Topic: Workers’ Compensation Fraud

April Showers Bring … North Carolina Construction Accidents?

May 23, 2013, by Michael A. DeMayo

April showers don’t just nourish the sweet smelling flowers of May — they also can precipitate serious North Carolina construction injuries.

That sounds perhaps somewhat cynical, but it’s true. When inclement weather strikes, accident rates at workplaces often go up. Why? When it rains or snows or blows, the wooly weather creates extra hazards at construction sites. Even though professionals are trained to deal with wet and furious weather, when you aggregate these hazards, bad weather impacts accident rates.

Does this mean that you shouldn’t go to work when it rains?

No. Wild weather also causes more auto accidents. But that doesn’t mean that you should only drive when it’s sunny out. In fact, ironically, if you only worked (or drove, or did anything) during good weather, your ability to deal with bad weather would likely degrade.

For instance, let’s say you only decide to work on sunny days because you want to minimize your accident risks. But then you get caught out on a surprisingly wet day. Your ability to work safely during would be diminished because of your dearth of experience in those conditions.

The key to managing life’s dangers — and the dangers on construction sites — is to manage them systematically. You need to get educated and to understand your risks and options to protect yourself. You also need to develop habits and behaviors that are safety-focused.

Even more fundamentally, you want to make sure that you are working with a group of men (and/or women) who take safety seriously. Your construction company’s work culture, perhaps more than any other factor, will help you manage risk — or leave you exposed to excess risk.

What if you already got hurt in a scaffolding accident, ladder fall, burn, etc? The team here at the Law Offices of Michael A. DeMayo has an extensive, highly successful record of helping workers’ compensation beneficiaries quality for benefits after construction accidents.

Please give us a call now at (877) 529-1222 for a thorough and free evaluation of your matter.

You do not need to fight your own case or work through intricacies of your legal situation on your own. In fact, right now, you should be concentrating 100% on your medical recovery, on taking care of your family, and on managing your own chores and errands and psychology.

Leave the legal work — the accident reconstruction, identifying liable parties, etc. — up to a solid, professional legal team. Call DeMayo law now at (877) 529-1222 to find out more.

Your Complex North Carolina Construction Accident: who should be held responsible?

May 20, 2013, by Michael A. DeMayo

Whether you fell off a ladder or sliced open your leg or suffered a burn at a North Carolina construction site, your gruesome injury may take months to heal, and you are still haunted by vivid recollections about the fateful afternoon when it all happened.

Unfortunately, your case seems complicated. Maybe you were working for a subcontractor on a bigger site, and some other subcontractor’s signage error precipitated an engineering miscalculation, which resulted in your falling off scaffolding.

Or maybe some wild concatenation of factors — a mislabeled bucket, surface slicked by rain, an inaccurate step by you –conspired to cause your injury. Perhaps multiple people got hurt in different ways. Given all the money at stake, many different parties that could be liable (e.g. subcontractor, the general contractor, the landlord, the municipality, any of these parties’ insurance companies, investors, on and on and on).

Untangling complex construction accidents is both an art and science.

Even in relatively simple cases (or seemingly simple cases) there is often more to accidents than meets the eye. For instance, maybe you stepped into a bucket that shouldn’t have been in your way, and as a result, slipped and plummeted 20 feet to the ground where you broke your legs.

Why was that bucket there? Short answer: a naïve subcontractor’s helper left it on your scaffolding by mistake. Your intuition might be to sue the subcontractor for hiring an inept worker. But perhaps different and/or larger elements played into the injury. For instance, perhaps the general contractor erred in hiring a subcontractor with a shoddy record for
screening his people. As a result, maybe the general contractor should be sued for liability as well.

You also need to anticipate how the various defendants might respond. For instance, maybe you were working on only four hours of sleep and made an error that contributed to the disaster.

In some cases, companies can protect themselves by filing for bankruptcy or engaging in legal defer and delay tactics. This is further complicated by the fact that personal injury law in North Carolina is constantly changing.

Is there a solution to the madness?

As complicated as these matters can seem — and your matter maybe astonishing complex, even if you think it’s already pretty scrambled — you can relax for two reasons:

You do not have to think through these contingencies and solve these problems yourself.

If you find the right North Carolina construction accident law firm, you can effectively detach from thinking about your case and focus instead just on healing, helping your family, and dealing with your financial and emotional stresses effectively.

DeMayo Law is an experienced North Carolina construction accident law firm. Please reach out to us at (877) 529-1222 for a free evaluation of your matter.

Keeping Strong and Motivated While on Charlotte Workers’ Compensation

May 18, 2013, by Michael A. DeMayo

How can you stay focused and ready while out on North Carolina workers’ compensation?

More specifically, how can you avoid “getting soft” and growing dependent on this
income? How can you maintain a sense of autonomy and feeling of usefulness? How
can you keep your job skills sharp? What common “traps” do Charlotte workers’
compensation beneficiaries fall into during their idle time?

If you even begun to have questions along those lines, first of all, congratulations.

Many beneficiaries (or would be beneficiaries) never take the time to consider the
potential downside to winning a workers’ compensation case. That’s dangerous because there are always downsides to achieving any objective. If you fail to surface those potential problems, you could subconsciously hold yourself back.

In other words, it’s good that you are already thinking along these lines. However, you now have a practical challenge. How DO you stay on course, once you have “won” fair benefits?

Here are some ideas:

Figure out what jobs skills you want to protect and keep in good shape, and then work with your spouse or friends–or outside counselors–to keep those skills in shipshape.

For instance, maybe you are an accountant, and you broke your leg falling down the stairs outside a Raleigh Bank. Your body may hurt, but your mind is still pretty sharp. So you might want to spend some time everyday playing word and number games to keep your brain functioning at a high level. If you are too hurt/fatigued to practice physical skills, you can try to do them in your head.

For instance, maybe you are a construction worker who needs to stay in bed for the next three months because of a back injury. Very well. You can still imagine doing your work. That may sound silly. But if you spend 15 minutes a day or so visualizing successfully implementing tasks at work or moving your body, your mental circuitry will remain intact, and you will find it easier to return to the job force.

With respect to the motivation issue … you absolutely must strive to meet your needs for autonomy and productivity.

Even if you are confined to your bed or so sick that you only really have two or three hours of “productive time” a day, you need to find some way to make use of that time in a way that you will find gratifying and, ideally, financially remunerative. (Be sure your pursuit does not violate terms of your North Carolina workers’ compensation benefits!)

Again, planning, visualizing, and goal setting can help. But recognize that the motivation needs to be intrinsic–in other words, don’t do an activity in hopes that you will be rewarded at the end. Instead, do something that you find rewarding “in the doing.”

For help with your workers’ compensation case, look to the DeMayo Law team today for a free consultation.

Winning Your North Carolina Workers’ Compensation Case: A Top Priority?

May 17, 2013, by Michael A. DeMayo

Life is full of imbalances and unexpected (and often unpleasant) surprises. As someone who was recently hurt in a North Carolina work accident, you understand, firsthand, how quirky life can be.

No one goes into work expecting to suffer a massive injury that sends him to the hospital and creates permanent life changes. But that’s what happened to you. Some days are more fraught and fateful than other days. Life is full of imbalances.

When it comes to your recovery — medical recovery, financial recovery, and spiritual recovery — imbalances also exist. To the extent that you can identify useful imbalances and leverage them is to the extent that you can speed up, cheapen and soften the whole recovery process.

What does that all mean?

It means that certain activities or projects that you do now can give you tremendous leverage — leverage that the vast majority of other activities or projects will not afford you.

For instance — and this is a bad example to illustrate the point — but let’s say that you wrenched your knee. Your knee got thrown out of its socket. As a result of all that pain, you are feeling lethargic and nauseous. You are unable to walk. You are unable to work.
You can do a lot of “medical stuff” to treat your various symptoms. You can take Advil to relieve some of the pain. You can take a nap to sleep off fatigue. Etc. But your biggest point of medical leverage is obviously to treat the knee effectively — to get it back in the socket.
The big point of leverage is the “knee surgery/repair stuff” — all the other medical treatments will only glancingly deal with the problem.

Likewise, when it comes to your personal financial situation, only a small handful of projects will yield the best results for you. Your challenge is to identify what those projects are and to focus your limited attention/stamina/resources on those problems.

In all likelihood, one of those projects involves your quest for North Carolina workers’ compensation. If you can get workers’ comp benefits quickly, you can staunch your cash flow problems and buy yourself some time/sanity to recover and figure out your next steps.

So what’s a great “point of leverage” to deal with your workers’ comp problems?
Instead of trying to manage the situation by yourself — assuming that you’re not an expert in NC workers’ comp law or in how to make recalcitrant employers and insurance companies work for you — consider getting in touch with the team here at the law offices of Michael A. DeMayo for a free consultation.

Call us at (877) 529-1222, or find out more about our services and success rates online. Do the small, important things that are necessary to heal your body and heal your finances, and you’ll likely enjoy better odds of long-term success.

How to Fix the North Carolina Workers’ Compensation System — Surfacing Hidden Dangers at Our Workplaces, Part 2

May 5, 2013, by Michael A. DeMayo

One of the cheapest and most humane ways to lighten the burden on the North Carolina workers’ compensation system is to suss out hidden dangers at our workplaces. In a recent blog post, we discussed two surprising but potentially very effective ways to create safer workplaces.

1. Reduce the availability of sugary, refined junk food snacks and replace them with healthier alternatives.

2. Create better information sharing platforms so that safety conscious workers and employers can better disseminate their useful insights.

Today, we’re going to look at one more insight from the world of business process improvement.

 If you’re not a business owner, you may not be that familiar with the concept of Systems.

Basically, a system transforms input into output and thus provides value to clients. Top management thinkers often use business process improvement thinking to identify gaps in service or quality. Then they make incremental improvement (via process improvement) and/or major change-ups (via reengineering) to get better results and continually improve.

 Most business thinkers — at least the successful entrepreneurs — engage in systematic thinking, planning, refinement, improvement, etc.

 But although the North Carolina workers’ compensation system is, in fact, a System, very few thought leaders apply this business process improvement “kaizen-type” thinking to the dilemmas we all face.

That all sounds a bit abstract. So let’s break it down a bit.

 The workers’ compensation system has thousands of stakeholders, including insurance companies, employers, state bureaucrats, attorneys, taxpayers, and of course workers.

 The many moving parts of this system are dynamic. But the purpose of the system is well defined — to provide a financial help for hurt and injured workers and to resolve disputes that arise during the compensation process.

 When problems arise in this system, the conventional approach is to blame stakeholders:

     “The insurance company didn’t play fair”

     “The sick/injured worker wasn’t really that sick and/or trumped up his damages”

     “The employer was bad because he didn’t have insurances”

     “The bureaucrats took way too long with the case.”

         “The legislators are in the pockets of the corporations.”Etc.

We’re obviously not saying that these judgments aren’t important. If you’ve personally suffered because of an insurance company’s cruelty or employer’s narcissism, you know how damaging this kind of passing-of-the-buck can be.

 But in addition to calling out lame stakeholders, we also could benefit from finding/repairing problems with the system itself — instead of just blaming people or companies or whole classes of stakeholders.

 Of course, if you’ve personally been hurt, the last thing you care about is fixing this system as a whole. You want specific, actionable advice about your case. Call the DeMayo Law team today for a free consultation to help you maximize your results — 1.877.529.1222.

Solving the North Carolina Workers’ Compensation Crisis by Eliminating Hidden Dangers at Work (Part One)

May 4, 2013, by Michael A. DeMayo

Ever since the Charlotte News & Observer blew the lid off the North Carolina workers’
compensation insurance scandal last spring, our blog and many other thought leaders in the North Carolina community have wrestled with how to refine our system to improve worker care and reduce burdens on insurance companies andemployers at the same time.

It’s a tricky puzzle.

Obviously, no single entity can solve everything. But we might benefit, collectively, from surfacing and eliminating certain hidden dangers that lurk at many North Carolina workplaces.

For instance, anyone who studies North Carolina workers’ compensation issues readily acknowledges that chronic diseases, such as type II diabetes, obesity, cancer, and dementia, exact a horrific toll not only on the lives of the people in our state but also on our infrastructure.

The origins and treatments for so called metabolic syndrome (the cluster of diseases associated with obesity and diabetes) is surprisingly ambiguous. But many health authorities are beginning to rethink certain common dietary paradigms. For instance, according to the official USDA statistics, we are consuming less fat today (during this obesity epidemic) than we did during the 1960s (when there was no diabetes/obesity epidemic).

Conversely, we consume a LOT more sugar and refined carbohydrate.

In light of these and other observations, many health authorities have been recommending
that people worry less about fat consumption and more about sugar/refined carb consumption. If these authorities are right, one way we could make our workplaces healthier is by eliminating or reducing worker access to sugary sweet junk food.

Obviously, workers need to eat. But perhaps instead of vending machines stuffed with processed junk food and sodas, we should have more healthy snacks available, such as fresh fruits and vegetables, hard boiled eggs, and the like.

We can also benefit from better information sharing. Odds are that numerous workers and
employers have developed ad-hoc systems to reduce dangers at their workplaces. These systems just happen to work really well. Maybe a Raleigh construction team has developed particularly nifty way of preventing scaffolding accidents. If that solution could be shared broadly, it could help the entire scaffolding industry eliminate or at least reduce certain types of accidents.

Thanks to the Internet and mobile technologies, we now have a lot of ways to share
information better. If we can somehow collectively collaborate to exchange workplace safety lessons — in real time and across industries — we can almost certainly drive down rates of injury and thus, indirectly, relieve some burden on the North Carolina workers’ compensation system.

We’re going to talk more about this issue in a follow-up blog post. But if you or someone you know needs help with your Charlotte workman’s’ comp case, get in touch with the DeMayo Law team now at 1.877.529.1222 for a free case consultation.

Keeping Strong and Motivated While on Charlotte Workers’ Compensation

May 2, 2013, by Michael A. DeMayo

How can you stay focused and ready while out on North Carolina workers’ compensation?

More specifically, how can you avoid “getting soft” and growing dependent on this income? How can you maintain a sense of autonomy and feeling of usefulness? How can you keep your job skills sharp? What common “traps” do Charlotte workers’ compensation beneficiaries fall into during their idle time?

If you even begun to have questions along those lines, first of all, congratulations.

Many beneficiaries (or would be beneficiaries) never take the time to consider the potential downside to winning a workers’ compensation case. That’s dangerous because there are always downsides to achieving any objective. If you fail to surface those potential problems, you could subconsciously hold yourself back.

In other words, it’s good that you are already thinking along these lines. However, you now have a practical challenge. How DO you stay on course, once you have “won” fair benefits?

Here are some ideas:

Figure out what jobs skills you want to protect and keep in good shape, and then work with your spouse or friends–or outside counselors–to keep those skills in shipshape.

For instance, maybe you are an accountant, and you broke your leg falling down the stairs outside a Raleigh Bank. Your body may hurt, but your mind is still pretty sharp. So you might want to spend some time everyday playing word and number games to keep your brain functioning at a high level. If you are too hurt/fatigued to practice physical skills, you can try to do them in your head. For instance, maybe you are a construction worker who needs to stay in bed for the next three months because of a back injury. Very well. You can still imagine doing your work. That may sound silly. But if you spend 15 minutes a day or so visualizing successfully implementing tasks at work or moving your body, your mental circuitry will remain intact, and you will find it easier to return to the job force.

With respect to he motivation issue … you absolutely must strive to meet your needs for autonomy and productivity.

Even if you are confined to your bed or so sick that you only really have two or three hours of “productive time” a day, you need to find some way to make use of that time in a way that you will find gratifying and, ideally, financially remunerative. (Be sure your pursuit does not violate terms of your North Carolina workers’ compensation benefits!)

 Again, planning, visualizing, and goal setting can help. But recognize that the motivation needs to be intrinsic–in other words, don’t do an activity in hopes that you will be rewarded at the end. Instead, do something that you find rewarding “in the doing.”

 For help with your workers’ compensation case, look to the DeMayo Law team today for a free consultation.

North Carolina Workers’ Compensation Trap: Be Aware of “Easy Escapes” to Your Money Problems

April 26, 2013, by Michael A. DeMayo

Be Aware of “Easy Escapes” to Your Money Problems

Whether you got hurt in a Charlotte scaffolding injury or endured a wicked case of thoracic outlet syndrome after working as an executive in Raleigh, you’ve been desperate to get your financial situation sorted out — and fast. Without your income stream, you’ve been racking up credit card debt, and your spouse or partner has been forced to work extra hours and/or take on more shifts to compensate. You feel tremendous pressure, in other words, to “get healthy ASAP” and, ideally simultaneously to bring in an income.

To that end, you’ve been searching for solutions to your North Carolina workers’ compensation problem. If you can get adequate workers’ comp, you can cover your budget and — at least temporarily — relieve some of the pressure from you and your family. However, while you are waiting for your matter to resolve, you still need to eat and spend money to support your lifestyle.

Plus, given the extent of your injury and your medical prognosis, you may not be able to return to the kind of work that you’ve been doing for months or even years. If you’re doing heavy labor, for instance, that kind of work may be “out” for you, permanently.

Many people in your situation might find themselves tempted by “make money from home” scams and internet work. While it’s true that you can make a living operating a business or even doing freelance work online, pitfalls abound.

You can all too easily spend hundreds or even thousands of dollars on scammy enterprises or just a poorly thought out business plan. Even if you are prudent and educated and experienced at starting a business offline, you will almost certainly find the online world confusing and disoriented. This isn’t to say that you cannot make some kind of career transfer — adopt the skills that you’ve been using to make money on the web. But you need to be careful.

More specifically, you need to learn, operate “lean,” use your current skills and knowledge (as opposed to learning too much “new stuff”), and avoid reinventing the wheel. Operating a business online is all like operating a business offline — if you don’t have the right knowledge, skills, mentors — and a bit of luck — you’re going to have trouble.

One of the biggest rules in business, for instance, is that you need to generate cash flow. That’s true for most of your business and for your personal finances.

To that end, one of the easiest ways for you and your family to generate cash flow might just be to resolve your workers’ comp case quickly. To that end, get in touch with the team here at the Law Offices of Michael A. DeMayo to go over your options regarding your workers’ comp case.

Rube Goldberg North Carolina Construction Accident — Who’s to Blame?

February 19, 2013, by Michael A. DeMayo

Some North Carolina construction accidents cases are pretty clear cut. A careless worker steps off a scaffold because he forgot to put on his harness, and he breaks his legs. Or a negligent foreman forgets to label certain noxious chemicals, provoking a spill that gives second-degree burns to several workers. Even in cases that appear this simple, surprising complexities with respect to North Carolina workers’ compensation liability law can arise.

But certain cases are obviously hard to parse just upon inspection of the basic facts.

For instance, perhaps you were involved in a large project with numerous subcontractors and subcontractors of subcontractors. Maybe an onsite fire destroyed part of the structure and hurt you and eight other co-workers. Dozens of people, companies and insurers could be implicated as defendants in a North Carolina work injury lawsuit.

How does anyone sort fact from fiction after such a chaotic event?

Turns out, there IS a process.

If you’ve personally suffered harm in a similarly chaotic event, you may benefit a lot from talking with a team member here at the Law Offices of Michael A. DeMayo. We’ve helped hundreds of people in very similar situations — including victims of complex Charlotte construction accidents — get results and regain control over their lives. We also can connect you with diverse resources to assist with your recovery. Our crackerjack investigators will protect your rights and untangle the potentially complicated truth about who caused your injury and who should be on the hook for paying your medical bills, lost wages and other damages.

Legislators Propose New Tools to Stop North Carolina Workers’ Compensation Fraud

February 5, 2013, by Michael A. DeMayo

The Charlotte News & Observer is reporting important breaking news on North Carolina workers’ compensation. Journalist Mandy Locke reports that several state legislators are piecing together a bill to detect and punish employers who fail to purchase appropriate workers’ compensation insurance.

The special committee aims to take several key actions, including:

•    Putting employers’ workers’ comp insurance coverage on the public record;
•    Forcing NC agencies to hand over information for analysis to ensure that companies abide by their insurance and tax requirements;
•    Calling for new strategies to limit the frequency and cost of workers’ comp claims (any legislators reading this should peruse the back-issues of this blog, which are chock full of creative ideas to reform the system!)

Per the News & Observer’s article “already, the [state] controller’s office is helping the Industrial Commission identify the tens of thousands of businesses failing to carry insurance…eventually, the hope is to use the data to catch businesses that may be misrepresenting the scope of their business…to avoid certain taxes and insurance.”

But not all the news is good news, at least from injured workers’ point of view. Thanks to last year’s legislative changes, the North Carolina Industrial Commission will be reducing reimbursement rates in April: “in-patient costs will drop 10%, outpatient and ambulatory center surgeries will be cut 15%, and implant costs will not exceed 20% above cost.”

So what might this flurry of legislative action mean for your case? What do you need to pay attention to?

To understand best practices for workers’ comp in North Carolina, based on the new rules and changes to the law, look to the team here at DeMayo Law for steady, intelligent, and up-to-date guidance. Call our offices at (877) 529-1222 to schedule your free workers’ comp case consultation.

Looming North Carolina Workers’ Compensation Study Sparks Concern among Labor Leaders

January 31, 2013, by Michael A. DeMayo

It’s not often that a North Carolina workers’ compensation study becomes a lightning rod for political controversy.

But we live in unusual times.

In December, NC state lawmakers established a nine member commission of state legislators (made up of almost all Republicans) to study North Carolina workers’ compensation. The commission will release a report in February — a document that could have profound implications for the nearly 90,000 state employees of the Old North State.

Some union leaders and their advocates are concerned about how this study will be conducted. Specifically, they fret that it will fail to take into account workers’ positions.

