The Myth of Workers Compensation Fraud

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Alex Collie, CEO of the Institute for Safety, Compensation and Recovery Research (ISCRR) in Victoria recently flagged this article on Twitter as worthy of reading.

Although the article refers to rates of fraud in the United States, where there the perception is that people are very litigious, the commentary suggests that the true incidence of blatant fraud in probably quite low.

Most people I speak to in Australia who have some knowledge of this subject agree the situation is the same in Australia.

Here is a link to the article:

The Myth Of Workers’ Compensation Fraud – NAIDW My Blog Application

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About Tasworkdoc

As an occupational physician in private medical practice in Hobart, Tasmania - the southernmost state of Australia, I see workers referred by their general practitioners with various types of work-related injuries and diseases. These are mostly musculoskeletal injuries, both of traumatic and gradual onset as well as various associated psychological disorders. With interaction with patients for treatment and providing advice about rehabilitation, I have the opportunity, first-hand, to observe interactions between individual patients and compensation systems. I also conduct independent medical assessments, including impairment assessments for musculoskeletal injuries and asbestos-related disease compensation. This provides another perspective of workers within compensation systems.
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3 Responses to The Myth of Workers Compensation Fraud

  1. Rosemary says:

    Finding fraud in the injured worker community is like fishing in a bucket filled with fish- it is easy to infer and to imply and to “decide” that all injured workers are fraudulent.
    However try the same inference with the providers to the system- try telling an IME who never looks at the x-rays provided and then writes a report without acknowledging the information from the x-rays that they are committing fraud try telling an employer that denying that a car/computer/phone was a part of a wage packet is committing fraud, try telling an investigator that filming an injured worker with the use of a rear view mirror is committing fraud and you will be accused of stirring up trouble with no base to lay the claim

    Fraud is fraud regardless of which part of the workers compensation system it comes from, I am just over tired of injured workers carrying the can for all that is wrong when the majority of injured workers are as honest as the day is long.

  2. John Green says:

    I have had nearly 30 years acting for injured workers trying to recover proper compensation for them.

    In my opinion the major problem in the workers compensation system is the attitude of the insurance industry which is determined to payout as little money as possible.

    One tactic they use and I have had it confirmed by Managers at insurance organisations is to “starve them out” that is they string out the process as much as possible knowing that the worker doesn’t have the emotional or financial resources to continue fighting.

    This of course is very stressful for workers and I have never known a worker with a major workers compensation claim who was seriously injured who didn’t finish up being psychologically injured by the stresses of the system.

    In my opinion it would be much better if there is a single workers compensation insurer. For motor vehicle injuries the MAIB has a more reasonable attitude towards claimants.

    In particular MAIB claims can be dealt with much more quickly.

    The other problem workers face is the widespread prejudice against workers compensation claims especially large workers compensation claims.

    In my experience they are nearly always subject to surveillance by private detectives which violates their privacy and often discovers nothing of great significance.

    But it creates stress and I need to advise my clients that they are being spied upon so they should be careful what they should do while the medical advice often is you should do as much as you can.

    If you follow the medical advice and not the legal advice you will find that you are going to be accused of fraud, and if you follow the legal advice you may not recover from your injury.

    Again I think a single insurer could make the process run more smoothly as a single insurer owned by the government which doesn’t have to pay a dividend and doesn’t pay its managers bonuses if they reduce claims and also has an overview of all the injuries in Tasmania it is in a better place to administer the system fairly and is in a better place to see where there are unsafe practices because they can see where there are more injuries than average occurring.

    Regards

    John Green
    Solicitor

  3. Tasworkdoc says:

    Thanks John and Rosemary for your comments.
    The AMA in Tasmania is promoting some measures in the local workers compensation jurisdiction to gain more emphasis on health outcomes, but I doubt there is any political will to move to a single insurer system like MAIB (Motor Accident Insurance Board – for those mainlanders who read this).

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