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