Don't Mess with Our BBQ

Saturday, September 22, 2007 | 0

By Julius Young

We really, really want that BBQ! Better not file your comp claim! If you file your claim the store won't make its safety incentives. And your fellow workers won't be getting that BBQ and other perks. You definitely won't be winning the Mr. Popularity award. And forget about "Most Likely to Succeed" accolades.

So just deal with your problem as non-industrial. Put it on the group health plan. If you're out of pocket for co-payments, maybe we'll give you a little money on the side.

Sounds fanciful? It's the real world.

Managers love safety bonuses. Safety departments want to look good.

Risk managers frown on too many claims.

But there's a little problem. That's fraud.

Check out the fraud case charged by the Amador County DA and the California Department of Insurance Fraud Divison against Roseville Bel-Air market managers Nichole Leddy and Amy Looper. The indictment in Placer County charges Looper and Leddy with multiple felony counts of discouraging employees from filing comp claims.

In one instance, an employee was apparently instructed to claim that an on the job injury had happened off the job in order to shift the coverage to group health benefits.

Perhaps Blue Cross, Blue Shield and Kaiser and various union health trust funds will wake up one day to see that they have been left "holding the bag". As many workers are encouraged to (or decide to) deal with claims as non-industrial rather than hassle with a complicated comp system, the group insurers are stuck paying for treatment.

The spectre of worker fraud has often been used by employer groups to tarnish the California comp system. Funny thing, though. Employer fraud is increasingly being seen as a major problem.

Starting in 1979, Julius Young has represented thousands of individuals who have sustained life-changing injuries or illnesses while on the job. A partner of Boxer & Gerson since 1988, he practices workers' compensation and disability law in Oakland. This article originally appeared in his blog, Workerscompzone.com, which focuses on California's workers' compensation law, its politics, and culture.

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