An organizer for the NC’s Public Service Workers’ Union, UE Local 150, Dante Strobino, told a local paper “they [the legislators] could fast track the study and give us even less time for worker and public input. Or they could just scrap it altogether and make whatever cuts they want based on purely ideological arguments.”

North Carolina has banned collective bargaining for public workers — it’s only one of two states in the entire union to do so — so unions believe that they are particularly disempowered here. Workers worry that legislators will cut off so called longevity pay for state workers; change retirement and healthcare benefits; and even write a ban on collective bargaining into the state’s constitution.

Workers’ advocates also fear any changes that might make public sector work appear more distasteful. Talented people might opt out of government careers and flee to the private sector. This brain drain could then stimulate leadership crises among the ranks of public workers.

It’s hard to separate truth from facts, especially when it comes to heated issues, like North Carolina workers’ compensation reform. Advocates on both sides tend to approach the topic from an ideological point of view. So we often reach a point of gridlock. Name-calling and fear mongering rule.

That’s obviously not so great.

We cannot square the circle regarding how this study should be done.

But if you’re a worker – or a friend or loved one of a worker – who has been struggling with an injury or illness, we can help you. We at the Law Offices of Michael A. DeMayo are renowned for winning complex and difficult workers’ comp cases. We can provide a free, thorough, confidential consultation. Don’t wait another day to get answers to the stuff that’s been confusing you: call our team now.

The End of the Uncertainty about Your North Carolina Workers’ Compensation Case (What’s Causing All the Stress)

December 4, 2012, by Michael A. DeMayo

Why is your North Carolina workers’ compensation case causing you so much agita?

That’s a loaded question. Dwell on it for a second. When you mentally fixate on your situation – what happened at work, how your employers have reacted so far, what the potentially liable insurance company has done – you likely feel some negative feelings.

So what’s causing these feelings? What’s at the root of your stress?

Your instincts might be to blame your lack of “stuff.” Your lack of money. Your lack of cooperation from your employer or the insurance company. Your lack of ability to function, physically, or live your life free of pain.

These all might be problems that are currently holding you back in your life. But they are likely NOT the core constraint that’s causing you the frustration.

The core constraint, almost certainly, is your lack of certainty.

Uncertainty – both negative uncertainty (“is the diagnostic dire or not?”) and positive uncertainty (“will I get the promotion or win a big North Carolina workers’ compensation award?”) — can cause stress because it causes your mind to “spin out” diverse positive, negative, and neutral scenarios. When you envision yourself in these different scenarios, the stakes of any actions mount.

It’s not hard to get on board with the notion that instability could cause stress.

But what IS somewhat counterintuitive is the idea that the instability in and of itself – independent of the positive or negative stuff associated with it – might cause stress. Yet research from diverse fields bears this out.

Painful events and setbacks do cause stress in the short-term, but they don’t necessarily impact our happiness or satisfaction in the long-term. Taking an extreme example… consider studies on the hedonic effect of getting paralyzed. You might think that losing your ability to move your arms and legs would radically decrease your life satisfaction and happiness. In the short-term, it does. But over longer periods of time – a year plus – even this kind of epic medical crisis does little to impact baseline happiness and life satisfaction.

What this means is that, if we can manage the instability and uncertainty surrounding North Carolina workers’ compensation cases, we can go a long way towards resolving the emotional problems that accompany it.

Think about all the pressing questions that, when you dwell on them, cause you stress. They all involve your “not knowing” some key factor:

•    Will I get benefits at all?
•    If so, what will my weekly allowance be?
•    How will my finances change when/if I get the compensation?
•    How will my financial plans change if I don’t get the compensation?
•    When will I be able to get back to work?
•    How serious is the injury?
•    Who can help me resolve these and other questions?

The team here at the Law Offices of Michael A. DeMayo cannot fix everything in your life and tie up your circumstances in a near little bow. But we have ample experience helping people in very, very similar situations get great results and resolve their stresses.

A More Methodical Approach to Your Most Pressing Charlotte Workers’ Compensation Problem

October 23, 2012, by Michael A. DeMayo

You live in Charlotte, and you need workers’ compensation because you hurt yourself at your job or while engaging in an employment activity.

In some sense, your quest is pretty simple: you just want your employer or your employer’s insurance company to compensate you, while you heal, go through rehab, and otherwise “right your ship.”

In another sense, your journey is exquisitely complicated and unclear.

Here’s the basic problem. Whether you got hurt in a one-time terrifying event – such as a construction accident mishap or a slip and fall on a factory floor – or you got injured slowly over time (e.g. as a result of working in a less than ergonomic position for 20+ years) – you can pretty clearly identify one or several “things” that went wrong and that need to be fixed ASAP.

For instance, maybe you shattered some vertebrae in your back. You need to repair and heal those vertebrae. Or maybe you developed carpel tunnel syndrome, and you need to fix your wrists and hands. From a certain perspective, it looks like your situation was caused by something simple and should be fixed by something simple.

On the other hand – and this is the subtle part! – simple accidents can lead to complex injures. And even if your injuries are simple, the solution to even a simple injury can be complex.

Consider the theoretical example of the shattered vertebrae. If your back is broken, not only must you deal with your back pain, but you also might need to take medicines, rest in a certain position for long periods of time, and undergo multiple surgeries. Every time you undergo a surgery, you may need to take other medications, some of which may have side effects which may require the use of even more medications, which can in turn change how your body regulates fat storage or change your biochemistry and other complex ways. You also will face logistical, financial, and relationship-based problems. If you have a shattered vertebrae, for instance, you may no longer be able to take care of your children. Thus, you may need to hire full time child support or call in a favor from an estranged brother or sister.

The end result is that your life becomes a lot messier and financially more difficult.

Thus, simple accidents – and even simple injuries stemming from simple accidents – can lead to a lot of complex “stuff” in your life that you need deal with effectively. Most remedies for workers’ comp are overly simplistic, in that fail to address all or even most of these secondary and tertiary issues.

The team here at the Law Offices of Michael A. DeMayo in Charlotte can help you with the big, important legal issues – compelling an insurance company to treat you with respect, e.g.. But just understand that anyone who promises you overly simplistic, speedy solutions is just not being honest with you.

Dealing with Hypochondria as a North Carolina Workers’ Compensation Beneficiary

October 2, 2012, by Michael A. DeMayo

Perhaps you suffered a Charlotte workplace accident or illness that left you severely sick or otherwise physically incapacitated. Or maybe you endured a “chronic” injury, such as a typing injury you sustained while working as a secretary of a bank in the Research Triangle.

In any event, you crave a return to good health. When you don’t feel good, nothing else really matters. You can have a billion dollars, a castle in Spain, and fame and glory; but if you can’t get out of bed because your spine hurts, all of that fame and fortune is worth a hill of beans.

North Carolina workers’ compensation beneficiaries (or people who want said benefits) often go through a period of becoming far more aware of their bodies following the illness/accident/event. Speculation abounds about why this takes place. Some people argue that the injury/illness increases the salience of the physical body. Others suggest that people who are forced to take time off of work have less to preoccupy themselves with – so they find new “stuff” – like an obsession with their bodies – to fixate on.

Psychology aside, hypochondria can be a real problem for this population.

After all, if you’re legitimately hurt/ill, you have a real medical problem. You might also be waiting for test results or waiting to see how rehab or medication will impact your health. These uncertainties can create a kind of mental tension, which your mind naturally “works on” by hypothesizing both catastrophic outcomes (e.g. “what if it’s terminal cancer?”) as well as grandiose hypotheses (e.g. “if this rehab tech works, I’ll be back to work in two months, rather than 12!”)

It would be glib to suggest that hurt workers moderate their expectations.

Easier said than done!

But it may behoove you to test the reality (or lack thereof) of your thoughts. You may also find it hugely helpful to keep a health journal, so you can objectively identify whether your hypochondriacal musings have any merit. If they don’t, you can use “the facts” that you’ve recorded in your journal to assuage yourself when the anxiety/depression starts.

Of course, your own insights should never be substituted for the ongoing guidance of a wise, licensed physician. Likewise, your own intuition about how/whether you might be able to recover benefits should not be considered a substitute for a consultation with experienced and well recognized Charlotte workers’ compensation law firm.

What If Your Employer Lacks Adequate (Or Any) North Carolina Workers’ Compensation Insurance?

September 20, 2012, by Michael A. DeMayo

The Charlotte News & Observer’s summer blockbuster expose of the state of North Carolina workers’ compensation insurance caused an uproar in our community. The news pieces even inspired state lawmakers and Gov. Beverly Perdue to “do something” about the disastrously low rate of compliance among Tar Heel employers with workers’ comp insurance requirements.

In a recent blog post, we talked about how workers can best approach potentially recalcitrant employers about their workers’ comp coverage… without risk of losing face or making your employer feel unduly uncomfortable.

What can workers who are operating in a “gray zone” do to protect themselves — in other words, if you don’t know whether your employer has insurance coverage, what do you do? Obviously, if you’ve already been hurt or made sick, step one is (after seeing your physician) should be to get in touch with a North Carolina workers’ compensation law firm, like DeMayo Law.

But there are also steps you can take to protect yourself from injuries/accidents at work, so you don’t wind up “in the system,” having to fight tooth and nail for compensation.

For instance:

1. Improve your diet by reducing how much sugar you eat.

Powerful new research suggests that North Carolinians’ love affair with sucrose may be at the heart of our state’s (and our nation’s) obesity problem, at least if researchers like Dr. Robert Lustig are to be believed. Reducing how much sugar you eat is not necessarily easy, but it might increase your health, help your immune system, and give you more stamina and alertness, which can in turn limit your vulnerability at the workplace.

2. Get stronger.

Other new research suggests that increasing your muscular strength using slow, safe, high intensity resistance training can reduce the otherwise inevitable bone loss and loss of lean tissue that coincides with getting older. If you’re stronger, you’ll likely be less at risk for lifting injuries and other problems at your workplace.

3. Reduce stress.

Powerful research from multiple disciplines suggests that stress can impede the body’s immune system, warp our decision making capabilities, and do lots of other nasty stuff to our brains and bodies. Find ways to limit/reduce stress in your life to reduce injury.

If you’ve already been hurt, get in touch with the team here at DeMayo Law to discuss what you can do to make your situation better and potentially get compensated for your damages.

What Motivates People to Commit Workers’ Compensation Fraud in North Carolina and Elsewhere?

August 28, 2012, by Michael A. DeMayo

Workers’ compensation fraud in North Carolina and elsewhere costs taxpayers tremendously and harms every stakeholder in the system – insurance companies, lawyers, employers, employees, the government, and fellow North Carolinians.

Why then are so many beneficiaries tempted to break the rules?

The answers are diverse. They include:

•    Some cheaters just grew up without an appropriate ethical foundation;
•    Some people turn to fraud after struggling so long with the system they felt they had “no choice” but to ignore the law;
•    Some commit fraud out of ignorance;
•    Others commit it out of desperation to feed their families… and/or to enjoy a better life.

Corrupt systems take their toll on all stakeholders

We can and should be compassionate with the people who commit fraud – i.e., avoid judging them as “bad” people but rather as people who have made mistakes because they tried to meet their needs using inappropriate strategies. But we also need to acknowledge that bilking the workers’ comp system out of money can ricochet throughout the system and cause harm in all sorts of indirect and even impossible to predict ways.

For instance, imagine someone defrauds an insurance company out of few hundred thousand dollars by faking a back injury. And one day, the alleged victim is spotted playing rugby with some friends – clearly, his back is not injured. This revelation then in some sense “spooks” that insurance company – and possibly other insurance companies as well.

Going forward, all these insurers now compel anyone who complains of a back injury to go through a strict gauntlet of tests and scrutiny. Inevitably, several “false positives” gets screened out of the system, i.e., people who are legitimately hurt get denied coverage because of this extra screening.

Now imagine all the indirect consequences that results; people who now CAN’T get workers’ comp benefits – the strains on their families, the strains on the community, etc. And you can see how a single act of fraud can “pay it forward” throughout the system in a negative way.

All this is to say that, if you are struggling to figure out how to collect benefits and deal with your multiple, diverse struggles, look to the team at the law offices of Michael A. DeMayo for sharp, compassionate, and ethical help.

Getting Beyond the North Carolina Workers’ Compensation Anger

August 2, 2012, by Michael A. DeMayo

Anger – it plays a lively, yet subtle role in the North Carolina workers’ compensation process.

•    For instance, you might be angry at your employer or your boss or coworkers for being less than sympathetic – for challenging your version of events, putting your safety at risk, failing to adhere to the values of your company, and so forth.
•    You may be angry at the actions of an insurance company that has acted in bad faith or otherwise made life needlessly and unfairly complicated.
•    You might be even angry at friends and relatives who have been less than supportive of your bid to get compensated.
•    You might be angry at a physician or rehab specialist or other caretaker who either didn’t do a good job or who led you to feel more confused and frustrated than you were before.
•    You might be angered by the glut of information you’ve found online – it’s confusing to sort the good information from the bad about Charlotte workers’ compensation.
•    You might even feel angry at yourself because of your perceived incompetence, lack of skill, lack of understanding of the nuances of workers’ comp law, etc.

Unfortunately, we are taught in modern American society to avoid expressing anger outright.

Our M.O. is to internalize our bad feelings – to try to act as if “nothing really bad” is happening.

According to back injury specialist Dr. John Sarno, our repressed anger, fury, frustration, and anxiety can actually manifest internally in the form of muscle tension and muscle knots, which in turn can trigger physical symptoms, such as numbness and tingling, heart palpitations, and beyond.

Sarno’s ideas are theoretical. But the general point is that subtle feelings like anger and anxiety are often indicators that certain needs are not being met. Aim to surface these unmet needs and do something positively to try to meet them.

Part of dealing with the overwhelm and uncertainty of your situation is getting the right people on board to move in a positive direction.

•    Finding a great rehab specialist, for instance, can be a blessing.
•    Connecting with the friends and family members, who support you physically and emotionally (and possibly financially), can also be a blessing.
•    And finding a great Charlotte-based North Carolina workers’ compensation law firm, like DeMayo Law, can be profoundly helpful, in that the team might be able to help you quickly access workers’ comp benefits to pay for critical care.

Connect to someone on our team immediately for help with your situation.

A Compassionate Look at the North Carolina Workers’ Compensation Insurance Problem – Part 2: Employers – And Everyone Else

June 26, 2012, by Michael A. DeMayo

In a recent blog post on the state of the North Carolina workers’ compensation system, we explored the implications of a disturbing survey recently conducted by the Charlotte News & Observer, which found that nearly 30,000 businesses operating in NC may be uninsured or underinsured.

We talked about how employees need to recognize the inherent dangers of working for a company that lacks good insurance coverage. If you or someone you care about worked at a company that lacked coverage, you may want to talk to someone at the team here at the Law Offices of Michael A. DeMayo immediately to understand your best next steps.

Beyond the tactical implications of the investigative article, what are some deeper points to consider? Here are a few insights the study can tell us:

1. The message is not getting through to business owners that they need adequate North Carolina workers’ compensation insurance.

Approximately 140,000 businesses have insurance, while 30,000 or so might not.

That’s a huge disparity! It suggests that there is a massive breakdown in the system. It’s not enough to blame business owners or to blame insurance companies. Some deeper, core constraint must be to blame. It’s incumbent on everyone who has a vested interest in the health of the workers’ compensation system to explore that constraint and figure out how to eliminate it or make it irrelevant. For instance, maybe business owners need to be notified about their responsibilities in a different way – or rewarded or/punished differently.

2. The “underinsurance problem” suggests that there could be other large scale problems with the system that might cause drag, inefficiencies, and excess costs.

Assuming that the Charlotte News & Observer did their homework properly, it’s hard to contextualize this problem as a “fluke.” Odds are that there are other gaping inefficiencies in the system that could possibly be surfaced and eliminated to everyone’s benefit.

3. We collectively need to do more “holistic thinking” about how to serve all the clients in the North Carolina workers’ compensation system better.

All too often, the discussions about how to reform workers’ comp become trivialized. It becomes law firms versus businesses, employees versus employers, employers versus insurance companies, etc, etc. In other words, there is this mentality of “the pie is only so big, so let’s grapple for our slice, tooth and nail”.

A more generous view: every stakeholder can benefit from positive reforms and improvements and efficiency.

So let’s expand the pie, instead of just slicing and dicing it.

North Carolina Workers’ Compensation Momentum – Punctuated Evolution

June 5, 2012, by Michael A. DeMayo

In a recent post on how to deal with the mountain of problems associated with your North Carolina workers’ compensation claim – what we metaphorically describe as kind of a “big elephant” that you want to shrug off your shoulders – we talked about how you need to get into action and seek continuous improvement towards a positive end state.

Whether you want to get your finances in order, straighten out your employment situation, deal with your health issues, or simply understand your potential legal rights and responsibilities with respect to North Carolina workers’ compensation, taking action is critical.

That said, there is another myth about how cases typically progress. A more subtle one!

While most people know that they need to “take action” to get things to happen in their lives, they don’t understand this second point too well. And that point is that progress does not happen linearly! It’s not like, day by day, your body will heal and heal and your financial circumstances will get better and better. On some days, you might see progress. But on other other days, you might feel like you are going in reverse.

Imagine you’re walking towards the Appalachians from Charlotte. You won’t just slope gently up and up and up until you get to the top of a mountain somewhere in West Virginia. Sometimes you will be going up, sometimes you will be going down. But as long as you keep heading in approximately the right direction, you will eventually reach the mountains. You will eventually get to the top. That is, if you continue to reset your perspective, reevaluate your progress, check your map, etcetera.

What does this all mean, specifically, for your workers’ comp case?

It means that, if you find yourself suddenly concerned about your medical situation or your legal battle, the answer is not necessarily to panic. The answer might be to panic! But not necessarily so. Because progress towards a worthy goal always has its ups and downs.

Of course, you also need to know whether you’re marching towards the proverbial mountains or heading towards a cliff. And you can’t really do that if your perspective is overly limited. That’s why it’s so helpful for beneficiaries or would-be beneficiaries to work with an experienced law firm, like the team at the law offices of Michael A. DeMayo. Since we have gone through the process of getting clients the resources they need many, many times, we know the common hurdles that they face and how to bypass those obstacles or make them irrelevant.

How Not to Commit North Carolina Workers’ Compensation Fraud

May 2, 2012, by Michael A. DeMayo

The crime of North Carolina workers’ compensation fraud often leads to curious news stories.

“Bad apples” sometimes try to game the system by feigning illness or by pretending that certain injuries are much worse than they actually are (and moonlighting at another job while illegally collecting benefits!).

A case out of Los Angeles last week illustrates the absurdity of workers’ comp fraud. According to the LA Times, Raphael “Noodle” Davis has been charged with four counts of insurance fraud (all felony counts), and he faces up to five years behind bars because he collected $30,000 in workers’ comp… all while participating in mixed martial arts fights!

Investigators discovered the ex-firefighter’s scheme when they found videos of Davis on YouTube fighting in these athletically demanding competitions. To Davis’s credit, he did pretty well in the bouts, racking up a 6-1 record. That being said, his workers’ compensation fraud charges could be a knock out punch.

Pretty amazing stuff, all told. Of course, not all cases of North Carolina workers’ compensation fraud are as cut and dry. In fact, many people who have very legitimate work-related complaints can find themselves hounded by insurance companies, investigators, and others – their credibility questioned, their privacy intruded upon.

Other beneficiaries may not fully understand the rules of conduct – what they can do and cannot do. These folks can accidentally get into trouble for violating certain aspects of their benefits arrangements. This kind of issue is far more common than stories like Davis’. After all, even generous workers’ comp benefits may not compare favorably to the salary that you had made before you got hurt. And we all have a drive to continue to produce valuable products and services and get rewarded for our efforts. So it’s tempting to “push yourself,” even if pushing yourself means potentially violating the rules or spirit of the law.

To develop the most effective, strategic, and appropriate path towards getting benefits, sustaining those benefits, and rehabilitating your life, career, and finances, you may need help. You may find it hugely useful to connect with Michael A Demayo’s North Carolina workers’ compensation law firm for a free consultation about how to meet your needs, given your financial stresses and other concerns.

More Web Resources:

Los Angeles firefighter charged with workers’ comp fraud

Davis’s mixed martial arts fights on YouTube.

North Carolina Workers’ Compensation: When You’re Just Trying to Get By

April 30, 2012, by Michael A. DeMayo

Many articles online about workers’ compensation in North Carolina and elsewhere focus on the technical aspects of how to get benefits quickly, maximize the utility of the benefits you collect, “fight the system,” compel employers and insurers to “play fair” and so forth. These are all important topics to address – indeed, this blog has spent a tremendous amount of time analyzing these issues.

However, many hurt and sick workers are concerned not just with getting benefits – and “closing the loops” associated with their benefits quickly and efficiently – but also with managing the core instability and frustration of the workers’ comp journey. It’s important to address these issues, too. And the distinction is important. Obviously, hurt and sick workers – and their families – need the appropriate strategies and tactics and resource partners to achieve sufficient results. But focusing on your grand plans – all the big picture thinking – can lead to a kind of overwhelm and dismay.

If you just read a little bit online, for instance, you can immediately recognize:

•    50 problems that you have that are associated with your North Carolina workers’ compensation situation;
•    20 tactics that you should be implementing yesterday to get control of your life;
•    30 possible resource partners;
•    100 North Carolina workers’ compensation law firms;
•    And that’s just the beginning!

Getting human beings to change and move away from the status quo is almost never a comfortable activity, even under the most generous and simplest of circumstances. In other words, if you are young and healthy and you are looking to change your diet or improve your fitness routine or get a little bit more productive… you still nevertheless will face challenges breaking out of old habitual thoughts and actions.

