.

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  4. I wish someone would police the insurers with such vigor. When I represented workers, I saw much more questionable activity from overzealous adjusters trying to gip workers with meritorious claims.

    I would sometimes catch them, but the statutory penalties were so small that it made business sense for the insurers to keep stonewalling legitimate claims, considering a good many would get fed up and drop them. Somehow, these investigation units don't consider such activity to be "fraud" even if it is intentional wrongdoing that harms people.

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  5. The Cooperative Disability Units do not have the authority to investigate fraudulent behavior by insurance companies. That is a task for the various state and federal insurance regulatory agencies.

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  6. In my experience, only the most egregious examples of fraud/possible fraud are investigated. The problem is not that the CDU is too focused on minor instances of possibly fraudulent behavior and casting too wide a net, but rather that many instances of likely fraud are never investigated.

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  7. 10:40 AM You and I have a similar definition for "Insurance 'Fraud'" laws that should be enforced in both directions.

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