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."
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.
ReplyDeleteA 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.
ReplyDeleteA real problem, but not that reveiling article.
ReplyDeleteI 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.
ReplyDeleteI 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.
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.
ReplyDeleteIn 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.
ReplyDelete10:40 AM You and I have a similar definition for "Insurance 'Fraud'" laws that should be enforced in both directions.
ReplyDelete