My friend and colleague Len Jernigan has again compiled the Top 10 Workers' Compensation Fraud Cases for 2017.
His results emphasize a theme that has been present for the last dozen years during which he has been compiling a "Top 10" list. This year the Top 10 non-employee fraud cases resulted in fraud totaling just under $700 million. Employee fraud cases resulted in zero fraud. Seven of the Top 10 cases were from California, two from Texas, and one from Tennessee.
The cases involve health care fraud, where doctors prescribed inappropriate medications to pharmacies they operated, overbilling schemes for durable medical equipment, mail fraud, kickback schemes, referral of patients for unnecessary care, and prescribing unnecessary treatment.
A recurring theme, falsifying documents and under-reporting payroll to workers' compensation insurance companies also appeared in the Top 10. In one notorious case, the owners of a hotel hid the existence of 800 housekeeping and janitorial workers to avoid paying workers' compensation insurance rates and payroll taxes. The list also contains references to dishonest employers misclassifying more and more workers as independent contractors. This misclassification is a fraud that wrongfully denies these employees workers' compensation when injured, denies the government millions of dollars in payroll taxes to support Medicare, Social Security, Unemployment Compensation, and the fundamental rights of the workers. Simply put, this misclassification is another employers shift the cost of accident and injury to the taxpayers and the fraud continues.