Joe Paduda asserted a familiar theme in his ManagedCareMatters blog last week; that is, the “real fraud” in workers’ comp involves employers who don’t provide coverage to their employees, and organized medical and legal crime rings that rake in millions.
He advised “real journalists” to avoid “click bait” coverage of fraud that is perpetrated by individuals. Although Paduda didn’t say so, I’m pretty sure he was talking about claimant fraud, which is the subject of countless “I-Team” exposes by unimaginative television reporters.
But those same type of stories are also a staple of WorkCompCentral’s news coverage.
Just last week I wrote up a short piece about a California appellate court decision upholding the perjury conviction of a 38-year-old San Diego woman who said her arms and shoulders were so badly damaged from stocking shelves at Trader Joe’s that she had to ask friends to carry her paddle board across the beach so she could take it out onto the water. Talk about a crimp in your SoCal lifestyle.
The woman was videotaped, of course, pulling the 30-pound paddleboard off the roof of her 4Runner and lugging it across the beach without any help by friends. That story baited 1,019 clicks last week.
Another example is the Fort Lauderdale, Florida, woman who — when a fire-suppression sprinkler head dislodged from the ceiling and fell onto her desk — picked the sprinkler up and whacked herself on the forehead with it. Maybe that was a good plan to get a few weeks off at two-thirds pay. Head injuries can be tricky, after all. But the woman was foiled by her employer’s security cameras.
Readers love dumb crook stories. She got 18 months' probation. The story got 928 clicks on our website and made the rounds in media outlets literally around the world. In fact, a Google news search shows that three Australian television stations posted reports about the sprinkler caper on the same day that Florida media picked up the story.
To follow Paduda’s advice on story choice would be to deny our readers a few moments of schadenfreude as they peruse our report. I have no shame in providing that moment to hard-working adjusters who likely come across plenty of abusive claims that don’t rise to a level that merits a criminal investigation and take pleasure in learning that at least some of the scoundrels get busted.
But I also see a larger purpose in telling these kind of stories.
Somebody with the sprinkler woman’s employer or insurance carrier had the presence of mind to check the videotape from the camera above her work station. The claim was successfully denied and the woman was rightfully convicted as a result.
In the case of the paddleboarder, the carrier’s special investigations unit knew exactly what it had on tape, and the defense attorney knew exactly what to ask during the deposition that led to two perjury convictions. (The appellate court had ruled that the woman lied separately about being able to carry the paddleboard and her ability to pull it off the roof, rejecting her argument that she had lied only once, not twice.)
You can’t attend a claims conference without hearing a panelist harping on the importance of a good accident investigation. But it is one thing to hear sage advice and another to take it to heart.
News stories that provide real-life examples of how to successfully defend against a fraudulent claim cement a lesson that should be taught to every front-line supervisor: If somebody gets hurt at work, find out everything you can about how the accident happened, mostly to prevent future mishaps, but also to make sure the claimant didn’t make it up.
To give due credit to Paduda’s point, there is shame for any news organization that does all of its reporting from press releases. Back when I was in the newspaper business (does anybody remember newspapers?), the daily police blotter was a subject of constant ethical hand-wringing. The chronicle of folks caught exposing themselves in public, throwing rocks through windows or poisoning the neighbor’s cat draw a lot of readers, but those reports are also totally one-sided in that they are based solely on a police officer’s version of events.
Often, the people named are never convicted. As an editor, I sometimes get a call from a formerly accused perpetrator who has been exonerated and wants that part of the story told, too. I am always happy to oblige with a follow-up, but I suspect most of the alleged wrongdoers who escape conviction don’t bother calling. One time in the public square was bad enough.
In his column, Paduda gave kudos to WorkCompCentral’s Greg Jones for writing an in-depth piece about a California lawmaker’s efforts to stem the kind of capping schemes that led to the arrest of 10 attorneys and six others who allegedly swindled $300 million from workers’ comp insurers. (That one got 2,247 hits, and the initial story by Sherri Okamoto about the arrests 4,131, probably an all-time record for WorkCompCentral.)
Paduda is correct in that journalism that explores policy and examines the roots of widespread malfeasance is more important than writing up the routine fraud bust. Most journalists I know got into the profession because they believed their reporting can make a difference. Stupid crook stories are fun, but not the calling.
As long as we continue to find those stories, we will keep telling them. But I promise we’ll spend a lot more time looking into the "real fraud" that Paduda mentioned.
Jim Sams is senior editor of WorkCompCentral.
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