Congress Seeks to Stamp out Workers’ Compensation Fraud in North Carolina and Elsewhere in the U.S.

July 17, 2011, by Michael A. DeMayo

Congress’ investigative arm, the Government Accountability Office (GAO), wants to clamp down on North Carolina workers’ compensation fraud (and workers’ comp fraud throughout the country). According to the official GAO website, the government is seeking information about beneficiaries secretly working second jobs, overstating claims, or collecting money owed to a deceased worker.

In fiscal year 2009, the U.S. Office of Workers’ Compensation Programs paid more than a quarter of a million workers over $4.1 billion (disbursed through four programs) for workplace injuries and illnesses. Many of these workers resided in North Carolina. (To be more specific, only $2.73 billion was spent on federal workers or their survivors, per the GAO’s report.)

It’s nice to see the government trying to clamp down on North Carolina workers’ compensation fraud, since systemic abuse doesn’t just hurt “faceless” corporate entities and government agencies with big pockets. Fraud “pays forward” throughout the system and creates mistrust, frustration, gridlock, friction, and bureaucracy.

When insurers and employers become more suspicious of beneficiaries’ intentions and actions, they throw up more roadblocks to prevent getting scammed. Inevitably, legitimate claims get held up in the dragnet. What’s the most appropriate response to this kind of abuse? Should scam artists, schemers, and those who aid and abet workers’ comp fraud be punished harshly?

Perhaps a better solution would be to disincentivize fraud through some non-punitive way. A broad and deep analysis of typical workers’ comp fraud crimes, for instance, might reveal certain patterns of behavior and typical perpetrator motivations. Policy analysts could then work towards solving would-be perpetrators’ problems in advance to prevent them from turning to the dark side and seeking to exploit vulnerabilities in the system.

If you or someone you care about needs help with a benefits issue, a reliable, honest, and aggressive North Carolina workers’ compensation law firm can help you move forward.

More Web Resources:

Government Accountability Office (GAO)

Fraud “pays forward” throughout the system