When you’re sick and injured – when you have a family to care for, bills to pay, hidden anger about your employer, your insurance company and possibly yourself, a painful rehab and a scary medical prognosis in front of you, et cetera – the thought of taking on even MORE risk can be almost too overwhelming to bear. Even if the risk is worth it, by any practical calculation. And so many would-be beneficiaries don’t bother taking any action about their cases. So the research that they do comes to naught. So they feel WORSE about their poor results than they would have had they done no research at all!

Not a Good Situation, By Any Means

So how can you begin to move it in some right direction — to get the wheel moving? Unfortunately, there is no cookie cutter answer here. But, if you can at the very least internalize the concepts that we’re discussing here – that taking no action is often worse than taking an inefficient or even negative action (i.e. one that moves you the wrong direction). Action creates its own clarity because of the law of inertia. Once you’re moving in any direction, you’ll find it easier to pivot and change course based on the feedback that you get.

More Web Resources:

The Hidden Cost of “No Action”

The Law of Inertia

Could Massive Changes to California’s System Be a Guiding Light for the North Carolina Workers’ Compensation System?

April 28, 2012, by Michael A. DeMayo

Last year, when we discussed 2011’s massive overhaul to the North Carolina workers’ compensation system, we went on and on about the amazing amount of waste and inefficiency in our system.

If only we could come together as a state and find out ways for all parties involved – insurance companies, lawyers, employers, workers, hospitals, and bureaucrats alike – to work towards mutual solutions. Think about it. It would be awesome. We could probably make massive improvements not only in terms of cost savings but also in terms of better care and better results for everyone involved.

Well, good news. The great state of California has apparentlt taken us up on the challenge. According to a April 12 article in the Los Angeles Times, big companies and labor unions are working in tandem (yes, together!) to overhaul the $15 billion California workers’ comp system to reduce delays, improve medical care, and help break down some of the obstacles facing workers who need compensation.

California workers are hard up.

According to the Los Angeles Times, back in 2004, the average permanent partial disability recipient got $25,000. Meanwhile, UC Berkeley data show that that number has been more than cut in half – down to $12,000 per worker! Employers have been making out okay in the Golden State – workers’ comp premiums have actually gone down by 60%, per the Times. And insurance companies have done well because they have had to payout fewer claims and smaller claims at that.

But the workers themselves are apparently suffering grievously!

Meanwhile, a 2009 analysis conducted by then Governor Arnold Schwarzenegger’s administration found that CA’s system could be streamlined to the effect of $1.5 billion savings annually. That’s about 10% of the total value of the system – a significant amount of waste. California’s system is clogged up with “inefficiencies and frictions” according to stakeholders. Negotiations to overhaul the system will focus on how to strip down those obstacles to make the system “more administrative, more predictable, more affordable [while putting] more money in the hands of injured workers and [bringing] down the cost to employers.” (That quote is courtesy Sean McNally, a VP for a California carrot grower quoted in the Los Angeles Times story.)

Are there any takeaways for the North Carolina workers’ compensation system?

Perhaps – and perhaps not. Comparing the California system to the North Carolina one is a lot like comparing apples-to-oranges. Yes, they are both metaphorical fruits, but there are many important distinctions.

Again, however, the lesson holds not just for California and North Carolina but for all 50 states – we need to strip away inefficiencies and obstacles and needless bureaucracy. It is a quest that concerns us all and it is a quest we should collectively root for.

If you need help dealing with a specific injury or illness, connect immediately with a responsible and respectable North Carolina workers’ compensation law firm.

More Web Resources:

California’s workers’ comp overhaul is stirring

UC Berkeley’s survey on California workers’ disability costs

Employers and North Carolina Workers’ Compensation Insurance Cost: Part 2 – Possible Solutions

April 12, 2012, by Michael A. DeMayo

In a blog post earlier this week, we discussed a piece in the Charlotte Observer about employer related struggles regarding North Carolina workers’ compensation insurance.

Although state law requires most companies to purchase workers’ comp insurance or at least certify that their businesses are flush enough to self insure, 30,000+ companies lack insurance, according to an analysis done by News & Observer.

This “underinsurance” problem creates a crisis for the entire North Carolina workers’ compensation system. Employers who break this law may get hit with a Class H felony charge, which can lead to jail time. Hurt workers, meanwhile, may wind up without recourse to pay for lost wages, time off of work, medical care, and beyond. And the underinsurance problem creates stresses on the entire system – upping the workload for the North Carolina Industrial Commission, causing insurance related headaches, and on and on.

It would be great if we could all sit down and try to figure out some solutions. To that end, here are some speculative ideas:

#1. Make it easier, less stressful, and less expensive for companies to purchase workers’ comp coverage.

Employers often claim that they simply lack the money or resources or time to shop and buy policies. If we can lower the bar for them (we can experiment with various mechanisms for doing so), then we can likely reduce some of the underinsurance problem.

#2. Improve employer education.

Most employers do not like to contemplate worst case scenarios: a worker getting sick at the shop or on the industrial floor, for instance. But employers need to understand not only the risks for themselves and for their businesses but also the risks to their employees.

#3. Employees need to investigate and speak up.

If you’re an employee, you want to be able to trust that your employer is doing the right thing and following proper procedures. And while legally, your employer is responsible, employers are human beings too, and they can make mistakes. As the old Cold War saying goes: trust, but verify. If you’re a new employee at a construction job, for instance, and your new boss tells you that he is bonded and insured and licensed and everything, why not go ahead and ask to see proof? The more informed you are about your own welfare, the more protected you will be, and the less likely you will need the services of a qualified North Carolina workers’ compensation law firm.

More Web Resources:

Charlotte Observer’s Piece on the Consequences of When Employers Dodge Workers’ Comp Costs

Speaking up for yourself as an employee

Modeling What Works: How to Find the (Right) Help While on North Carolina Workers’ Compensation

March 11, 2012, by Michael A. DeMayo

A tragic number of North Carolina workers’ compensation cases end badly. Why?

Often, it’s because beneficiaries (or would be beneficiaries) or their family members took bad advice. Or they took the right advice from the wrong person. Or they took the right advice from the right person at the wrong time.

Getting everything to “sync up” is more difficult than you might imagine. Likewise, it’s nearly impossible for amateurs – people without ample experience dealing with North Carolina workers’ compensation cases – to make all the right decisions. We intuitively know this. But we insist (or at least many of us do) on “reinventing the wheel” when it comes to figuring out our benefits situation.

Think about it. It makes zero sense:

•    You’ve never had experience dealing with an insurance company….
•    You’ve never had to face down a contemptuous or uncooperative employer…
•    You’ve never had to go through rehab or physical therapy…

So why would you assume that you would be able to “intuit” best practices?

It’s silly.

Unfortunately, we are programmed by habit and by our cultural beliefs to “pull ourselves up by our bootstraps.” Self reliance can be wonderful tool. And we all fundamentally need autonomy. But there is a difference between being self reliant and being foolishly self-absorbed.

Indeed, the most self reliant and successful entrepreneurs, thinkers, inventors, artisans, etc all stand on the backs of giants, metaphorically, to succeed.

The point here is that your preoccupation with trying to “solve your own problems” from scratch is almost certainly costing you time, money, and energy – not to mention subjecting you to profound amounts of psychological stress and long-term uncertainty.

A North Carolina workers’ compensation law firm – at least a good one, that has a terrific reputation, lots of experience serving clients with similar needs, and robust systems and processes to help clients through their difficult challenges – can be a terrific ally. We all need great mentors. Often, the most difficult part of our challenge is accepting that we deserve the best mentors out there to help us through our problems.

More Web Resources:

Modeling What Works

The Power of the “Right” Mentor

Simple Causes, Complex Problems (A Guide for North Carolina Workers’ Compensation Applicants)

March 2, 2012, by Michael A. DeMayo

Disaster has struck at your workplace. You now need North Carolina Workman’s Compensation to pay staggeringly high medical bills, supplement your family’s income during your time off (and who knows how long that will last), and generally keep you moving (perhaps limping) towards your long-term financial goals.

How did you end up here?

Two classes of events can lead people to get hurt or sick at work: Acute and chronic.

Acute Workplace Injuries

These are the more “obvious” injuries. They include things like:

•    You fall off a loading dock and break your leg in three places;
•    You inhale aerosolized toxic chemicals while working in a chemical refinery and suffer immediate burning and lung damage;
•    You suffer a massive concussion and blood loss after a careless driver t-bones your delivery truck or rental car while you are en route to a conference;
•    You get into an altercation with a co-worker, and he beans you with a rock or a fist.

Acute accidents/illnesses are relatively easy to trace. In other words, you can identify the cause of the illness/injury pretty easily and with great certainty. The injury also happens across a very short span of time (seconds, minutes).

Chronic Workplace Injuries

Examples might include:

•    You develop carpal tunnel syndrome or another typing injury after working as a secretary for 13 years for a bank in the Research Triangle;
•    You develop fibromyalgia or type II diabetes or some other ailment which degrades your performance at work and, possibly, ultimately, prevents you from doing your job at all;
•    You suffer a lung ailment, skin problem, or some other medical concern after being exposed to environmentally dubious conditions at your workplace.

Chronic ailments are far difficult to “trace.” In other words, it’s harder to put together an argument or a story that connects workplace exposure or conditions with your illness/injury. Chronic problems by definition develop over long swaths of time. As a result, you cannot as easily connect the “causative event” with your injury, since so many different factors might have contributed to your problems.

That being said, many workplace injuries – even chronic, complicated ones – stem from simple causes done repeatedly over time. If someone hit you over the head with a hammer, you would develop a fractured skull, contusion, bleeding, swelling, etc. You could clearly say “the hammer blow caused all these problems.” But if someone taps your head with a hammer softly, repeatedly for a few weeks, and you suffer subtle, long term neuronal damage, now your case is harder. You can no longer say “the cause is still simple. All of my injuries and woe stem from the simple cause of the hammer blow.”

The moral here is: Your problems may seem complicated and not interrelated. But don’t be so sure. Even if you have a host of ailments right now, a single prominent chronic stressor in your life or at work might be responsible for a vast number of them.

A North Carolina Workers’ Compensation law firm can help you drill down to discover the root cause (or causes) of your problems and help you get compensated.

More Web Resources:

Example of a Simple Cause Leading to a Complex Problem.

Chronic Versus Acute Injuries

Simple Solutions to Complex Problems? Are There Magical Fixes for North Carolina Workers’ Compensation?

February 28, 2012, by Michael A. DeMayo

Your North Carolina workers’ compensation issues are so diverse (and possibly hard to catalog) that you get a headache just thinking about all the fires that you have put out.

Let’s just surface a few of the deep obstacles holding you back:

•    You’re no longer bringing in income;
•    You are in constant chronic pain;
•    You’re confused about your medical prognosis and probably more than a little scared;
•    You have no idea how long it will take for you to recover your function – or how much of your function you can recover;
•    You may be fighting more with your spouse, family members, friends, and others who want to help you;
•    You may be completely confused and overwhelmed by all the different sources of North Carolina workers’ compensation “wisdom” on the web and elsewhere;
•    You may be locking horns with an uncooperative employer or shady insurance company;
•    You may be dealing with chronic problems that were draining your attention before you got hurt at work (e.g. relationship drama, struggles caring for an elderly parent, financial pressures, an imminent foreclosure, etc.)

It might be worth it to pause from reading this for a second and pick up a pencil or a pen (or open a Word document). Go ahead and type out your own list of problems and concerns associated with your workers’ comp claim.

If you filled out more than a single sheet of paper, you would be in the vast majority of beneficiaries (or want-to-be beneficiaries).
Bottom line: you’re dealing with a lot of complex, diverse and scary “stuff.” And you probably are laboring under the belief that you will need to solve each one of these “fires” separately.

That might be true. But we might be able to borrow from the insights of complexity theory to find a way around your issues. Complexity theory tells us that simple problems can have complex causes; conversely, complex problems can have simple solutions.

Perhaps, then, small changes in perspective, behavior, habit, or thinking can “knock out” many of your chronic problems at once. Here are three speculative “hacks” which can help you get started. These three ideas have a significant empirical and scientific support. Educate yourself by reading the references at the bottom.

1. Mindfulness Meditation

The ancient art of meditation traces its roots across cultures, religions, and continents. Most people associate “meditation” with Eastern traditions, such as Buddhism, Hinduism, Sufism, etc. But meditation like states are often created through other traditions – Catholics who count rosaries, for instance, are engaging in meditative practice. Recent scientific analyses of the effects of meditation on the brain suggest that mindfulness can be a powerful way to treat a vast number of ailments, including depression, anxiety, ADHD, and other psychological traumas.

2. Low Carbohydrate Diets

In their bestselling book, The Art and Science of Low Carbohydrate Living, doctors Jeff Volek and Stephen Phinney discuss dozens of carefully controlled studies that suggest that a properly formulated low carbohydrate diet (low in easily digestible starches and sugars, in particular) can essentially cure metabolic syndrome (which includes diabetes, obesity, and many other ailments associated). Essentially, the low-carb diet theorists suggest that obesity and many diseases result from problems with insulin signaling. Low-carb diets normalize insulin levels and thus help people heal from these problems.

3. Strength Training

In their book, The Slow Burn Fitness Revolution, authors Fred Hahn and doctors Mike & Mary Dan Eades debunk many common myths about fitness and exercise. In particular, the authors suggest that individuals who engage in regular, safe muscular strength training can protect themselves and/or heal from a staggering range of problems, including chronic lower back pain, osteoporosis, etc.

Of course, you need a guide to help you synthesize and structure your recovery. A North Carolina workers’ compensation law firm can point you in the right direction and connect you with more powerful resources to succeed.

More Web Resources:

The Benefits of Strength Training for Rehab?

A Simple Solution (low-carb) for a Complex Problem (obesity)?

North Carolina Workers’ Compensation Fraud Alert: 18 People Busted for Major Scam in NY

February 21, 2012, by Michael A. DeMayo

Let there be no doubt: if you are charged with and convicted of North Carolina workers’ compensation fraud (or grand larceny, false statements, conspiracy, etc), you might face massive jail time, astronomical fines, and other penalties.

A disturbing case of New York workers’ comp fraud has been circulating in the blogosphere. 18 people in 13 counties across New York were arrested in a state-wide crack down. One of the accused, John Czechowski, allegedly took $12,000 from a New York state insurance fund. He suffered a back injury while doing roofing work. Investigators found that he was working off the books for a different company while continuing to collect workers’ comp for the back injury.

Commenting on the case, a spokesperson for the New York State Department of Financial Services blamed fraud artists for victimizing both companies and taxpayers. He emphasized that the state will end fraud to reduce the cost of insurance for workers’ compensation.

Case in Context

It’s easy to understand why fraud poses such a problem – not just for individuals who need money to pay for time off of work and medical costs, but also for employers and even insurance companies. When scam artists drain money from the system, those costs must be compensated. It’s not as if North Carolina can just print more money and call it a day. That money gone becomes money taken out of everyone’s pocket.

There is also a more subtle danger: fraud degrades trust.

Insurance companies who have been ripped off will institute more strict investigative rules to check up on future claimants. Legitimate claimants will then find themselves put through the gauntlet and often interrogated at length. This can be a stressful experience, if you’re in the middle of recovering from an injury.

As the network of trust unravels due to fraud, everyone pays in ways that transcend purely financial repercussions.

Given that you are not in a position to stamp out fraud yourself – you just want to make sure that you get fairly and justly treated by the system – what should your next steps be?

An experienced and a reputable North Carolina workers’ compensation law firm can help you come up with the most appropriate plan and protect your assets and rights.

More Web Resources:

New York state workers’ compensation fraud dragnet sweeps up 18 suspects

How fraud damages trust in the system

Is 10% All It Takes for North Carolina Workers’ Compensation to Change?

February 17, 2012, by Michael A. DeMayo

The behemoth that is the North Carolina workers’ compensation system seems like a tough beast to tame.

We want to smooth out inequities, give employers breaks, enhance trust among insurers, employers and employees, and, most critically, help employees receive a fair piece of the “grand bargain”. It all sounds like a lot of work. And it might be.

But intriguing scientific research suggests that complex systems – such as the North Carolina workers’ compensation system – can be powerfully shaped and molded with “nudges” as opposed to “sledgehammer blows.”

Let’s unpack that for a second. When you think about large systems – systems involving 100s of millions of dollars, thousands of people and employees and insurance companies – we intuitively believe that, to create change, we need lots of top down power. For instance, we need massive top down legislation. We need a huge influx of cash. We need rate cuts. Or rate hikes, depending on your point of view.

While using a sledgehammer can sometimes get the job done, sledgehammer blows are problematic for a few reasons:

1. They require massive amounts of energy and resources, so you can only fire off a very few;

2. Calibrating sledgehammer blows is very difficult. For instance, say you’ve got a gangrenous arm. A doctor saw off your arm at the shoulder to save you. You’ve cured the gangrene, but you’ve done it in a very sloppy way. The gangrene is gone, but we have no idea why it grew in the first place or what we can do in the future to fix/prevent it. We burn through a lot of our resources needlessly.

3. Hard to replicate. A hammer blow can work one time for one type of problem. But what happens when another problem emerges (and problems always do emerge)?

An Alternative to the Hammer Blow – The Chisel Or The Nudge

Another way to change complex systems is far less cost and energy intensive.

The other paradigm involves using nudges or slight changes in pressure and perspective, applied over extended periods of time. For instance, here is a good metaphor to illustrate the power of nudging. It’s easy to give someone a bruise on his arm by punching him on his arm hard. It is also, however, possible to cause a bruise by putting slight but constant pressure on the arm for an extended period of time. You know how much it hurts if you sit in a chair in the same exact position for too long. The point is: we can nudge easily, without investing a lot of time and energy. We can also run far more experiments to try to nudge the system in the right direction.

Whereas we can only maybe fire one or two or three cannonballs a year at our North Carolina workers’ compensation problem; we can try hundreds of different nudges to get the system to come into line with our values and vision and expectations.

Master business theoretician Jim Collins discusses this kind of resourceful thinking in his recent bestseller, Great by Choice. Collins argues that enduring systems (be they giant companies or institutions like North Carolina’s workers’ compensation) can be shaped and molded most effectively through a process that he calls “Fire Bullets, then Cannonballs.” In other words, conduct small little experiments and try to reach your goals (bullets). Once you are able to “connect” with the bullets, then you fire a cannonball after the bullets to get a massive effect.

This approach doesn’t guarantee success, but it makes success much more likely.

More Web Resources:

Fire bullet, then cannonballs

Small Shift Yields Massive Results Over Time

Change Takes Time… Or Does It? North Carolina Workers’ Compensation Transformation

February 13, 2012, by Michael A. DeMayo

If you are sick or injured – or if someone you love and care about needs North Carolina Workers’ Compensation – then you probably fear that you’re “in this” for the long haul. The problems with your health, finances, and career situation are not going to go away overnight. So you better get used to them. It’s going to be a long, hard grind. It’s going to take months or maybe even years.

Or perhaps positive change can come swifter than you realize!

That may sound like a pollyannaish statement. After all, many workers’ comp and workplace injuries are anything but simple to manage. In fact, somebody might even take affront to the suggestion that your injury or illness could be easily resolved. There is a subtlety here. Workers’ comp problems can last a long time and can lead to the “grind” we talked about earlier.

At the same time, however, when change happens, if often happens blindingly quickly. Ask famous writers, celebrities, and politicians about how they succeeded. You will come across a surprising pattern. Often, a person struggles for years, even decades, before a “lucky break” changes everything. Most people think in terms of “how can I make that lucky break happen for me?” For instance, they will try to win the lottery or hope for some other windfall.

But this way of thinking about your problems may not be particularly useful. In fact, the “lucky breaks” and the “swift changes” that follow do not occur spontaneously. They are nurtured and prepared by years of practice and – by consistently making small positive decisions and changes to behavior.

Once there is enough positive momentum going on, efforts can catch fire rapidly. It’s kind of like lighting a match. If you rub the match against the surface nothing will happen. As you rub faster and faster – still nothing. But once you hit some kind of a tipping point – FWOOM – the match suddenly bursts into flame and releases massive amounts of heat.

Likewise, so goes the transition from struggle to success. You struggle, struggle, struggle. Then one day, you “catch fire” and success seems inevitable instead of a distant dream.

The moral here is two-fold:

1. Avoid thinking in terms of “grand, one time fixes” to your North Carolina workers’ compensation problems.

Single decisions that you make – single behaviors or habits or thoughts that you have – are probably far less crucial than your overall habits and rituals. Instead of focusing on wiping out your problems with a single “smart decision” or a one-time phone call with a mentor, focus on winning the marathon.

2. Change, when it happens, can be swift and sudden.

For instance, say that you’ve lost the ability to walk effectively due to a knee injury you contracted at work. You might go through rehab for six to eight months, during which time you slowly but surely regain some capacity in your knee. Then one day, you notice that your knee “feels fine” and you’ve totally regained function. It took the six to eight months of rehab to make the healing happen. But once it did happen, it happened quickly.

Begin the path of good habits, good relationships, and positive outcomes by connecting with a North Carolina workers’ compensation law firm.

More Web Resources:

The Revolution, When it Comes, is Often Swift

Tipping Point

More Lessons in North Carolina Workers’ Compensation: Senator’s Company Shut Down for Lack of Insurance

January 3, 2012, by Michael A. DeMayo

If you are an employee, you expect your boss to carry North Carolina workers’ compensation insurance. This coverage helps pay for damages and disability costs if/when you (or your co-workers) get hurt on the job. State law compels most employers to carry this coverage. So you would expect that most business owners would comply.

