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.