However, that’s often not the case!

As we saw in a recent blog post about Jay-Z’s fracas with the Workers’ Compensation Board of New York (the rapper was hit with an $18,000 bill for failing to have workers’ comp for his domestic employees over a two-month period in 2009), even the most wealthy and well-educated business owners often do not understand their obligations under North Carolina workers’ compensation law.

You might be tempted to give Jay-Z a pass on this. After all, he is a rapper and musician – not a lawyer. But you might be shocked to know that even lawmakers themselves often violate the laws they create.

Consider, for instance, Vermont State Senator Bobby Starr, whose company, E. Starr Trucking, was shut down on December 20 pursuant to its failure to acquire adequate workers’ compensation insurance. Judge Robert Bent granted a permanent injunction against the firm, sparking much chatter among citizens and state labor officials. On paper, the situation is not particularly huge, especially when you consider it in light of some of the more flagrant North Carolina workers’ compensation fraud cases that we’ve talked about in this blog.

On the other hand, quotes like this from the Burlington Free Press are kind of disturbing: “Starr said he didn’t know whether he and his son would get the insurance or ‘just switch everything to the other company’ that carries the insurance.”

Obviously, business owners must make complicated decisions in a fluid environment. Hurt and injured workers should be mindful of the complexities that entrepreneurs face. On the other hand, if you’re a lawmaker, shouldn’t you have a grasp of your company’s legal obligations? Shouldn’t you be able to prevent problems like this from occurring? A permanent injunction against your business is, by most accounts, a black eye.

Of course, lawmakers, like all of us, are often all too human. This system is complicated. Opportunities for error abound. This is why it is so critical for hurt and injured workers to team up with a reputable North Carolina workers’ compensation law firm to identify best practices and protect their rights using every tool and strategy the law allows.

More Web Resources:

Permanent Injunction against Starr’s United, Inc.

E. Starr Trucking Website

What Can Chaotic Fraud Charges out of West VA Teach Us about North Carolina Workers’ Compensation Fraud?

November 30, 2011, by Michael A. DeMayo

North Carolina workers’ compensation fraud is a profound and seemingly indelible problem that saps much needed resources, degrades trust in the system, and leads to hardship and chaos for dependants. Why, then, do so many people continue to perpetrate this crime?

For example, let’s look just over the border to West Virginia, where last week, owners of an Apple Dumplin in Oak Glen, West VA, Keith McBride and Lois Ventura, got hit with three charges of workers’ comp fraud. Investigators with the workers’ compensation fraud prosecution unit tracked the couple since July. Here’s the scoop. The 51-year-old Ventura was hurt last August at her former job at Big Cheese Pizza. She collected workers’ comp benefits as a result of that claim. All good. But then, in violation of the benefits arrangement, she started running an Apple Dumplin with her boyfriend, Mr. McBride, and continued to “receive cash and medical benefits through the workers’ compensation program.”

When questioned about his girlfriend’s allegedly fraudulent activities, McBride “reportedly misrepresented the facts of the case by stating that he was the sole owner of the business and had no knowledge of the workers’ compensation benefits Ventura was receiving.” Not a good move. Now both Ventura and her boyfriend face counts. On November 3, at their arraignment, they both pled not guilty. A court date has been set for January 10.

Obviously, based simply on news reports, you should avoid leaping to judgment. Unless you probe the back story, evidence, and other relevant details, it’s probably wise to withhold “convicting people in your mind,” if only to hone your ability to see life objectively.

For the sake of a discussion, let’s assume the charges are correct. What lessons can we extract?

First of all, the story suggests that a significant number of North Carolina workers’ compensation fraud cases probably result from unplanned errors and inappropriate innovations. In other words, while some people plan workers’ comp fraud far in advance, many people simply “stumble into it” because fraud is easier and faster than operating ethically.

Often, people who are simply trying to “scrape by” come to believe that somehow they have been wronged by the system and that they “deserve” to break the rules.

The story also suggests that many workers’ comp beneficiaries do not receive enough training to understand the limits of what they can and cannot do. People might know that violating workers’ comp rules is somehow “wrong” in the abstract, but they may not know the specific punishments that are likely to meet them if they commit a crime.

For excellent guidance, no matter what your situation, connect immediately with a qualified and compassionate North Carolina workers’ compensation law firm.

More Web Resources:


Apple Dumplin couple hit with workers’ comp fraud charges.

Fraud is Not Okay in OK: Midwest Lessons for Would-Be North Carolina Workers’ Compensation Fraud Perpetrators

November 4, 2011, by Michael A. DeMayo

As this North Carolina workers’ compensation blog has opined numerous times, when individuals or institutions perpetrate workers’ comp fraud – or any other kind of fraud – “downstream” effects on workers, employers, insurers, and governmental institutions can be profoundly damaging. Indeed, the North Carolina workers’ compensation system works, when it does, because various parties trust one another to act fairly and in good faith.

That’s why it’s so disturbing to read stories like a recent account from Tulsa, Oklahoma, where a local attorney pled guilty last week to embezzling more than $1 million from his clients and conspiring to commit workers’ comp fraud.

According to the Oklahoma Attorney General’s Office, 61-year old Fred Schraeder will receive a “five-year deferred sentence and will pay more than $36,000 in restitution, $500 in fines and a $100 victim’s compensation assessment… Schraeder must surrender his law license and isn’t eligible to reapply while on probation.”

Schraeder did not act alone. He apparently had an accomplice, William Anton, who was sentenced in August to pay over $700,000 in restitution and serve “four consecutive sentences totaling 35-years, with 25-years suspended.”

The Attorney General’s Office claims that Schraeder and Anton embezzled money from clients between 2004 and 2009. They stole from their “personal injury benefits, insurance settlements and workers’ compensation benefits.” Over 49 victims were identified by the Attorney General’s office.

This disturbing story highlights how important it is for sick and injured people to work with trustworthy North Carolina workers’ compensation law firms. Just because an attorney or a law firm boasts a pretty website and ostensibly credible qualifications does not mean that the team will be a “best fit” for you. Before you select your law firm, ask many questions, really research your prospective firms, and make sure you choose a firm that has a reputation for ethical behavior as well as for getting good results in complex cases similar to yours.

More Web Resources:

Oklahoma attorney embezzles over $1 million dollars from clients

Charges filed against Schraeder and Anton

When the North Carolina Workers’ Compensation Money Runs Out…

October 17, 2011, by Michael A. DeMayo

Maybe you’ve been on North Carolina Workers’ Compensation for months or years as you work feverishly to heal your life, your finances, your body, and your stamina. Or maybe you are only exploring workers’ comp options. At some point, most likely, you will have to face the “end of the line” as far as your benefits are concerned.

Whether you consider this “fair” or not – whether you have legal means to fight the end of your benefits or not – you need to make adjustments to your lifestyle, budgeting, and possibly career path to accommodate the transition. Make no mistake: the transition can be quite difficult. You’ve gotten used to a certain way of living, a certain way of thinking about your income, and certain habits and expectations. Even if you’ve known that the “dry up” was coming for months or years, you can only prepare so much in the abstract.

When the reality hits – when you stop getting checks — you must make due with far less money. You may panic and potentially even make bad or dangerous decisions that can imperil your body, your recovery, or worse. Indeed, financial panic often drives uninformed, desperate people to commit crimes like North Carolina Workers’ Compensation fraud – crimes that can be prosecuted as felonies and lead to substantial prison time as well as the catastrophic destruction of your professional life.

The process of weaning yourself off benefits does not have to be agonizing, however. The more planning you can do, the better. And don’t simply focus on “planning your finances.” Focus on the psychological preparation. Understand that you will need some time to adjust to your new reality and to accommodate for the stresses of the transition. Maybe set aside some “special treats” for yourself during the transition. For instance, plan an inexpensive vacation (e.g. camping trips in the woods or meditation retreat) or spend some time with your family or close friends – a so-called “staycation.” Or give yourself permission to indulge in a treat, like a fun meal out, or fancy new gadgets from Apple or your other favorite tech product purveyor. (Obviously, don’t spend beyond your means when you get these “treats”.)

All that said, the doom and gloom you are feeling maybe a bit premature. Investigate your resources by connecting with a compassionate, skilled and thorough North Carolina workers’ compensation law firm.

More Web Resources:

After Your Benefits “Dry Up”

Transitioning to Life with a Reduced Income Stream

Felony Charges for Stealing Less Than $4,000 – A Cautionary Tale for North Carolina Workers’ Compensation Beneficiaries

October 10, 2011, by Michael A. DeMayo

Few people dream of committing North Carolina workers’ compensation fraud. But the temptation to “cheat” on your paperwork and collect a little more than you might be legally entitled to can lead to life-changing disasters.

Witness the fate of 31-year-old Patrick Rosenzweig, a New Yorker charged on October 6 with attempting to defraud The New York State Insurance Fund out of $3,973.24. According to a report in a local newspaper, The Wayne Post, “[Rosenzweig] was charged with workers’ compensation fraud, making a fraudulent statement in workers’ compensation insurance applications, offering a false instrument for filing the paperwork and grand larceny.”

Rosenzweig now faces a smattering of felony charges. If convicted of any of them, he could face over a year in jail… all for trying to obtain workers’ comp while he was still working.

What can the Rosenzweig ordeal teach us? First of all, note the cost benefit analysis. Assuming he had gotten away with this alleged scam, he would have collected an extra $4,000. But he didn’t, and he now faces huge fines and possibly significant time behind bars. Assuming he ordinarily made something along the lines of $60,000 a year, and he gets three years of jail for the felonies, he will be out close to $200,000 for committing a crime that would have only netted him around $4,000.

All this is to say that North Carolina workers’ compensation fraud does not pay off.

That being said, one can still be sympathetic and compassionate here. Hurt workers often lack the job training, skills, and resources to make ends meet. If you are a mother of two who got hurt at work – not badly enough to receive workers’ comp, but badly enough to struggle with day-to-day activities – you might be tempted to break the law and lie on your paperwork. The impulse comes from a place of wanting good help. Instead of making reckless, illegal decisions, however, make responsible choices.

For instance, connect with a North Carolina workers’ compensation law firm to review your options for getting more compensation or to find other resources to make ends meet.

More Web Resources:

Canandaigua Man Charged with Workers’ Comp Fraud

Making the Most Out of Your Reduced Income

Small Scale Crime Has Implications for North Carolina Workers’ Compensation Fraud Prevention

October 5, 2011, by Michael A. DeMayo

What can be done to reduce or even eliminate North Carolina workers’ compensation fraud?

To solve this dilemma, we need to look beyond our state’s borders and pick apart relevant news stories, data, analyses, and arguments compiled by experts. It’s all well and good to theorize about different methods to deal with, manage, or punish North Carolina workers’ compensation fraud. It’s another story altogether to operate in the “real world” and get good results.

Even “small scale” cases of fraud can yield surprisingly relevant and far-reaching lessons, if we understand how to appreciate these stories in context. Consider a small bore story about workers’ comp fraud in Des Moines, Iowa. As the AP reported on September 23, the president of DES Staffing, Dinesh Sethi, plead guilty last week to wire fraud: “He acknowledged that he participated in a scheme to defraud Travelers Insurance and Liberty Mutual between 2006 and 2009 by giving the insurers’ false information to calculate the firm’s premiums…he and his Director of Finance shifted payroll from high-premium job classification codes to lower-premium codes such as clerical workers.”

Per the plea arrangement, Sethi’s five other charges have been dropped, and prosecutors will not go after either his company or his family. He will face sentencing at the end of December.

So is it really possible for us to extrapolate from this small case and learn more widely applicable lessons?

Maybe so.

Here are three lessons:

Lesson number one: Outsized punishments can affect criminals who commit even small, technical crimes.

In the grand scheme of things, Sethi’s wrongdoings (or alleged wrongdoings) are relatively tame, if you measure them against other criminal acts, like felony murder, vehicular manslaughter while DUI, and massive multimillion-dollar Medicare schemes. But he could still face jail time and other career-ending punishments for what he did.

Lesson Number Two: Schemes can go on for a while before the authorities step in, but con artists are never safe.

According to the AP article, Dinesh and his finance director perpetrated fraud for approximately four years before getting busted. The long arm of the law, however, finally caught up.

Lesson Number Three: It’s almost always worth the time and effort to ensure you are operating fairly, ethically, and legally.

Many people who commit fraud do so inadvertently, or at least without knowledge of the consequences. A sick mother on workers’ comp leave, for instance, may take a second job to try to earn a little extra money for her family, oblivious to the fact that taking the second job violates her workers’ comp arrangement.

To protect your rights and ensure that you stay within the bounds of the law, always consult with an experienced North Carolina workers’ compensation law firm.

More web resources:

Des Moines exec pleads guilty to insurance fraud

Ankeny man pleads guilty to insurance fraud

Police Officer Theft Charge Stimulates Discussion among North Carolina Workers’ Compensation Analysts

September 13, 2011, by Michael A. DeMayo

Policy wonks and ethicists in the North Carolina workers’ compensation community have been riveted by a case unfolding in nearby Waynesboro, Pennsylvania. Allegedly, a local police officer there stole over $22,000 workers’ comp checks over an eight-month period (from September 7, 2009 to May 3, 2010). The officer, Derrick Lange, hurt himself in an August 2009 foot pursuit and had to see a hand specialist for ongoing pain in his hand and wrist. After a specialist advised him to stay off of work after surgery, Lange began collecting workers’ comp payouts. But Lange later made an agreement that allowed him to collect his regular salary as long as he turned over the worker comp checks that he had collected.

Apparently, the 31-year-old officer ignored the terms of arrangement and actually deposited the checks into his bank account. Eventually, the insurance company that represents the Waynesboro Municipality caught on and alerted local authorities, who arrested Lange on Tuesday, September 7th and held him on a $15,000 bail. A September 21st preliminary hearing has been scheduled. Lange faces charges of theft by failure to deposit the funds that he received.

As this case illustrates nicely, abuses of the North Carolina workers’ compensation system can take many forms and can be years in the making. Individuals who defraud the system or cheat insurance companies or lie about their injuries can not only suffer grievous legal consequences – including having money stripped away from them and having to serve jail time (in some cases) – but they also endanger the efficacy of the entire system. For instance, an act of fraud has a “ricochet effect” throughout the system: insurers tend to trust claimants less and so they subject them to more bureaucracy and more invasive follow up. When money gets siphoned out of the system, employers and insurers try to make up those costs by doing things like cutting benefits, jacking up rates, and scrimping on service to save.

All this is to say that, if you or someone you care about wants to pursue a claim, make sure that you “dot all the Is and cross all the Ts” and that you stay away from anything even vaguely resembling illicit or unethical action. All that said, just because you play fair doesn’t mean that your employer or a responsible insurance company will play fair with you. To that end, if you are having trouble with any aspect of your claim, connect with a competent and battle proven North Carolina workers’ compensation law firm to develop a strategy to get the compensation due to you efficiently and quickly.

More Web Resources:

The saga of Derrick Lange

Waynesboro police officer Derek Lange arrested for theft after allegedly stealing more than $22,000 in worker’s compensation checks

When North Carolina Workers’ Compensation Is Just Not Enough

August 31, 2011, by Michael A. DeMayo

The fight to qualify for, collect, and utilize North Carolina workers’ compensation benefits to pay for your post accident/injury expenses can be dreary, annoying, drawn out, and full of ups and downs.

This holds true even if you have a high-caliber North Carolina workers’ compensation law firm on your side, fighting to protect your rights. But what if, after your case seems resolved, you still don’t have enough money – even after the workers’ comp is incorporated into your budget – to pay for the bare necessities? What options do you have?

Obviously, you might want to talk to your law firm about getting more benefits, extending your existing benefits, or searching for other social service programs to fill the gaps. But you also should consider other strategies and tactics to either lower your expenses or pump in new income in a way that doesn’t violate the terms of your North Carolina workers’ compensation arrangement.

You can find gazillions of articles online about how to penny pinch, coupon clip, and otherwise tighten the belt on your home budget. So we won’t ramble on about that.

But you might be surprised by the different ways you can reboot your productivity by tapping into latent talents, skills, and passions. For instance, say you spent 22 years working a difficult welding job outside of Raleigh. One day, a piece of equipment malfunctioned and gave you severe burns, lacerations, and few broken bones. In short, now you can’t – or you won’t – go back to your old welding job. So now what?

Well, let’s think. Maybe you’ve always had a passion for NASCAR. You’ve been a huge NASCAR fan, you know all the great drivers’ names and stats, you obsess over events, take your family hundreds of miles to see the big races, etcetera. If so, you might explore how to turn that passion – and your deep knowledge of the sport – into a money-making venture that could yield a second or third income stream for your family.

Of course, if you do enter into a business venture, be sure that it’s allowed by your workers’ comp arrangement. Otherwise, you can get into trouble for workers’ comp fraud – and that can lead to a revocation of benefits and other punishments, like jail time.

But assuming you do this correctly, you might be surprised at how many of your secret passions, hobbies, and skills you can leverage to rebuild not just your sense of excitement and joy about the world, but also your financial possibilities. We will talk more about the nuts and bolts of how to do this in our next workers’ comp post…

More Web Resources:

Tighten Your Budget

Rediscover Your Passions

North Carolina Workers’ Compensation Fraud Blotter: Gym-owner Hammered by Fraud Charges – Gets 5 Months in Jail and Must Pay over $100,000 in Restitution

August 23, 2011, by Michael A. DeMayo

On August 26, 48-year-old Nicki Lee Buxmann of Sacramento was sentenced to jail for federal workers’ comp fraud. Our North Carolina workers’ compensation analysts react…

According to an article in the Sacramento Bee, Buxmann allegedly suffered injuries while working the United States Postal Service and obtained workers’ comp benefits from the Department of Labor.

While she collected those benefits, Buxmann owned and operated the TNT Takeover/MMA Boxing gym in Roseville, California. This was in violation of her sworn statements that she was not working and earning no income. When news of Buxmann’s alleged workers’ comp violations reached federal overseers, the inspector general of the USPS launched an investigation. According to the Sacramento Bee, “An undercover agent caught Buxmann teaching defensive tactics techniques, replacing light bulbs, cleaning windows, and sweeping exercise mats.” U.S. District Judge Garland E. Burrell, Jr., sentenced her to five months in prison, 36 months of supervised release, and restitution of nearly $105,000.

When someone like Buxmann defrauds the North Carolina workers’ compensation system, everyone in the system loses. Workers’ comp works only when all the players involved – including government entities, insurers, employers, and employees – trust that the system is fair and equitable. Plus, when $105,000 “disappears” from workers’ comp coffers, that money must be compensated for. Typically, the money lost through fraud is replenished by increased taxes, higher insurance premiums, and so on.

Of course, individuals who are hurt often want to get back to work quickly. The question is: Will taking another form of income replacement violate the terms of your workers’ comp? There is no way to answer that in the abstract. That’s why it’s so important to get good legal advice. A North Carolina workers’ compensation law firm will help you understand all you can (and cannot) do to supplement your income, get back to work quickly, and generally augment your career, your injury/illness notwithstanding.

More Web Resources:

Nicki Lee Buxmann fraud

Grand Junction Woman Sent to Jail for Fraud: North Carolina Workers’ Compensation Experts Weigh In

July 27, 2011, by Michael A. DeMayo

On Monday, a woman named Michelle McKee was sentenced to 2 years in prison for defrauding the Colorado workers’ comp system out of $25,000. North Carolina workers’ compensation experts and analysts are closely following the story, as it may have relevance to in-state cases. According to a local news report, McKee had been working as a housekeeper at a hotel, when she hurt her ankle. Although she claimed the injury was work related, an insurance investigation found that McKee had been bragging to friends about cheating the workers’ comp system. She also allegedly admitted to hurting herself not while at work but while out partying (she twisted her ankle after stepping off a curb). The state’s senior assistant Attorney General convinced the court that Ms. McKee had made false statements to collect money – a felony charge. In addition to her 2-year jail sentence, Ms. McKee now faces $25,000 in forced restitution to her old employer, Pinnacol Assurance.

As this blog has often discussed, North Carolina workers’ compensation fraud matters create tensions throughout the system and ultimately harm all major players involved: insurance companies, employers, legislators, and genuinely injured employees. It’s this latter category that is most vulnerable – subsequent to fraud cases like this one, legitimately hurt workers will likely have a harder time in Colorado collecting benefits without hassle. When insurance companies and employers grow suspicious of claimants, they tend to require higher burdens of proof and conduct longer investigations as to the veracity of claims.

If you’ve been the victim of undue harassment, frustration, or non-compliance by your employer or your employer’s insurance company, it may behoove you to seek out the counsel of a North Carolina workers’ compensation attorney to figure out how to resolve your situation adequately, get the benefits you want, and get these issues off your mind so you can focus on recovering and fixing your financial circumstances.

More Web Resources:

Michelle McKee

Colorado workers’ comp system

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

A Bird’s Eye Look at North Carolina Workers’ Compensation eBilling Reform: Are the Changes Worth It?

July 11, 2011, by Michael A. DeMayo

The political fracas that accompanied the recent debate (and subsequent passage) of North Carolina workers’ compensation reform drowned out a few curious and intriguing developments. Thanks to the reform – just penned into law by Governor Perdue – and a piece of legislation called the Patient Protection and Affordable Care Act (PPACA), states like NC (and the nation as a whole) are reassessing their medical billing systems.

North Carolina, for one, adopted new eBilling rules. The state joins Illinois, California, Minnesota, and Texas as part of a select, small group of states that has accepted the new “e-reality” of medical e-billing and moved away from traditional paper bureaucracy.

So what does this all mean? Will eBilling, in and of itself, radically alter the North Carolina workers’ compensation system?

According to many experts, eBilling is inevitable. The internet is altering every facet of our lives. And more and more people feel more and more comfortable paying bills online and even banking at institutions like ING Direct.

But will eBilling eliminate redundant and needless bureaucracy and thus streamline and smooth out hiccups in the system? One would like to think so. If you Google around, you can find countless examples of how eBilling solutions have improved trade, souped up customer service, and even made whole industries workflow processes work better.

On the other hand, eBilling does carry risk. Security, technology, and recordkeeping issues abound. One can easily concoct dozens of “nightmare” scenarios, in which workers’ comp beneficiaries get sucked into a vortex of bureaucracy – or even defrauded out of money or a social security number – due to an eBilling error, technological glitch, or hacking scandal.

Nevertheless, the time has passed for what-iffing. The new eBilling paradigm is upon us.

To make sense of your rights, opportunities, and “best practices,” avoid doing all of the legwork yourself, and turn to a trusted and experienced North Carolina workers’ compensation law firm to help you develop a strategy for the way forward.

More Web Resources:

Patient Protection and Affordable Care Act (PPACA)

medical e-billing

North Carolina Workers’ Compensation Fraud Case: NC Man Accused of $2.7 million Scam

June 27, 2011, by Michael A. DeMayo

The Friday before last, a Wake Forest man, Carl Delmas Fuller was charged in a North Carolina workers’ compensation scam. Fuller was arrested in Florida after the Florida Department of Financial Services Division of Insurance Fraud investigated fishy business practices and concluded that Fuller had scammed National Employment Services (NES) out of a whopping $2.7 million in premiums. NES slowly awakened to the duplicity. The company had believed that had bought insurance from an North Carolinian agent named David Walters who had been serving them through a company called Southeast Services Incorporated. But the company investigation realized that the certificates “Walters” provided were useless, that “Walters” in fact did not exist, and that there was no such entity as “Southeast Services Incorporated.” And indeed, all the checks sent to Southeast Services Inc. wound up in a Myrtle Beach mail box owned by Carl Delmas Fuller.

Both the FBI and the United States Attorneys’ Offices assisted the Florida Department of Financial Services in the investigation to North Carolina workers’ compensation fraud. Fuller faces two decades behind bars if he is convicted of all charges.

As this blog has discussed many times, when individuals like Fuller siphon money out of the system and destroy trust among the various parties (insurers, employers, employees, etc.) everyone suffers in an indirect way. At first blush, 20 years behind bars for a white color crime like fraud might seem “over the top” especially when you consider that rapists, murderers, and violent gang leaders often get a fraction of that jail sentence. The consequences of this kind of fraud can be far reaching and devastating. When the money leaves the system like this, beneficiaries who desperately need funds to pay for medical care, rehabilitation, emergency surgeries, etc. may not have access to the funds or may be unfairly challenged by insurance companies who’ve been “once bitten twice shy” when it comes to dealing with the workers’ comp system.

The big moral and philosophical lessons of the story aside, however, if you or someone you care about is struggling with an issue such as a bad faith insurer, an uncaring boss who won’t listen to your concerns, or simply a lot of red tape regarding your benefits, a North Carolina workers’ compensation law firm can provide tremendous assistance.

More Web Resources:

Carl Fuller


Florida Department of Financial Services

Colorado Fraud Case Piques Interest of North Carolina Workers’ Compensation Community

June 25, 2011, by Michael A. DeMayo

A workers’ comp case way out in Aurora, Colorado has caught the attention of the North Carolina workers’ compensation community because of the heart breaking realities at the center of it all.

Martin Lobatos and his wife Belen Lobatos were indicted on 18-counts last Friday, after Colorado investigators alleged that the couple collected $140,000 worth of workers’ comp claims from Pinnacol Assurance. Lobatos worked as a roofer until September 8, 2008, when he sustained a terrible fall off of a ladder. He went back to work a month later but started complaining of ongoing vertigo and dizziness from his accident. Six months later, in April 2009, Lobatos’ doctors maintained that he had fully recovered.

Lobatos was fired and later collected a $20,000 settlement from Pinnacol Assurance. In the fall of 2009, however, Lobatos began experiencing more symptoms, such as memory loss, having trouble recognizing his children, dizziness, and a host of other frustrating problems. His doctors agreed. In March 2010, Lobatos claimed to be “fully catatonic.” And he allegedly acted catatonic in medical exams. But witnesses later saw him driving around, shopping, engaging in activities in a decidedly non-catatonic state. This evidence allegedly led to the investigation and ultimately to the allegations and 18 count indictment against Lobatos and his wife. If convicted of the crime, the Lobatoses could face fines of $750,000 each and a dozen years in prison.

Obviously, North Carolina workers’ compensation fraud (and such fraud elsewhere in the country) is an enormous problem, and perpetrators should be held to account. But is it really fair to slap these people with $1.5 million in fines and over 10 years in prison? Many homicide cases don’t get punished that severely. Again, this is not to say fraud shouldn’t be punished appropriately. But the punishment must fit the crime, and the context of the crime should also deeply inform the legal remedies.

What’s frustrating here is that many injuries that ultimately send people to seek the services of a North Carolina workers’ compensation firm don’t manifest immediately after an accident. A fall off of a ladder, for instance, may lead to a temporary concussion that seems to resolve after few weeks or months…only to give way to longer term, chronic, and confusing injuries months or even years after the fact.

Again, it’s impossible to weigh in on the Lobatos’ case without far more information. But victims of workplace accidents or illnesses should understand that they may go through a similar kind of rollercoaster – feeling bad after the accident, then feeling better again for a while, then feeling suddenly worse for no apparent reason. This is why it’s so important to contact professionals, like experienced law firms and good doctors, to build evidence, stay within the bounds of the law, and maximize your chances for getting the money and support you need to get back to work and support your family.

More Web Resources:

Pinnacol Assurance

Martin Lobatos fraud

Ohio Fraud Case Puts North Carolina Workers’ Compensation Scam Artists on Notice

May 27, 2011, by Michael A. DeMayo

Whether you’ve recently been injured, and you need to collect North Carolina workers’ compensation benefits – or you’re a healthy individual who’s concerned with the North Carolina’s fiscal state, you want to stamp out workers’ comp fraud. When someone – or some company or institution – steals money from the North Carolina workers’ compensation system, you suffer, and the state in general suffers.

Often, the indirect effects are the most insidious.

Breaking news out of Ohio illustrates the seriousness of this crime. According to woio.com – an action news team based out of Ohio – On April 29th, a man named Luiz Paneto pled guilty to a fourth degree felony for defrauding the Ohio workers’ comp system. Paneto was ordered to pay over $24,000 in restitution and nearly $20,000 in investigative costs.

In 2001, Paneto got hurt at work while performing a general contracting service. Shortly thereafter, he began to collect living maintenance and temporary total disability benefits. In 2007, he was granted permanent total disability.

In 2009, however, the Ohio Bureau of Workers Compensation’s Special Investigations Department received a tip off that Paneto had been doing home remodeling and labor – the same heavy work that he had being doing prior to his 2001 injury.

Per www.woio.com: “[the special investigations department] conducted surveillance and Paneto was seen walking, lifting heavy construction materials, driving his truck, and performing work as a home remodeler… in April 2010 [he] admitted to working in violation of his receipt of BWC benefits.”

Now look: $43,000 is not a tremendous amount of money, especially when you consider the millions of dollars that flow through the North Carolina workers’ compensation system every year.

But every case of fraud essentially pokes holes in people’s trust in the system. Stopping fraud is more than about simply preventing funds from being siphoned off. When fraud happens, suspicion ratchets up, and the system degrades.

If you or someone you care about has been dealing with a benefits issue – or an uncooperative insurer or employer – leverage the resources of a North Carolina workers’ compensation firm today to get results.

More Web Resources:

Luiz Paneto fraud

North Carolina Workers’ Compensation Experts Weigh in on Big Fraud Case out of Ohio

March 17, 2011, by Michael A. DeMayo

Experts in the field of North Carolina workers’ compensation spend a lot of time ruminating about how to identify and stamp out fraud. When parties bilk the system out of money, not only do the costs ultimately get passed on to insurers, employers and employees who need benefits, but the bonds of trust that hold the system together also weaken.

To that point, the Ohio Bureau for Workers’ Compensation has its hands full dealing with a case of workers’ comp fraud out of Butler County. A chiropractor pled guilty last week to fraud and agreed to pay $104,000 in restitution payments as well as $5,000 to cover the cost of the investigation. Dr. Gary Berner took the plea deal to stop an impending trial. His Back and Spine Center had been at the center of a probe. Dr. Berner and three other employees of the Back and Spine Center faced multiple charges, including workers comp fraud, forgery (32 counts), theft, and racketeering. The other three employees have already been convicted of workers’ comp fraud – Dr. Berner’s trial will start up on March 29th. Dr. Berner, along with his partner, Dr. Bruce Holaday, allegedly developed a scheme to bill for services even after being banned to provide said services to hurt workers.

Obviously, in cases like this, unless you read the investigation very carefully and examine all the arguments that both sides make, you can’t really come to a clear determination. For instance, did the chiropractor and his co-workers harm their patients, or did they simple bend the rules in a relatively benign way? Hard to tell from a simple news account.

All that said, there is a “broken windows” aspect to consider. The “broken windows” theory of crime management suggests that, when a city, store, or other place winds up in disarray (e.g., lots of broken windows, trash on the floor, etc,) it becomes easier for people to “misbehave” and commit criminal acts. Likewise, when chiropractors get away with committing forgery, fraud, and theft, other doctors – who might be “on the fence” about whether to commit fraud or not – may take the plunge and commit illegal actions. Thus, as a precaution, it may be useful to severely punish those who skirt the law.

This debate aside, what’s important to remember is that the workers’ comp system should help injured workers heal and support them and their families. If you are having difficulties navigating the North Carolina workers’ compensation system, you don’t have to keep plugging away on your own.

Connect with a reputable and skilled North Carolina workers’ compensation law firm to go over potential solutions today.

More Web Resources:

“Broken Windows” theory

Dr. Gary Berner workers’ comp case

North Carolina Workers' Compensation Newsletter: Two Curious Cases from Last Week

February 28, 2011, by Michael A. DeMayo

Many North Carolina workers’ compensation news stories involve subtle and arcane discussions about insurance rates, employment policy, and the state’s fiscal strategy. This blog wanted to take some time out to examine two more “down to earth” stories that should hopefully pique your interest and stir up discussion.

1. First on the docket: crazy workers’ comp fraud case.

On February 23rd, the Louisiana Workforce Commission reported an arrest for workers’ comp fraud. The owner of Streamline Framing Incorporated, Richard H. Woodle, allegedly engaged in “willful misrepresentations by an employer and unlawful practices” and was hit with felony charges. A local news outlet reported that the business owner made false reports to his workers’ comp insurer for three years to get out of paying his workers’ comp premiums. By lying to his insurer, “it is estimated that Woodle avoided paying hundreds of thousands of dollars in premiums.” The man could face a decade behind bars for felony workers’ comp fraud.

2. Story No. 2: KFC retaliation.

A KFC worker claims that his employers retaliated against him for filing for workers’ comp.

Most North Carolina workers’ compensation claims (and claims from other states) involve straightforward scenarios. An office worker gets carpel tunnel syndrome and then seeks benefits to pay for her hand surgery, for instance. Or a hurt dockworker struggles with an insurance company to get fair payment for his disability.

An Illinois worker at a KFC has filed suit in Madison County Circuit Court, alleging that his employers fired him for filing a claim. Michael Franklin managed a KFC on Johnson Road for more than 8 years. Last January, he reported an injury to his employer and made a claim pursuant to the Illinois Workers’ Compensation Act. 11 months later, his employer fired him. Franklin wants Morgan Foods to pay him $100,000 for compensatory and punitive damages.

If you or someone you love has been engaged in a fractious dispute with an employer or insurance company over your benefits or another workplace issue, it may behoove you to get a free consultation from a reputable North Carolina workers’ compensation law firm.

More Web Resources:

Streamline Framing Incorporated workers’ comp fraud

KFC retaliation case

Baby Steps: Transitioning from North Carolina’s Workers’ Compensation Back to Work

February 9, 2011, by Michael A. DeMayo

Whether you’ve been on North Carolina workers’ compensation for two weeks or eight years, with your doctor’s blessing, you’re now ready to start looking for part-time work again. This blog post will give you ideas about how to make this transition as painless and productive as possible.

1. Don’t violate the terms of your North Carolina workers’ compensation arrangement

If you take certain work while on workers’ comp, you may violate the terms of your benefits. Not only could you lose your benefits as a result, but you could also get in trouble for North Carolina workers’ compensation fraud. Penalties for fraud can include fines as well as jail time, so play it safe.

2. Don’t go “all in”: Test your limits, and work incrementally towards a full return

For instance, say you twisted your knee badly on a construction site. Your orthopedist and physical therapist helped you recover full function of the damaged joint. Now you’re tempted for financial reasons to get back on site and start drilling holes (or whatever) again. Careful! A too-early return to work could undermine the sensitive reconstruction efforts.

Your basic process should be: “Start small. Test. Ramp up a bit. Test. Ramp up a bit more. Test again.” And so forth. Yes, it can be frustrating to have to hold back when you “know” you could handle more. But the goal here is not a one-time push or exertion – it’s the ability to engage productively in the work that you love for as long as you want to do that work. If you shortcut the recovery process, you may make it difficult, if not impossible, to recover fully.

3. Pay attention to medical issues that snag your attention

Often, in our desperation to return to gainful employment after an injury or illness, we ignore or subconsciously repress feelings of pain, uncertainty, and anguish. Especially if your family is depending on you to produce — and your coworkers and employer are counting on you to “step it up” in the wake of your recent time off — you may be tempted to go faster, harder, or more vigorously than your body is ready for. Don’t ignore your body!

One way to identify your subconscious feelings about your work is to keep a journal. Write down your experiences after every work shift. Note any chronic or acute pain or even general odd feelings you have about your job. Often, these written descriptions of your day-to-day work will give you clues to help avoid re-injury and even speed up your recovery. For instance, you might notice that a specific kind of bending exacerbates your pain. If so, talk to your boss about not having to do that bending work anymore.

4. Get advice you can trust

Is your employer giving you a hard time about your benefits? Are you caught up in insurance red tape? Are you confused about something you read on the North Carolina Industrial Commission (NCIC) website? If so, a qualified North Carolina workers’ compensation law firm can give you insight and guidance about how best to proceed.

More Web Resources:

North Carolina Industrial Commission (NCIC) website

going back to work “too soon”

North Carolina Workers’ Compensation Pundits Ponder Whether Illinois Awards Constitute Fairness or Fraud

January 6, 2011, by Michael A. DeMayo

Many in the North Carolina workers’ compensation community have spent some serious time looking over the $1.5 million settlement award handed out to prison guards at Menard Correctional Center in Illinois. In case you haven’t been following the news, this massive case has drawn attention throughout the nation not just because of its size but also because it represents (to some pundits) an example of systematic waste.

55 workers – most of them guards – will collect between $22,000 and $120,000 to pay for damages stemming from chronic hand, wrist, and elbow injuries they sustained while locking and unlocking manual crank wheels and keys. Approximately 10% of guards at Menard experienced serious repetitive trauma. The prison’s warden, 35 year-old David Rednour, will collect more than $75,000 not because of injuries he sustained at the correctional center but because of injuries he sustained at an earlier job working for the IL police department.

The $1.5 million settlement – and, in particular, Mr. Rednour’s settlement – has angered many local Illinoisans, including State Senator Kyle McCarter, who responded to the news with this passionate statement: “The abuses and the fraud in the workers’ compensation system in Illinois have gotten out of control and are costing tax payers more than they ever will know… we have to take a strong stand against this while helping out workers who are legitimately hurt on the job. The fraud and abuse has got to go. It’s driving business out of the state.”

Rhetorical opponents of the Senator in Illinois (and here in the North Carolina workers’ compensation community) would likely retort something to the effect of: “Yes, sure: abuse and fraud corrupt the system and generate problems for everyone touched by it. That said, is there a better way to deal with the costly and painful occupational injuries that these workers are stuck with? And if so, what is it?”

Unfortunately, debates over workers’ compensation often devolve into essentially political tantrums. One side says the workers’ comp system is bloated and corrupt. The other side says that benefits are essentially always appropriate.

Instead of this unproductive conversation, it might help to look for ways to shortcut problems. For instance, what if the injured correctional facility workers got better treatment for their repetitive stress problems? A growing body of evidence suggests that repetitive stress injuries are not merely “local” injuries. Rather, they involve chronic distortions of muscle, soft tissue, bones and ligaments. Therefore, they should be treated not necessarily with an array of modalities, such as strength training, trigger point massage, and enhanced body awareness.

The point here is that, rather than see cases like the Menard case devolve into shouting matches, let’s quit the blame game and get on to the business of drafting creative and results-oriented solutions.

To that end, if you or someone you care about has been struggling with a benefits-related issue, get immediate and confidential help from a top level North Carolina workers’ compensation law firm.

More Web Resources:

Menard Correctional Center

Debate over Menard Compensation

North Carolina Workers’ Compensation Analysts Look At Heartbreaking Fraud Escalation

December 30, 2010, by Michael A. DeMayo

The typical case of North Carolina workers’ compensation fraud involves only one kind of crime. But a breaking case out of the Bronx has been getting special attention throughout the workers’ comp community for its sheer complexity. On December 15th, New York police arrested 60-year-old Rosa Rivera, after prosecutors investigating her for federal tax fraud discovered that she had collected over $135,000 in workers’ comp benefits from New York State illegally. Ms. Rivera’s compounding legal woes illustrate just how seriously the government takes any fraud. Her story serves as a cautionary tale for those who have been toying with the idea of skirting the workers’ comp laws, rules and regulations.

It all began in 2002. Rivera, who had been working as a bookkeeper, hurt her elbow, ankle and knee at work. She claimed the injuries prevented her from working. The NY Workers’ Compensation Board awarded her $400 a week in benefits. Meanwhile, in 2004, right under the nose of authorities, she began operating an income tax filing service out of her home. She ran this business for 5 years, until she was stopped in October 2009 and charged with fraud for filing false tax returns for her business. In September, Ms. Rivera pled guilty to the federal charges and got ordered to pay restitution in excess of $150,000. She also faces a two year probation.

Now, with this additional workers’ comp fraud charge — a fraud amounting to $135,000+ allegedly purloined from the New York State Insurance Fund (NYSIF) — she may face up to 7 years behind bars. Her hearing at a Suffolk County Court has yet to be scheduled.

Defrauding the North Carolina workers’ compensation system – or any state system – can get you in serious trouble, even if you plead things like hardship or extreme circumstances. For instance, Ms. Rivera’s benefits of $400 a week certainly could not be considered lavish by any standards – particularly by New York City standards. So it’s understandable that individuals on worker’s comp might want to find ways to supplement their income. But if you skirt the law or bilk the system by lying about your injuries — pretending they’re worse than they really are — not only do you cheat the legitimately injured, but you also create hostility and distrust amongst the various participants in the NC workers’ comp system.

If you’ve been having trouble with an insurance company or employer — or with the bureaucracy in general — a qualified North Carolina workers’ compensation law firm can provide crucial, timely guidance. Empower yourself today by getting a better education in workers’ comp rules.

More Web Resources:

New York State Insurance Fund (NYSIF)

Rosa Rivera’s Double Trouble – Tax Fraud and Worker’s Comp Fraud

Cop Whacked with Fraud Charges; North Carolina Workers’ Compensation Pundits Delve into the Case

December 18, 2010, by Michael A. DeMayo

On December 8, New York police arrested Kevin Schwebke, a 26-year-old corrections officer, for felony grade workers’ comp fraud. North Carolina workers’ compensation pundits and others who follow stories about fraud and corruption in the world of workers’ comp, have been hotly discussing the legal and even moral implications of this matter.

First, the facts. Schwebke had been working at the Coxsackie Correctional Facility in 2009 when he got into an accident on the job that damaged his ankles. After undergoing surgery, Schwebke went on workers’ compensation. Up until Wednesday, he had amassed $34,000 in payments. Meanwhile, Schwebke continued working for the Cairo Police Department on a part-time basis – in violation of his workers’ comp arrangement. The Chief of Police, Chris Sprague, said that he had not been aware that Schwebke had been collecting workers’ comp.

If convicted of the class E felony charge, Schwebke could face a seven-year state prison sentence. He will appear at Albany County Court to face the charges at a later date.

This seemingly simple case has some very interesting implications. Let’s just say that the 26-year-old did in fact lie about his physical condition to collect the $34,000 illegally.

Is it really fair to punish someone for this level of minor fraud with seven years in state prison? Doesn’t that seem somewhat excessive, from a common sense standard? Obviously, you don’t want to reward workers’ comp fraud or encourage it in any way. But at least theoretically, it’s odd that someone who commits such a relatively minor crime (from a purely monetary standpoint) should be subjected to such a harsh potential jail sentence, especially when you consider that much more serious white collar crimes, like corporate fraud and embezzlement, often carry less punitive consequences.

On the other hand, North Carolina workers’ compensation fraud is a profound problem, not just in terms of the money it leeches from the system but also in terms of the culture of distrust it creates. When insurers can’t trust whether claimants are telling the truth, they ratchet up investigations and force legitimately hurt workers to jump through more hoops. When stories like Schwebke’s break, employers become more suspicious of their workers. It’s hard to quantify how all this distrust percolates through the system, but the toxic atmosphere surely drains time, resources, and money and makes it more difficult for the system to function effectively – that is, to rehabilitate legitimately hurt workers and get North Carolina’s workforce up and running at maximum effectiveness.

Have you been having trouble collecting your benefits due to your employer’s lack of cooperation or an insurance company’s recalcitrance? Whatever your issues, you may benefit greatly from engaging in an free confidential consultation with a reliable North Carolina workers’ compensation law firm today.

More Web Resources:

Kevin Schwebke’s arrest

Corrections officer accused of fraudulently accepting $34,000 in workers comp

A Win-Win for Everyone in the North Carolina Workers’ Compensation System: How to Increase Productivity without Working Harder

November 13, 2010, by Michael A. DeMayo

When policy analysts, insurance companies, employers, and employees come together to work on problems with the North Carolina workers’ compensation system, they inevitably look at things like cost control, red tape cutting, and the elimination of fraud. But the experts often overlook global solutions that could yield profound good for every entity in the system. This essay takes a look at some mechanisms that employers and employees can institute at their workplaces to boost productivity and efficiency without making employees work harder or longer.

This may sound like an impossibility. But good research suggests that these principles can be broadly applied to serious benefit for North Carolina workers’ compensation professionals.

1. The Pareto Principle (also known as the 80/20 rule)

A 19th Century economist named Pareto made the observation that 80% of systems often divide according to a kind of 80/20 principle. 20% of people in a population will own 80% of the population’s wealth, for instance. Similarly, 20% of the activities that you do at work will generate 80% of your profits. And so on. A careful deployment of the 80/20 rule in your office can eliminate time wasting and potentially dangerous repetitive activities and replace them with productive activities that generate more profit and create less of a strain on workers.

2. Parkinson’s Law

As author Tim Ferriss points out in his book, The 4-Hour Workweek, “Parkinson’s Law” is an excellent companion to the 80/20 rule. What this law states basically is that a task will fill up the amount of time allotted for it. So if you ask an employee to do a report in six hours, he will finish that report in six hours. If you ask him to do it in two hours, he will finish it in two hours. And the difference in quality between those two results will actually be surprisingly quite negligible. This may be counterintuitive, but Parkinson’s Law does bear out in many different cases, at least anecdotally. So you could use this principle to streamline machining processes, prevent workers from typing too much, and limiting the amount of hours and energy you put into dangerous activities, such as scaffolding work on a construction site (for instance).

3. Get People Talking

The best solutions to workplace dangers often come from the people closest to the problems. Corporate management in the United States – and in North Carolina – tends to work on a top down level. In other words, the CEOs and other high executives dictate terms to the people lower on the food chain. But this kind of practice leads companies to turn a blind eye to persistent ground level problems. If these problems could be solved, not only would the company benefit, but the employees would also get more control over their activities and hours and enjoy their work more – and be less at risk for workplace injuries.

If you’ve been hurt at work – or if one of your co-workers needs help – you should look to a qualified North Carolina workers’ compensation law firm to discuss strategies and tactics to get benefits in a timely fashion.

Developing an efficient and resourceful response to your workers’ comp problems is almost certainly doable, and the faster you get good guidance, the faster you will be able to resolve the stress associated with your injury and recovery and move on with your life.

More Web Resources:

Pareto Principle

Parkinsons Law

Ten-year Prison Sentence Handed Out in Fraud Case: North Carolina Workers' Compensation Experts Debate the Fallout

November 2, 2010, by Michael A. DeMayo

North Carolina workers’ compensation experts along with media analysts across the country are all talking about a momentous sentencing decision out of California. A Laguna Hills man convicted of perpetrating the biggest California workers’ comp premium fraud in history has been sentenced to a decade in state prison.

51-year-old Michael Vincent Petronella was ordered by the court to pay $500,000 in restitution to the CA State Compensation Insurance Fund on top of fines of equaling $550,000. In February, Petronella was found guilty of an unbelievable 33 felony counts of insurance fraud. According to an AP report, Petronella and his wife “fraudulently submitted 42 claims for uninsured workers and unreported $29 million in pay roll to avoid paying insurance premiums.” As a result of their scheme, the state lost millions in insurance premiums and over $250,000 in uncovered worker claims. At the same time, Petronella and his wife apparently lived a life of opulence. They owned 2 Ferraris, jewelry worth hundreds of thousands of dollars, and closets upon closets of apparel from luxury designers like Burberry, Chanel, and Gucci.

Petronella’s ex employees and the local Deputy District Attorney complained that the judge did not order even more forced restitution. The Deputy DA, who had asked that Petronella pay $35 million to California, said that “the court’s ruling establishes that it pays to commit fraud.” The DA wanted Petronella to spend 37 years in jail. She expressed contempt for the judge’s decisio: “[Petronella] has taken no responsibility for his conduct… when he gets out, he will do it again.”

North Carolina workers’ compensation policymakers pay attention to out of state fraud cases to understand potential industry-wide implications. Since this case against the Laguna Hills roofer may be the biggest in California’s history, the decision could indirectly inform future debates over the correct punishment for workers’ comp fraud.

Pulling back from the abstract, for a second, what might this case tell us about the rights and responsibilities of individual claimants? The biggest takeaway is that a claimant needs to be mindful of adhering closely to the rules. Even if you don’t “intend” to cheat the system, you can still be flagged for problems with your claim if, for instance, you shortcut your paperwork or miss a deadline.

If you’ve been dealing with issues regarding your claim, consult with a reputable and highly credentialed North Carolina workers’ compensation firm to strategize about the most efficient ways to eliminate the constraints on your benefits.

More Web Resources

Michael Vincent Petronella sent to prison

Roofing contractor gets 10 years for workers’ comp fraud scheme

Race to the Bottom? North Carolina Workers’ Compensation Analysts Examine Crazy Fraud Case out of Massachusetts

October 26, 2010, by Michael A. DeMayo

Most cases of fraud – attempting to game the North Carolina workers’ compensation system, for instance – involve a certain degree of subtlety. For instance, this blog recently covered the sad case of a woman who got accused of workers’ comp fraud after she took a job as an exotic dancer to supplement her income – and then got caught by insurance investigators. In that case, what the defendant did was clearly wrong, but her circumstances seemed bleak and thus somewhat sympathetic.

A breaking case out of Massachusetts contains none of that kind of subtlety. According to Fox News in Boston, John Cloutier, a former prison guard who got on workers’ comp after getting injured on the job in July 2008, has been arrested for fraud. An insider tip revealed that he had been running half marathons and marathons – all while claiming that his lower back was permanently injured.

Here is the basic timeline.

* In July 2008, Cloutier allegedly got injured.

* Starting in January 2009, he started collecting workers’ comp benefits. The 45-year old collected $56,000 between last January and this March.

* After being out of work for half a year for his “lower back injury,” Cloutier ran half a marathon and then a full marathon at Walt Disney World in Florida. In September of 2009, Cloutier did it again – he traveled to California and ran another half marathon.

* In the midst of all this running around, Cloutier applied for disability retirement in June 2009 – an arrangement which would give him 72% of his former salary ($62,000) every year for the rest of his life – tax free.

Cloutier was arraigned on October 26 for fraud charges in Massachusetts Suffolk Superior Court and released on his recognizance. His next court appointment is July. If he is convicted of all the charges against him, he could face 5 years in prison as well as array of fines and other penalties.

It’s impossible to tell from a simple news story whether Cloutier actually committed this crime or not. That’s why it’s important not to rush to judgment on a person. But North Carolina workers’ compensation fraud cases (and fraud cases throughout the United States) do drain millions of dollars from the system. This money could otherwise go to people who legitimately struggle with lower back injuries and other occupational illnesses or diseases.

If you or a family member has suffered a problem that’s prevented you from working, connect with an experienced and responsible North Carolina workers’ compensation law firm to discuss potential remedies. A quality firm can help you make sense of your rights and your obligations, keep you strategically focused on maximizing your benefits and minimizing your hassle, and help you defuse constraints that may be preventing you from collecting your benefits.

More Web Resources

John Cloutier legal problems

Another story about the prison guard and his marathon fraud fallout

Fraud in the LAPD – North Carolina Workers’ Compensation Experts Weigh In

October 14, 2010, by Michael A. DeMayo

Last week, LAPD Officer Robert Yanez got arrested at police headquarters in downtown L.A. for workers’ comp fraud – provoking a lively debate among policy analysts and other North Carolina workers’ compensation experts. The 38-year-old officer got hurt in October 2008 on the job. After being ordered back to work by his doctor, he allegedly switched physicians and forged/altered his doctor’s notes to continue getting payments.

All told, the 11-year-veteran LAPD officer allegedly did this multiple times – he got charged with six total counts – and cost his department around $7,000. Officer Yanez was held at the Men’s Central Jail in downtown L.A. on $30,000 bail. If convicted, he could face seven years behind bars. According to a statement from the LA County DA’s Division of Healthcare Fraud, investigators discovered “probable cause to believe that Officer Yanez had received benefits to which he was not entitled.” According to news reports, the LA Police Officers Union is not representing him in this case, and Officer Yanez is on home duty until the investigation finishes.

North Carolina workers’ compensation
fraud – and workers’ comp fraud throughout the US – drains millions of dollars from the system and creates problems not only for insurance companies and employers but also for employees who have legitimate claims. The workers’ comp system is designed to help legitimately hurt or ill people make ends meet until they can recover. Unfortunately, a few bad apples do take advantage of the system and even resort to explicitly fraudulent activities (such as doctoring a doctor’s note) to avoid having to go back to work.

In response to fraud cases like this one, insurance companies may put in place more cumbersome screening procedures; employers may get more suspicious of workers who make any claims; and injured employees may find it more challenging to make the system work for them.

If you have been unfairly charged with fraud – or if you are dealing with some other issue with your benefits – such as an employer not paying a legitimate claim or an insurance company gumming up your claim by stalling or using bullying tactics – you may benefit significantly from a free consultation with a North Carolina workers’ compensation law firm. Smart attorneys and their associates – who understand the system and the law – can reduce your level of uncertainty and stress and steer you on a course to maximize your recovery and maximize your benefits.

More Web Resources

Veteran LAPD officer accused of workers’ compensation fraud

LAPD officer accused of workers’ comp fraud

Depressing PA Case Attracts Attention from North Carolina Workers’ Compensation Experts

August 12, 2010, by Michael A. DeMayo

A few months ago, this North Carolina workers’ compensation blog reported about the case of Christina Gamble, a 43-year-old woman who got arrested on charges of workers’ comp fraud, after insurance investigators found that she had been stripping while collecting disability benefits, ostensibly because she had trouble “standing and changing positions.”

The 43-year-old Gamble waitressed at Red Robin Restaurant in 2007. She allegedly hurt her back at work. In 2008, a judge granted her disability benefits of $360 a week. All told, she collected $4,000+ in expenses and $23,000+ in disability payments. However, the restaurant’s insurance representatives hired private investigators to track down Ms. Gamble. They found her working as an exotic dancer at CR Fanny’s Gentleman’s Club in nearby Wilson. The PIs taped her stripping and used this evidence to prove that her workers’ comp claim was fraudulent.

Obviously, any North Carolina workers’ compensation fraud case hurts everyone else in the system. When people fake disabilities or play up injuries to get benefits, this not only drains resources that could otherwise be used to help people who really are injured – but it also creates a sense of mutual distrust. When insurers and employers lose trust, they tend to crack down by making the process more difficult and the investigations more probing, personal, and annoying.

All that said, in the case of Ms. Gamble, you have to feel some sympathy for this woman. It sounds like she has had a very hard go of it. It’s obviously impossible to know her full story just from a news report. But it is important to remember that North Carolina workers’ compensation fraud comes in many flavors – some people purposely bilk the system to take advantage of loopholes; other people just get into desperate straits and do desperate and stupid things.

If you or a family member faces problems collecting benefits, your focus is 100% on getting these issues resolved ASAP. To that end, you might be well advised to set up a free consultation with a local North Carolina workers’ compensation firm to explore your rights, build a strategy to get your benefits and to resolve any agita associated with your claim, and work towards building a sustainable financial future for you and your family.

More Web Resources

CR Fanny’s Gentleman’s Club


Bucks woman to stand trial in workers’ comp case

Another Fraud Case – This One Involves Goats! – Has the North Carolina Workers’ Compensation Community Talking

August 10, 2010, by Michael A. DeMayo

North Carolina workers’ compensation experts have been following a bizarre breaking story out of Chenango County, NY.

According to the Associated Press, a 53-year-old New York woman named Susan Tansosch has been ordered to pay over $60,000 in restitution to the United States Postal Service for workers’ comp fraud, pursuant to charges that she falsely claimed that she had no additional income streams – when she had been making significant money selling goats.

Last Wednesday, Judge Thomas McAvoy sentenced Tansosch to four years probation and forced restitution to the USPS for making untrue statements to collect workers’ comp benefits from the federal government. The Department of Labor abruptly ended Tansosch’s benefits – all because she sold goats on the side.

This story drives home a point that many North Carolina workers’ compensation claimants often forget. Namely, that you need to read and understand the fine print of your benefits arrangement. If you fail to abide by the terms stipulated, you could wind up in court, in trouble, and in debt to the agency or insurer that provided the benefits to you.

There is no way to tell from this AP story whether or not Ms. Tansosch knew that selling goats would violate her workers’ comp arrangement. But don’t think that, just because you settle your North Carolina workers’ compensation case, that the situation will be permanently resolved. Insurance carriers are businesses. They investigate claims — even after they have settled! — to make sure that claimants are/were telling the truth about their injuries.

Managing the legal complications of a debate over your benefits can be a draining chore – one that you likely do not have the training to handle adroitly. That’s why, even if your case is relatively simple-seeming now, you might benefit from a consultation with a reputable and proven North Carolina workers’ compensation law firm. As the old adage goes, an ounce of prevention is equal to a pound of cure. Smart planning can mean the world for your workers’ comp case.

More Web Resources

NY goat-seller must pay back workers’ comp

Woman sentenced after conviction

Theft Case Out of the Aloha State Piques Interest among North Carolina Workers’ Compensation Experts

August 5, 2010, by Michael A. DeMayo

North Carolina workers’ compensation experts are all talking about the case of an Ewa Beach man, who got convicted in Honolulu last week for workers’ comp theft.

Jacob Belaski allegedly hurt himself while operating his Teixeira Trucking business. He fought for benefits from his insurance company, HEMIC. At the same time, he continued (on the sly) hauling materials to and from a cement factory. In the process, he earned over $100,000 – all while collecting benefits compensating him from being unable to work.

Investigators from the Honolulu Police Department’s White Collar Crime Unit discovered the scam and realized that Belaski had misrepresented his injury to his physicians, insurance company, and others. Mr. Belaski even testified under oath to being hurt. Mr. Belaski’s conviction of theft and perjury charges may dissuade others in the Aloha State from similarly trying to take advantage of the claims process to collect benefits illegally.

This blog has investigated a number of cases of workers’ comp fraud lately to try to highlight the shades and nuances of the law – and of the individuals who commit these crimes. It’s important not to paint these defendants with a broad brush. As we have seen recently, practically anyone can wind up as a defendant in a North Carolina workers’ compensation fraud case – from strippers to goat sellers to truckers.

If you cannot collect benefits, cannot deal efficiently with your employer or insurance company, or cannot figure out how to put your life and budget back together again after a significant injury or illness, you need good help. In particular, a qualified North Carolina workers’ compensation law firm can guide you towards good resources and ensure that you stay within the bounds of your benefits arrangement. A good attorney can also help you deal with uncooperative bosses or insurance companies.

More Web Resources

Case of Jacob Belaski

Honolulu Man Convicted in Hawaii’s First Workers’ Compensation Theft Related Case

$1.25 Million Earmarked to Fight Workers’ Comp Fraud in CA – What Do North Carolina Workers’ Compensation Specialists Think of This Move?

July 8, 2010, by Michael A. DeMayo

The California Department of Insurance made a decision in early July to earmark $1.25 million to battle workers’ comp insurance fraud. Steve Poizner, the often-in-the-news CA Insurance Commissioner, remarked that “fraud creates costs that burden our economy at a time it can least sustain it.”

Those in the North Carolina workers’ compensation community have reacted strongly to California’s decision. Advocates of similar measures here at home argue that funneling money into fraud control can help the system be more functional and protect benefits to attend to the needs of truly injured workers. Opponents of stronger fraud control worry that antifraud dragnets might accidentally sweep up legitimate claims. For instance, take someone who ordinarily would qualify for North Carolina workers’ compensation for a hurt lower back. She might wrongly be denied benefits — or at the very least given an overly hard time to qualify for them.

If you or a loved one or a coworker has experienced problems collecting benefits from a non-cooperating employer or bad faith insurance company, you may have rights and legal means at your disposal that you may not even be aware of. To find out how to protect your interests optimally, connect with an experienced North Carolina workers’ compensation attorney ASAP. Whether you have been improperly identified as trying to defraud the system, or you are having a simple vexing issue with your workers’ comp, get good help now before it’s too late for you and your family.

More Web Resources:

California Department of Insurance

County tentatively slated to receive $1.25 million for worker’s comp fraud

North Carolina Workers’ Compensation Fraud Analysts Follow a Major Scam out of New York

July 6, 2010, by Michael A. DeMayo

Kenneth Bullock, a St. Regis, New York man, has been charged with fraud in conjunction with a scheme that he allegedly had perpetrated since the early 1990s. North Carolina workers’ compensation blogs and analysts are closely following the story.

Background

Bullock worked as a mechanic in New York in the 1990s. While executing his duties, he hurt his back — or so he claimed. Bullock said that his at-work accident rendered him unable to keep servicing cars, and he was put on workers’ comp. While collecting benefits, he moved to Florida and took another mechanic’s job – in direct violation of his workers’ comp arrangement.

If convicted of scamming the system, Bullock could face seven years imprisonment for illegally collecting $39,000 in benefits. Allegedly, surveillance caught Bullock working at a shop – investigators were tipped off when his claims arrived with Florida postage. The Onondaga County Insurance Fraud office will handle the matter, since that location processed Bullock’s claims.

North Carolina workers’ compensation fraud
drains hundreds of thousands (if not millions) of dollars of funds from an already over-milked system every year. It’s obviously in the interest of all parties concerned – from trial attorneys to insurers to employers to injured workers – to clamp down on scams and schemes. Unfortunately, many injured workers with very legitimate claims wind up under investigation for fraud simply because they fail to file paperwork correctly or because they engage in activities to “stretch” themselves – such as aggressive physical rehab.

If you or a family member or a coworker has been wrongfully targeted for North Carolina workers’ compensation fraud, and you need guidance to make sure that you can collect benefits (and not get punished for making an illegitimate claim); or if you simply need basic FAQs answered about how to deal with a difficult employer or how to fight back against a recalcitrant insurance company, get in touch with a credentialed and experienced North Carolina workers’ compensation attorney ASAP. Get good guidance upfront, so you don’t wind up in a protracted battle over your benefits.

More Web Resources:

St. Regis man charged in alleged workers’ comp scam

Franklin County native charged with fraud

North Carolina Workers’ Compensation Experts Debate Wells Fargo Ruling Out of Minnesota

June 14, 2010, by Michael A. DeMayo

Last Wednesday, the multinational bank Wells Fargo was ordered to pay out $30 million to four non-profit entities, pursuant to a jury’s verdict that the bank participated in fraud. North Carolina workers’ compensation policy analysts have been reviewing the case to see whether it may have interstate implications.

The four non-profit entities — the Minnesota Workers’ Compensation Reinsurance Association, the Robins, Kaplan, Miller and Ciresi Foundation for Children, the Minnesota Medical Foundation, and the Minneapolis Foundation — all alleged that Wells Fargo essentially tricked them into believing that they were investing in low risk options, when in actuality the bank had been funneling their money into risky investments which blew up during the recent credit collapse. The jury found that the bank violated the Minnesota Consumer Fraud Act (and other laws). Punitive damages have yet to be assessed against Wells Fargo.

Representatives for the bank expressed disappointment about the decision, although it could have been worse for Wells Fargo. The non-profits asked for $400 million — more than ten times what the jury returned.

The litigation over punitive damages (and the potential Wells Fargo appeal) could stretch on for years – a not uncommon phenomenon in North Carolina workers’ compensation cases in which millions of dollars hang in the balance.

Most individual workers’ comp cases involving occupational diseases, injuries at work, and conflicts with insurers do not take as long to resolve and do not get nearly as complicated as the Wells Fargo case. Nevertheless, if you or a loved one faces friction getting benefits, dealing with an insurer, or managing the deadlines associated with your claim, connect at once with a reputable and experienced North Carolina workers’ compensation attorney to review your strategic options and make sure that you’ve dotted all your I’s and crossed all your T’s.

More Web Resources

Wells Fargo vs the non-profits

Minnesota Workers’ Compensation Reinsurance Association

North Carolina Workers’ Compensation Experts Debate New Workers’ Comp Fraud Case out of Quakertown, PA

May 18, 2010, by Michael A. DeMayo

A sad and disturbing fraud case out of Pennsylvania has North Carolina workers’ compensation policy makers and analysts furiously debating a number of moral and ethical quandaries.

Background

On April 29, authorities arrested 43-year-old Christina Gamble for workers’ comp and insurance fraud stemming from a claim she made in November 2007 that she allegedly made under false pretences.

The PA Attorney General’s office alleges the following:

Gamble had been working for the restaurant Red Robin, when she fell on November 9, 2007 and hurt her back. The restaurant alerted its insurance carrier. In November 2008, a judge awarded her benefits for workers’ compensation. She collected over $22,700 in disability benefits and $4,100 in medical expenses before being caught working in a new capacity – as an exotic dancer for C.R. Fanny’s Gentlemen’s Club and Sports Bar. A private investigator tipped off an agent of Highmark Insurance, which had been representing Red Robin. Since Gamble made her claim on the basis that she could barely move her back, her work as a dancer for hire obviously completely undermined her claim.

Gamble is due in court on May 7. If she is convicted of both accounts of insurance fraud and theft, she could face 14 years in jail and $30,000 in fines.

Workers’ comp and insurance fraud are obviously reprehensible. Enforcement of North Carolina workers’ compensation laws must be strict to ensure that people who do play by the rules get treated fairly and that system-wide costs don’t get out of control. Nevertheless, this case illustrates – or at least implies – how difficult it can be for some people to recover from bad injuries or occupational diseases. Here is a story of a waitress who presumably hurt herself and then did a wrong thing by stealing from her employer’s insurance carrier. But (likely) the news story does not give us the full human dimensions of Gamble’s struggle. As anyone who has personally dealt with North Carolina workers’ compensation issues can tell you, it’s not easy to handle insurance companies or to figure out how to correctly and efficiently get your life back on financially solid ground.

To that end, before you or a family member does something dumb like try to defraud an insurance company or misreport numbers on your workers’ compensation form, connect with an ethical, reliable, and results-proven North Carolina workers’ compensation attorney to discuss your situation in confidence. A free consultation can give you the strategic guidance you need to make wise and ethical decisions about how to move forward and recover from an injury, both medically and financially.

More Web Resources:

Christina Gamble fraud saga

Strip club no cure for her bad back

North Carolina Workers’ Compensation Experts Abuzz about Albany Felony Charge

May 12, 2010, by Michael A. DeMayo

A relatively small felony case is turning the heads of top North Carolina workers’ compensation specialists. According to news sources, a 48-year old man named Richard Scepkowski pled guilty to felony workers’ compensation fraud after being caught working at an auto repair center. Scepkowski worked for the Transportation Security Administration (TSA) at Albany’s airport before claiming injury around July 4, 2004. He filed workers’ comp paperwork with the Department of Labor and collected a payout of nearly $20,000 from September 2004 through August last year. This amount is (relatively) minor as far as workers’ comp fraud cases are concerned. But since Scepkowski pled guilty to making false statements, he now faces an array of strict penalties.

How This Small Case Relates Back to North Carolina Workers’ Compensation Concerns

1. It illustrates how persistent the government can be in terms of rooting out fraud and punishing offenders.

Scepkowski got away with collecting federal workers’ comp for more than five years before getting caught. This shows that people who attempt to defraud the North Carolina workers’ compensation system will always be at risk for getting caught and facing severe financial penalties and potentially other punishments, such as jail time.

2. Even small instances of workers’ comp fraud will be taken very seriously.

A felony conviction can result in jail time and the permanent loss of certain privileges, such as the right to vote in elections.

3. The case shows how important it is to file your workers’ compensation paperwork carefully.

In this case, a claimant willfully deceived the DOL in his paperwork. Nevertheless, even otherwise well-intentioned claimants who make mistakes in their applications can get in big trouble – or at the very least lose hard-won benefits.

If you have any questions about the North Carolina workers’ compensation process or about your paperwork, connect ASAP with a reputable and experienced NC workers’ comp attorney to learn more about your rights and responsibilities under state and federal law.

More Web Resources:

Scepkowski case

Another story about Scepkowski fraud

North Carolina Workers’ Compensation Policy Alert: Another Offender Hit with Harsh Penalties (Including Two Years Prison Time) for Federal Workers’ Comp Fraud

May 10, 2010, by Michael A. DeMayo

Those who follow North Carolina workers’ compensation policy debates often closely analyze minor court cases because these cases inform the broader discussion. To that end, we will review the implications of a recent US District Judge’s decision to sentence a former US Navy employee for workers’ comp fraud by sending him to prison for 21 months and compelling him to pay nearly $0.25 million in restitution to the Department of Labor.

Background

Mark Correnti worked for the US Navy for years as a civilian employee. In 1989, he hurt his back. Starting in the year 2000, he began collecting $2,000 a month from the Department of Labor in federal workers’ compensation for his back injury. These payments continued through 2008, during which time he accrued over $0.25 million.

According to prosecutors, Correnti violated the Federal Employees Compensation Act by starting up a small business, Safe & Sound Storage, and collecting income from this business. At seven different times, Correnti denied that he was bringing in money from this business. (These false statements allowed him to keep collecting federal workers’ comp.) After being caught, Correnti pled guilty last November to charges of making false statements, and the US District Judge sentenced him in late April to the harsh terms outlined above.

Now, obviously, most North Carolina workers’ compensation claimants work hard to understand their obligations and to avoid putting up red flags that might indicate fraud or non-compliance.

Nevertheless, claimant errors and omissions can torpedo otherwise valid North Carolina workers’ compensation claims. In other words, even if you did legitimately hurt your back lifting an object at work, for instance, your claim could be invalidated or downgraded if you don’t follow the correct protocol.

Fortunately, you don’t have to go through the rigmarole of applying for and securing workers’ comp benefits on your own. By connecting with a vetted, strategically focused, and experienced North Carolina workers’ compensation legal team, you can save yourself a lot of hassle and increase the likelihood of collecting the maximum benefits.

More Web Resources:

Federal Employees Compensation Act

Mark Correnti case

A Case that Should Be on Most People’s North Carolina Workers’ Compensation Radar but Probably Isn’t — Major Fraud Reported in San José!

April 26, 2010, by Michael A. DeMayo

Most North Carolina workers’ compensation fraud cases pale in comparison with two breaking stories out of California.

The first involves a San Jose man named Daniel Nelson, who allegedly bilked the CA State Compensation Insurance Fund out of nearly $60,000 by failing to report $600,000 in payroll for his businesses (Monster Magic LLC and Worldwide Attraction). According to the DA’s office in Santa Clara County, an investigation began shortly after it was discovered that Monster Magic and Worldwide Attractions had failed to report nearly $80,000 in payroll for the 2006 calendar year. But the amount of underreporting turned out to be nearly 10 times that much — all told, investigators found over $614,000 in underreported payroll. Nelson was arrested by deputies in Alameda County and held on a $50,000 bail. If convicted of California workers’ compensation fraud, he could face a $50,000 fine and a jail sentence of up to five years.

Meanwhile, in a separate matter, a man named Mitchell Zogob faces a decade in California prison for collecting nearly $5 million in fraudulent California workers’ compensation insurance premiums. Zogob pled guilty to a gamut of offenses. Experts who followed the case interpreted the sentence to be a shot across the bow to other would-be workers’ comp defrauders.

How does North Carolina workers’ compensation fraud impact employees, employers, insurance companies, and the economy as a whole?

When someone bilks the NC workers’ comp system, everyone ultimately pays. Fraud does two things. First, it removes money from the system that could (and should) go to deserving claims. Second, it encourages insurers and watchdog agencies to vet claims more thoroughly. Thus, claimants with legitimate grievances often must go through extensive hurdles to collect their (rightly-owed) benefits.

Indeed, occasionally, legitimate claims get flagged as “false positives” for fraud. If you or a family member has been wrongfully accused of North Carolina workers’ compensation fraud, or if you need help with anything else regarding your workers’ comp matter, look to an established and peer-reviewed NC workers’ comp law firm near you to get strategic advice.

More Web Resources:

San Jose Man Arrested for Workers’ Comp Insurance Fraud

OC man gets 10 years for $4.6m insurance fraud

North Carolina Workers’ Compensation Issues Raised by Lawsuit in California on Behalf of Ageing Football Players (Part I)

April 20, 2010, by Michael A. DeMayo

Most North Carolina workers’ compensation cases that this blog covers pertain to local events — debates about insurance coverage, fraud schemes, and occupational disease and injuries that relate specifically to North Carolina industries, such as tobacco (covered in a recent post), or tech (e.g. incidents out of the Research Triangle). But for this week and next week, we’re going to do a two-part investigation into a breaking story out California that may have serious implications for North Carolina workers’ compensation policy.

As reported in the New York Times last week, the National Football League and its insurers have been embroiled in a dispute over whether ageing football players should be entitled to California workers’ compensation for dementia. Already, due to California’s peculiar laws, several hundred former NFL players have filed for comp in CA. An NFL player who played even one game in California can file a claim for cumulative damage… even for injuries sustained years or even decades ago.

Point is, California has become a battleground for the NFL workers’ comp debate.

The newest wrinkle involves a dispute over the cause of dementia in NFL players. The New York Times story discussed the case of Dr. Eleanor Perfetto, the wife of Ralph Wenzel, an NFL lineman who played in the 1960s and ‘70s and who’s been hospitalized with severe dementia. Dr. Perfetto and her supporters contend that Wenzel and other NFL players in his generation (and afterwards) sustained cumulative damage playing football and that this damage caused (or at the very least exacerbated) the dementia.

If Dr. Perfetto’s claim on Mr. Wenzel’s behalf leads to a ruling in her favor–experts guess it would be about a $1 million settlement–it would open the door to dozens of similar claims. The Times’ story suggests that, all told, this could lead to over $100 million in claims. This money would not come from state coffers; it would come from the NFL and its insurers. Given that the NFL rakes in more $8.5 billion a year, this might seem like “a drop in the bucket,” but $100 million is $100 million, and experts expect a significant battle over this.

Dr. Perfetto claims that her husband’s care costs over $100,000 a year and that evidence significantly supports the theory that playing in the NFL increases the likelihood of getting dementia. For instance, in a recently conducted NFL commissioned study (published last September), players between the ages of 30 and 49 reported memory related problems at more than 19 times the normal rate for their age group. In addition, West Virginia University and Boston University researchers have discovered “traumatic encephalopathy” in the brains of diseased former NFL players — a telltale sign that cumulative football-related head trauma can in fact lead to dementia.

If you or a loved one has been suffering from an occupational disease or an injury sustained at work, it may behoove you to talk with a North Carolina workers’ compensation lawyer ASAP to develop a strategy for how to collect money owed to you. Take proactive action today to ensure that you collect the benefits that you and your family need to move forward and level your budget.

More Web Resources:

In N.F.L. Fight, Women Lead the Way

Ex-NFL Players Pursue Workers’ Comp

North Carolina Workers' Compensation Fraud Watchers Astounded by Salacious Case out of California

April 13, 2010, by Michael A. DeMayo

Bloggers who follow North Carolina workers’ compensation fraud cases have been riveted by a scandal out of San Francisco, California that’s captured national headlines.

Here is the nitty-gritty:

High-ranking Department of Corrections official John Smiley and his wife have been arrested for a workers’ compensation fraud following a shootout at a San Francisco swingers club.

Mr. Smiley alleged that one of his parolees shot him and that he deserved $2.4 million in workers’ comp benefits. His sympathetic co-workers also set up a golf tournament to rake in funds for him, netting him $30,000. In addition, John and his wife’s mother made a website, on which he expanded on his lie that a parolee shot him.

The truth, according to investigators, was a lot more salacious and twisted. Apparently, Smiley and his wife had gone to a swingers club, connected with another couple, and Smiley had sex with a female partner. But during intercourse, his condom broke open, and the woman’s partner became enraged and shot him.

If the allegations against the Smileys are true, not only is it a black eye for the Department of Corrections but is also a wake up call for North Carolina workers’ compensation fraud experts to double-check to make sure they are doing due diligence.

Individuals who make false allegations about injuries and occupational disease to game the North Carolina workers’ compensation system cause problems for everyone else. Insurers must raise rates to make up for costs, employers must carry more insurance, and employees who actually deserve benefits may have to jump through more hoops and may see fewer benefits over the long term.

Unfortunately, due to the prevalence of North Carolina workers’ compensation fraud schemes (and schemes in other states), legitimate claimants suffer undue harassment. If you or a loved one is having trouble dealing with an insurance company, an employer, or even with the North Carolina Industrial Commission, you might want to connect with a credentialed and vetted North Carolina workers’ compensation lawyer ASAP to go over your concerns and figure out a plan of attack.

More Web Resources:

John Smiley


Smiley Website

North Carolina Workers’ Compensation Policy Analysts Examine Case Out of Montana with Potentially National Implications

April 7, 2010, by Michael A. DeMayo

North Carolina workers’ compensation policy analysts and lawyers have been closely following a breaking story out of Butte, Montana involving a Homeland Security worker who attempted to rob Montana’s workers’ compensation out of almost $30,000.

40-year-old Richard Hannum pled guilty last Wednesday, according to the AP, of pretending to have injured his back while working as Transportation Security Administration (TSA) officer at a Montana airport. Hannum had claimed that he wrenched his back while lifting luggage and that this had caused him to be permanently disabled. But one of his workers’ compensation doctors saw him walking around a mall normally and without pain. The doctor alerted authorities, who followed him and ultimately videotaped him engaging in normal activities – which belied his claim that he was bedridden.

Hannum’s case is interesting, in particular, because it falls under federal jurisdiction. He didn’t collect his money from the Montana workers’ compensation system – he collected directly from the Department of Labor and Homeland Security.

Some North Carolina workers’ compensation fraud cases involve the defrauding of federal coffers as well. But these cases are rarer, and they can be legally more significant.

As this blog has discussed many times, North Carolina workers’ compensation fraud hurts not only the state system, insurers, and employers, but also beneficiaries. When someone steals money from the limited North Carolina workers’ compensation benefit funds, it has a ripple effect. With less money to go around, insurers, employers, and even state and federal overseers of workers’ compensation claims will be more dubious in the future of all claims. This means more invasive investigations and longer wait times before claimants can collect their benefits. So cracking down on North Carolina workers’ compensation fraud is ultimately in everyone’s interest.

That said, if you have been accused of North Carolina workers’ compensation fraud – and you are legitimately hurt – or if you are having trouble with other aspects of your claim, it’s probably a wise move to retain a reliable NC workers’ comp attorney as quickly as possible. A good representative can help you strategize and explain what to do and what not to do when confronting parties like your employer and the responsible insurance company.

More Web Resources:

Richard Hannum

Butte, Montana

Major Chicago Fraud Case Mirrors Other North Carolina Workers’ Compensation Fraud Matters

March 17, 2010, by Michael A. DeMayo

According to the Chicago Sun-Times, three individuals have been indicted for perpetrating a healthcare fraud in excess of a million dollars – the case has North Carolina workers’ compensation experts buzzing.

Details of the Crime

According to allegations, three individuals – Dr. Jacob Solomon, a chiropractor named Darwin Minnis, and a biller named Gary Strauss — collaborated from 2004 to 2007 to falsely bill over a million dollars worth of claims at a West Chicago doctor’s office. Strauss and Solomon have been slapped with one count of healthcare fraud. Minnis, who owned and ran the Maywood Spine and Joint Rehabilitation Center, faces 18 separate counts of fraud. The three inflated claims for insurance payments and workers’ compensation. They are due to be arraigned in federal court.

Many North Carolina workers’ compensation cases “rhyme” with this Chicago case. Often, one (or a handful) of individuals collaborate over a long period of time to slowly but surely bilk the workers’ comp system. In the short-term, the amount of money stolen is usually not enough to send up red flags. But over the long-term, this money can add up to something substantial. (This blog reported only few months ago about a local woman who netted tens of thousands of dollars before being busted for North Carolina workers’ compensation fraud.)

How do these fraud cases debilitate the system?

• First of all, any time someone drains money from the system, that shortfall must be made up through higher premiums, poorer care, and thinner benefits.
• Second, North Carolina workers’ compensation fraud creates an atmosphere of distrust. If doctors, insurers, employers, and employees cannot count on the system to be fairly run, they may choose to go around it or choose to ignore other pertinent and important rules of protocol.
• Finally, fraud cases – whether perpetrated by employers, insurers, or employees – create pressure on the parties that payout North Carolina workers’ compensation benefits to vet claimants more closely. Unfortunately, this enhanced vetting often snares innocent parties. For instance, someone who may have legitimately hurt his back in a work related lifting accident may come under close scrutiny by his insurance company. Many a legitimate claim has been denied because of this kind of irrationally strict vetting.

If you or a loved one has been battling over benefits, it is a good idea to speak with a knowledgeable North Carolina workers’ compensation lawyer as soon as possible. Good, strategic legal advice can help you compel an insurer to pay out a full claim and can end annoying and potentially illegal harassment. The more knowledgeable you are about your rights under the system, the easier time you will have of collecting benefits owed and recuperating from your injuries.

More Web Resources:

Maywood Spine and Joint Rehabilitation Center

Maywood Clinic Linked to Fraud

North Carolina Workers’ Compensation Experts Debate Massive World Trade Center Lawsuit Settlement

March 15, 2010, by Michael A. DeMayo

High profile North Carolina workers’ compensation experts have been vigorously debating last week’s settlement arrangement regarding compensation for 10,000+ plaintiffs who were exposed to toxic contaminants while cleaning up the rubble at the World Trade Center subsequent to the September 11, 2001 attacks.

According to the New York Times, US District Court Judge Alvin Hellerstein met with lawyers for the city and for the plaintiffs last week to go over the terms of the payout. Assuming 95% of the plaintiffs sign on to the agreement, the settlement will go forward. If only 95% agree, the settlement pot will be $575 million. If 100% of claimants agree, the pot will be raised to $657.5 million.

The New York Times quoted NYC Mayor Bloomberg saying that the arrangement was “a fair and reasonable resolution to a complex set of circumstances.” Both city lawyers and lawyers for the plaintiffs seem pleased by the arrangement. Under the terms, a special claims administrator will evaluate plaintiff claims, determine whether specific plaintiffs can participate in the compensation, and allot moneys to be paid out. Some people will likely be awarded only a few thousands of dollars. Others may qualify for over a million dollars.

Many plaintiffs fear that they might develop cancer or another chronic condition that might not manifest for a while due to their exposure, so the settlement stipulates that a special fund of over $23 million will be set aside to pay for their insurance policy costs.

The legal battle over how and whether to compensate victims who got exposed to chemical contaminants, particulate debris, and other hazards at the World Trade Center cleanup site has taken years to resolve. According to the NY Times, the battle cost the city over $200 million in legal fees.

A claims administrator is scheduled to start hearing cases in the middle of May. He or she will look at factors such as the severity of illness/injury suffered, whether the patient had any pre-existing conditions prior to working at Ground Zero, how long it took the patient to develop/report/diagnose his or her illness, and whether the patient has a history of smoking.

Judge Hellerstein also made an unusual decision to have “fairness hearings” about the reasonability of the settlement – fairness hearings are usually only held in class action lawsuits.

North Carolina Workers’ Compensation policy wonks have been blogging about this decision since it came down last week. On the one hand, the settlement does unclog the court system, and it provides a measure of significant recompense to injured victims. It also appears to be relatively balanced, and the extra measures to prevent fraud make a lot of sense, especially in light of the legal brouhaha over the September 11 Victim Compensation Fund.

That being said, the settlement is far from perfect, according to numerous North Carolina workers’ compensation experts. It took way too long to resolve this issue. One initial claimant actually died while waiting for the case to resolve, for instance. And the case consumed fantastic amounts of media oxygen and court time.

What should you do if you or a family member is struggling with a compensation case?

Rather than “going it alone,” connect with a qualified North Carolina workers’ compensation attorney to discuss potential remedies. The logistics regarding even simple worker claims can get extraordinarily complex, and small clerical errors can result in major problems with collecting benefits down the line.

More Web Resources:

Terms of the $657.5 9/11 settlement

Diseases of Ground Zero

Insurance Agent Sentenced in North Carolina Workers’ Compensation Embezzlement Case

February 15, 2010, by Michael A. DeMayo

A former North Carolina Workers’ Compensation insurance agent, Terri Lynn Spence, has been sentenced to four years of supervised probation and a full year of house arrest (under electronic surveillance) for multiple counts of embezzlement, according to North Carolina officials.

North Carolina Insurance Commissioner, Wayne Goodwin, publicized Ms. Spence’s sentencing at a news conference. The 34-year-old Emerald Isle resident was ordered to pay more than $46,000 in court fees and restitution to victims of her scheme. All told, 16 different insurance companies and 43 individuals were financially impacted.

Ms. Spence “obtained property by false pretences,” according to investigators at the Department of Insurance, who contacted police officers in La Grange to bust the embezzler back in June 2008. Most of the policies embezzled were North Carolina Workers’ Compensation policies (along with some homeowners’ policies). State officials do not believe that Ms. Spence worked in conjunction with any other entity or syndicate. But her arrest, trial, and sentencing likely have not gone unnoticed by others who would seek to embezzle or otherwise defraud the North Carolina Workers’ Compensation system.

If you or a family member has had trouble collecting your North Carolina Workers’ Compensation benefits, or if you are having any issues filing paperwork, dealing with your employer, managing negotiations with your insurance company, or talking to your physician or rehabilitation specialist about billing, go over your concerns with a qualified North Carolina Workers’ Compensation attorney.

More Web Resources:

Terri Lynn Spence

Wayne Goodwin

Tactics to Bring down North Carolina Workers’ Compensation Costs

January 28, 2010, by Michael A. DeMayo

Elevated North Carolina Workers’ Compensation costs concern everyone in the “employment ecosystem” – small business owners, employees, government agencies, insurance companies, and physicians alike. To bring down costs across the board, however, requires a holistic approach to problem solving. In this article, we will speculate about remedies that could be applied throughout this “ecosystem” – at little to no cost to employers, insurers, or employees.

1. Put in place systematic solutions to common workplace ergonomic problems.
How many North Carolina workers’ compensation cases begin at the keyboard? Carpel tunnel syndrome, repetitive stress injuries, and other soft tissue injuries abound in North Carolina – many of them no doubt due to bad workstation ergonomics. An employer can mitigate against risk of repetitive stress injuries by investing in more economic keyboards, for instance, more tailored workstations, and a program of regular breaks and stressing. The cost of such a proactive “war” against repetitive stress injuries would be minimal, and the benefits would no doubt be long lasting. Workers who are not exhausted from keyboarding and other repetitive tasks can work longer hours (thus making up any theoretical costs of ergonomic modifications). Fewer injuries would mean lower North Carolina Workers’ Compensation insurance premiums.

2. Better Alert and Response System to Control North Carolina Workers’ Compensation Fraud.
As the old saying goes, a few bad apples can spoil the bunch. Everyone loses when people cheat the system. But how do you get people the stop cheating? This is the $64,000 question. Better monitoring of claims might be a theoretically good solution, but when you incentivize insurance companies to look for fraud, these companies inevitably will turn up “false positives.” I.e., they will harass people who are legitimately injured – trying to get them to admit that they are not actually hurt. This is obviously terrible, and it results in many tragedies, some of which we have reported on this blog.

A better solution might be to build in a more robust tracking system to make sure that claimants stay honest. In addition, insurance companies and employers must recognize and respect the claimants who are actually hurt and go the extra mile to help them.

3. Involve physicians in more holistic patient care.
The fractured approach to patient healthcare no doubt exacerbates many medical problems. If a patient sees four doctors, chances are that each physician will require separate paperwork, and that the doctors will not communicate with one another about the patient. This needs to change. Implement across the board holistic treatment for injured patients, and we will see much better health care. This is obviously an enormous task. But if we really want to bring down North Carolina Workers’ Compensation costs, we need to start treating patients as whole people — and not just as carriers of individual symptoms they present with.

4. Better, more thorough and more regular data analysis of North Carolina Workers’ Compensation cases.

Organizations like the North Carolina Industrial Commission (NCIC) and other government agencies do track serious injuries and deaths at NC workplaces. But the amount of data that’s mined and shared about these accidents is extremely small, maybe even negligible, compared with what could be mined. We need to gather much more information – much more detailed analyses of various injuries and incidents. We must be able to share that information not only with government agencies, insurance companies, and fellow employers, but also with employees.
Do this kind of analysis, and we will no doubt be amazed at the kind of improvisations and “band-aid” solutions that emerge.

If you or somebody you love has been hurt or needs help with North Carolina Workers’ Compensation issues, connect with a qualified veteran attorney near you for a confidential consultation.

Preparing for a North Carolina Workers’ Compensation Trial

January 5, 2010, by Michael A. DeMayo

Most North Carolina workers’ compensation matters never wind up at trial. Usually, if there’s a dispute between a claimant and his or her employer or his or her insurance company, an arrangement can be ironed out.

However, in some cases, an insurance company or employer can act so egregiously that the only recourse is to pursue recompense in court. Here are some things to consider when debating whether or not to go to trial over your North Carolina workers’ compensation matter.

1. The process can be time consuming.

The judicial process is slow, sometimes aggravatingly so. You may be called into the courtroom multiple times over the course of months. You and your attorney alike may have a lot of logistical work to do to prepare. It can be months before a judge weighs in. So prepare yourself for a lot of starts and stops — and budget your time and patience accordingly.

2. Prepare for potentially brutal tactics.

Insurance companies can be quite aggressive — and even nasty — when defending decisions to deny coverage or to refuse to pay out a policy. In some cases, companies have actually videotaped plaintiffs on the sly in the hopes of catching them “acting uninjured.” These companies argue that they do this to prevent fraudulent claims, but if you are legitimately injured, this can seem to be quite a heartless tactic. Be prepared for assaults on your word and character, and work closely with your North Carolina workers’ compensation attorney to anticipate these tactics and defend against them accordingly.

3. How you dress and act in the courtroom counts.

In a perfect world, a trial would deal specifically with issues of law and nothing else. But human beings are susceptible to persuasion. How you conduct yourself in the courtroom, how you dress, how you articulate your stance, and how prompt you are to court proceedings can all dramatically influence a judge’s decision. To give yourself the best chances, dress appropriately (and soberly), be polite and attentive to everyone, think through your thoughts before speaking them out loud – particularly when you’re addressing the judge, and mentally rehearse your trial prior to the date, so you can envision the best possible outcomes.

4. Prepare both for victory and for loss.

To make the waiting period less excruciatingly stressful, anticipate both victory and defeat scenarios, and focus on tasks immediately at hand to avoid getting caught up in needless speculation. The judge’s decision will come, and when it does come, you (along with your lawyer) can piece together your best next steps of action.

5. Even if a verdict goes your way, the insurance company may still watch you.

Many North Carolina workers’ compensation claimants win at trial only to find themselves in hot water months or even years later. Insurance companies can follow you to make sure that you are as injured as you say you are. If you give an opening, companies may retroactively attack your claim. Again, there have been instances of insurance companies videotaping claimants to try to catch them in the act of “being healthy” in order to negate a claim retroactively.

All this being said, one of the best strategies to ensure victory is to connect with a reputable, trial proven, and results driven North Carolina workers’ compensation lawyer as quickly as possible to create a prepared and proactive strategy.

More Web Resources:

Preparing for Trial

Dealing with Insurance Companies who Videotape People

Understanding North Carolina Workers’ Compensation Fraud

January 3, 2010, by Michael A. DeMayo

Here is a brief primer on North Carolina workers’ compensation fraud — including relevant laws passed by the North Carolina General Assembly as well as information, implications, and a toll-free hotline for fraud investigation.

Laws
In 1994, the state assembly passed the Workers’ Compensation Reform Act, which included statute 97-88.2 (outlining punishments for misrepresentation in a North Carolina workers’ compensation filing) as well as statute 97-88.3 (outlining punishments for healthcare providers who fail to follow the law.)

The following year, the state assembly changed statute 97-88.2 and empowered the North Carolina Industrial Commission (NCIC) to look into fraud violations of the 1994 WCRA.

In 1997, the North Carolina Assembly passed House Bill 618, which further amended two key statutes – 97-88.2 and 97-94 — to spell out increased penalties for fraud and misrepresentation under the Workers’ Compensation Act.

Today, the NCIC operates a hotline at (888) 891-4895 from Monday through Friday during normal business hours.

Who can be accused of conducting fraud? Parties including but not limited to:
• employees/claimants
• employers/managers
• corporate officers
• administrators of third party services
• insurance adjusters/agents
• lawyers
• providers of healthcare services
• rehabilitation providers

Individuals who commit North Carolina workers’ compensation fraud imperil the whole system. Fraud drains millions of dollars that would otherwise go to claimants with legitimate problems. That being said, not all cases are cut and dried. Some individuals may accidentally commit North Carolina workers’ compensation fraud simply because they fail to fill out paperwork properly or fail to follow bureaucratic protocol. It’s not that they try to cheat the system, in other words; it’s that they do not understand how to operate within it effectively.

This isn’t to say that there are not some bad eggs out there who intentionally game the system. However, if you or a family member has been accused of this crime — or if you’re in need of other kinds of assistance filing or moving forward with your North Carolina workers’ compensation claim — it may behoove you to connect with a knowledgeable attorney right away to discuss your concerns in confidence. A free consultation with a reputable attorney can put you on a strategic path to maximize your benefits and minimize your hassle.

More Web Resources:

NC Workers’ Compensation Reform Act

More about Workers Comp Fraud in NC

How to Self-Destruct Your North Carolina Workers’ Compensation Claim

November 19, 2009, by Michael A. DeMayo

If you have been injured at work — or hurt while on the way to or from a work function or while otherwise engaged in company business — you may be entitled to a wealth of North Carolina workers’ compensation benefits, including replacement for lost wages, vocational training and placement, help with medical bills, and compensation for pain and suffering. Unfortunately, if you mishandle your claim, you can miss out on these benefits.

So what are some of the common ways in which claimants ‘self-destruct’ their cases?

1. Ignoring the injury/accident.

Obviously, a claimant who falls off a ladder and breaks her leg is not likely to ignore her injury; however, not all job injuries are acute. Some are chronic. For instance, repetitive stress injuries — such as carpal tunnel syndrome, cubital tunnel syndrome, and thoracic outlet syndrome — can all significantly impair your quality of life, make job duties harder, and lead to thousands of dollars in medical bills and therapies. If you don’t report a claim in time, you may miss out on key workers’ comp benefits.

2. Failing to get appropriate treatment.

Not only can delaying your treatment lead to a worsening of your health problems or injuries, but neglecting to take proper care of yourself can provide insurance companies leverage to deny your claim. Delaying can also make it more difficult to demonstrate that the injury sustained was a direct result of your on the job accident.

3. Failing to realize that the insurance company will continue to investigate your situation even after your claim has been approved.

This shouldn’t be a problem as long as your claim is real (ongoing investigations are designed to probe for instances of North Carolina workers’ compensations fraud). But insurance companies generally do all they can to avoid paying long term claims. They may look for any loophole to deny your claim and/or reduce your coverage — even retroactively. Insurers have gone as far as to secretly videotape claimants to look for evidence to deny claims.

4. Trusting employers or insurance companies to ‘do right.’

As the old adage goes: trust, but verify. As we just discussed, insurers and employers may have sympathy for you. Some individuals may even go out of their way to help you figure out your rights and fill out paperwork. But make no mistake. These companies are in business to make money — and that means they have a strong motivation to deny claims and/or to limit them as much as possible. Thus, if you disclose too much information — or the wrong kind of information — to an insurance company investigating your claim, you could significantly impair your chances of collecting of a good settlement.

5. Settling for far too less.

Many claimants are desperate for any money to pay for medical bills, lost wages, and therapies. They thus will often quickly settle with insurance companies to get some active cash flow. However, usually an insurance company’s first offer is not the best offer. A reputable and time-proven North Carolina workers’ compensation attorney can likely help you get much more for your claim.

6. Waiting too long to consult/retain an attorney.

The longer you wait to speak with an experienced attorney about your injury/accident on the job, the greater the likelihood that you will make some error of omission that could damage your claim or cause it to be dismissed altogether. The laws governing workers’ comp benefits and payouts can be extremely complicated; thus, your case may require delicate finesse to get you the most compensation and in the fairest possible terms. Furthermore, a qualified and creditable workers’ compensation attorney can help you develop a plan of action that will reduce your anxiety and uncertainty.

More Web Resources

North Carolina Industrial Commission

North Carolina Office of Economic Opportunity

Connecticut Man Busted For Complex Crime — May Give Pause to Potential Perpetrators of North Carolina Workers’ Compensation Fraud

October 18, 2009, by Michael A. DeMayo

The Hartford Courant reports that a man named Steven Zaczynski has been charged with fraud and other counts in conjunction with a complex workers’ compensation scheme in CT. Although North Carolina workers’ compensation experts have yet to weigh in on the matter, the attention grabbing nature of this case may impact how authorities investigate and deal with similar North Carolina workers’ compensation fraud matters.

According to The Courant, Zaczynski had been working for the Department of Corrections at the Carl Robinson Correctional Institution, when he filed for workers’ comp benefits, citing an on-the-job injury. But according to an investigation ordered by Attorney General Richard Blumenthal, Zaczynski just took the money and continued to work full time for his own business, New England Pallet of Enfield. (Zaczynski allegedly stole $12,656 in benefits.)

But the case gets weirder and more complicated. Apparently, Zaczynski also fleeced customers of New England Pallet — he took money for pre-orders but never delivered products — AND he failed to provide workers’ comp coverage for his employees.

Given the nuances and layers of this case, it may be a while (if ever) before a similar North Carolina workers’ compensation case goes to trial. But the situation illustrates how fraud, insurance scams, larceny, and other labor rights violations can coincide. This is important because injury claimants who have been unfairly denied workers’ comp by their employers or insurance companies need to be aware — not just of their own situations — but also of the extended situations that may be preoccupying their employers/insurers.

Correction Officer Charged With Workers’ Compensation Fraud, Hartford Courant, Oct 7, 2009

More Web Resources:

Carl Robinson Correctional Institution

North Carolina Workers’ Compensation Fraud — A Growing Problem?

October 8, 2009, by Michael A. DeMayo

Since the early 1900s, North Carolina workers’ compensation benefits have provided injured workers with money for missed wages, medical bills and retraining. Unfortunately, abuses of the workers’ comp system have reached epidemic proportions, according to the National Insurance Crime Bureau, which surveyed the industry and found that this crime costs America around five billion dollars a year.

Workers who feign injury to collect benefits pass the costs of these payouts onto insurance companies, employers, and the federal government, resulting in higher premiums for everyone and stealing focus from legitimate workers’ comp claims. Insurance company advocacy groups and federal and state regulators claim that perpetrators of North Carolina workers’ compensation fraud do systemic harm, in other words.

No doubt many people do take advantage of the system by intentionally misreporting or mischaracterizing aspects of their conditions, and so forth. At the same time, however, the insurance companies cannot fairly claim to be pure victims of this fraud. Companies are generally free to hike up rates. And by investigating — and in some cases harassing — legitimate North Carolina workers’ compensation policy claimants, insurers often exacerbate the stresses on these individuals, thus indirectly causing more health problems for them and thus straining healthcare resources further and hurting the economy.

It’s also debatable whether at least some of the fraud that’s been going on constitutes a “gray market” as opposed to a “black market.” Consider: many injured workers don’t get a fair shake when it comes to their benefits. Some then rebel against a system that they perceive to be (and objectively may be) biased against them by committing fraud. Thus some attempts to siphon money from insurance companies could theoretically be justified. (That said, the law is the law.)

The deeper issue that needs to be addressed may be more global in nature. In other words, perhaps neither the perpetrators of fraud, nor the insurance companies are at the root of this epidemic. Maybe the problem is that American workers do not get adequate safety training. Alternately, maybe some massive as-of-yet-fully-acknowledged problem (such as poor workstation ergonomics) is injuring a vast number of workers and thus draining the resources of insurance companies (who in turn must bully policyholders to survive financially; and in turn policyholders must
perpetrate small scale fraud to be able to pay their bills.)

The Cost of Fraud, NYSIF

The Myth of Workers Compensation Fraud, PBS, May 29, 2000

More Web Resources:

National Insurance Crime Bureau

Sentencing for Scam Artist Attracts Attention of North Carolina Workers' compensation Community

September 10, 2009, by Michael A. DeMayo

According to an El Paso, Texas news report from June 30, 2009, an El Paso man has been convicted and sentenced for trying to scam the US Postal Service via a fraudulent workers’ compensation scheme.

Attorneys, workers, employers, insurers and others interested in North Carolina workers’ compensation issues have closely followed the case of former postal worker, José Barraza, who accepted over $54,000 in workers’ comp payments before getting busted for his activities. After being clued into the possibility that Barraza had faked an injury to his arm, investigators videotaped him throwing a football, taking out trash, and otherwise using what turned out to be his perfectly healthy arm.

Although Barraza was arrested in Texas, his sentencing would likely have been similar had he been convicted of a North Carolina workers’ compensation scam. The US District Judge overseeing the case sentenced Barraza to pay back the $54,000+ he took from the US Postal Service and Department of Labor as well as a pay an assessment of $1,400. In addition, Barraza must serve out a 10 month prison sentence for committing fraud. Barraza was convicted by a jury of all 14 counts against him. But it is unknown at this time whether/how he will appeal the ruling. Following his jail sentence, Barraza will have to serve 3 years of supervised release.

Claims Journal.com, Former U.S. Postal Service Employee Sentenced for Work Comp Fraud, August 28, 2009

KVIA, Man sentenced for workers compensation fraud, August 26, 2009

More Web Resources

Workers’ Comp Fraud

El Paso, TX

AIG Wins Battle against NCCI in Billion Dollar Suit That Could Hold Implications for North Carolina Workers' Compensation Matters

September 7, 2009, by Michael A. DeMayo

On August 21, Reuter’s news agency reported that the American Insurance Group (AIG) won a significant battle against the National Council on Compensation Insurance (NCCI) regarding allegations that the insurer had defrauded workers’ compensation pools to the tune of over a billion dollars. The high stakes imbroglio between AIG and NCCI should ultimately have trickle down impacts on North Carolina workers’ compensation policy and process.

US District Court Judge Robert Gettleman ruled that the NCCI did not have standing to file the federal lawsuit against AIG. However, the judge did acknowledge that “there is no dispute that … the participating companies have standing to bring claim separately against AIG.”

The lawsuit alleged that AIG had deliberately understated its workers’ comp premiums so that it could keep costs down and that, as a result of doing this, the company could garner an unfair competitive advantage. AIG has been raked over the coals many times over the past months due to its widely criticized handling of $180 billion in federal bailout money. While Judge Gettleman’s ruling does not necessarily clear AIG of fallout from this workers’ compensation case – in North Carolina or elsewhere – it has bought AIG a bit of a temporary reprieve. And the ruling sent AIG’s stock price up by over 6%.

Reuters, AIG wins dismissal of $1 billion workers comp lawsuit, August 21, 2009

Bloomberg, AIG Wins Dismissal of Lawsuit Seeking $1 Billion, August 21, 2009

More Web Resources

AIG

NCCI

Southern California Magnate’s Arrest Puts Would-Be North Carolina Workers' Compensations Scam Artists on Notice

September 3, 2009, by Michael A. DeMayo

On August 20, the California Department of Insurance (CDI) reported that a Southern California resident named Joseph Baiden (56) had been arrested in conjunction with a massive workers’ compensation scam. Baiden, who surrendered to LA Superior Court, had an arrest warrant out on him stemming from allegations that he had deliberately underreported his workers’ compensation payroll numbers to reduce his insurance premiums. Over an eight year period, from 2001 to 2007, he allegedly cost his insurer, State Fund, around $1.4 million. North Carolina workers’ compensation insurers have taken notice of the case, and no doubt the outcome will dramatically influence local NC policies, procedures and safeguards.

The size and scope of the charges against Baiden have attracted attention from local and national media. The CA state insurance commissioner, Steve Poizner, broke the story personally. If the defendant is convicted of fraud, he could face up to 40 years in jail in addition to fines of well over $3.2 million. The California Department of Insurance has frozen Baiden’s bank accounts and seized five of his Southern California properties, including an exclusive estate in the posh Diamond Bar neighborhood.

One of the reasons why the CDI has come down so hard on the accused is that workers’ compensation fraud – whether it occur in North Carolina or elsewhere – pads costs across the employment spectrum. When insurers can’t collect premiums, they either raise rates or reduce service, thus creating a cascade of bad effects for employers and employees alike.

AP, Calif. man accused of cheating workers comp fund, August 21, 2009

Pasadena Star News, Diamond bar man suspected of fraud, properties seized, August 19, 2009

More Web Resources

Steve Poizner


California Department of Insurance

Companies Scammed in 2006 North Carolina Workers' Compensation Fraud Case to Collect $6.5 Million

August 29, 2009, by Michael A. DeMayo

In October, 2006, employers who had bought into a self-insured North Carolina workers’ compensation group fund got some terrible news. The Phoenix Fund’s reinsurance broker, a man named Thomas Raitz, had been engaging in complicated illegal shenanigans to steal from the fund via a money laundering and mail-fraud operation. Investigators from North Carolina’s Department of Insurance concluded that Raitz’s scheme impacted more than $20 million worth of the fund’s money.

Although Raitz was convicted in 2007 after pleading guilty and was subsequently sentenced to nearly 6 years in jail, members of the Phoenix Fund have yet to collect money and damages. Finally, in 2008, Raitz was ordered by the court to pay $19 million to reimburse the Phoenix Fund. To date, Raitz has paid out $18 million, of which $11.5 million has gone to meet the obligations of the fund itself and has not gone to remunerate individual employers. Only $6.5 million collected will be distributed among the injured parties. That said, the North Carolina Insurance Commissioner, Wayne Goodwin, released a statement that sounded a note of optimism for these employers, assuring the victims that they would “get back every available penny” owed to them.

Triangle Business Journal, North Caroilna employers to get $6.5M from Phoenix Fund, August 10, 2009

Workforce Management, Workers’ Compensation Fund Members Hit by Fraud Get Distributions, August 14, 2009

More Web Resources

North Carolina Insurance Commission


North Carolina’s Department of Insurance

Answers to Your FAQS about North Carolina Workers’ Compensation Benefits and Rules (Part I)

July 24, 2009, by Michael A. DeMayo

Is there a non-profit state agency that can provide unbiased information about North Carolina workers’ compensation benefits, eligibility and rights?

Yes. The North Carolina Industrial Commission (based out of Raleigh) is reachable at (919) 807-2500. You can also contact workers comp info specialists directly toll free at (800) 688-8349 or email someone for assistance at infospec@ic.nc.gov.

If your employer does not report your injury, for whatever reason (e.g. negligence, refusal to assist), is there anything you can do?

Yes. Collect a claim Form 18 or Form 18-B and file it with the NC Industrial Commission within two years of your on the job injury.

Can injured employees get benefits for using chiropractic services?

In some cases, yes. If your employer’s insurer allows, you can have up to twenty visits to a designated chiropractor paid for, provided that the services are “medically necessary.” If you require more chiropractic services, the chiropractor needs to contact the employer directly.

If you have been injured at work, what steps should you take immediately?

First of all, tell your employer — both verbally and in writing. It’s very important that you keep track of all of your correspondence and file it and date it. You should make sure to do this within thirty days of your injury, unless your recuperation has rendered you unable to make such a communication.

In the event that your employer lacks North Carolina workers’ compensation insurance, do you have any recourse to collect benefits?

Yes. First of all, the North Carolina Industrial Commission’s fraud hotline should be notified. You can call toll free at (888) 891-4895 or email a government representative at fraudcomplaint@ic.nc.gov. If you’ve been injured and then you discover that your employer lacks insurance, contact the Commission. You’ll likely have to fill out two forms — Form 33 and Form 18 — to attempt to collect benefits.

More Web Resources

North Carolina Industrial Commission


NC Workers Compensation Act