Fraud

Roofing Company Owner Faces Felony Charge for Not Paying Workers’ Comp

A Mason County, WA roofing contractor faces a criminal charge for allegedly failing to provide workers’ compensation insurance for his employees while they were on the job.

The Washington State Attorney General’s office has charged Peter Daniel Yeaman, 55, with unregistered contracting and doing business when his workers’ comp coverage was revoked.

The latter charge is a felony with a penalty of up to five years in prison and a $10,000 fine. Yeaman is scheduled for arraignment in Kitsap County Superior Court today, July 23.

The case resulted from a Department of Labor & Industries (L&I) investigation into Yeaman and his company, Southgate Roofing, of Belfair.

 

Unfair business advantage

“When contractors skip out on workers’ comp, it’s illegal and it’s incredibly unfair to legitimate contractors who pay their fair share and get underbid by these lawbreakers,” said Annette Taylor, deputy assistant director of L&I’s Fraud Prevention & Labor Standards. 

“Workers’ comp premiums for roofers are among the highest in building construction and the trades, based largely on the safety risks those workers face.”

State law requires employers to provide their employees with workers’ compensation insurance. The coverage provides medical care and other financial support if employees are injured on the job.

Construction contractors also must register with L&I. The department confirms they have liability insurance and a bond and that, if they employ workers, they’ve paid their workers’ comp premiums.

 

At least six roofing employees

L&I suspended Southgate Roofing’s contractor registration in November 2012 for failing to pay workers’ comp premiums, and later officially revoked the company’s workers’ comp coverage.

Nonetheless, according to the charges, L&I found two consumers in Silverdale who had work done by the company in May 2014 and in August 2014.

During the August job, six workers told an L&I inspector they worked for Southgate Roofing. Yeaman himself told the inspector he needed to pay a bill before he could register as a contractor, charging papers said.

 

Eight previous infractions

In addition, the charges say that between October 2013 and September 2014, the company bought roofing materials numerous times from a Bremerton supplier and made numerous trips to a Bremerton disposal site.

Apart from the criminal charges, L&I has cited Yeaman with six unregistered contracting and two permit-related infractions since 2013, and several safety violations in 2013. L&I currently lists him as ineligible to bid or work on public works projects. He owes the department more than $28,000 for the unpaid fines and more than $131,000 for unpaid workers’ comp premiums, penalties and interest.

Photo credit: davidwilson1949 / Foter / CC BY 

workplace injury, workplace safety

Tragic Cannery And Construction Site Deaths Highlight Need For Safety Enforcement

Today’s post comes from guest author Catherine Stanton, from Pasternack Tilker Ziegler Walsh Stanton & Romano.

I was horrified when I recently read about a worker for a tuna company who was killed when he was cooked to death at the company’s California canning factory. According to the New York Daily News, the worker, Jose Melena, was performing maintenance in the 35-foot oven when a co-worker failed to notice he was still in the oven and turned it on to begin the steaming process of the tuna. The co-worker assumed Melena had gone to the bathroom. 

While there apparently was an effort to locate the worker, his body was not found until two hours later when the steamer was opened after it completed its cooking cycle. As an attorney, my clinical instinct shifts my focus to the mechanics of the accident and to fault. There are so many unanswered questions.  Why didn’t anyone check the machine before it was turned on? Why wasn’t the machine immediately shut down when they realized the worker was missing? As a person with feelings and emotions, I think of the horror and pain he must have gone through and the loss experienced by his family and friends as a result of his death. It is almost too awful to imagine. 

While this terrible tragedy occurred in 2012, it appears the reason that the story is currently newsworthy is that the managers were only recently charged by prosecutors in the worker’s death for violating Occupational Safety & Health Administration (OSHA) rules. Closer to home, more recent and just as unfortunate were the cases of the construction worker in Brooklyn who fell six stories from a scaffold while doing concrete work and a restaurant worker who was killed in Manhattan when a gas explosion destroyed the building he was working in. 

These stories highlight why safety procedures are so important. In some cases, there are no proper safety precautions in place. In others, there are safety measures in place but they may not have been followed. In rarer cases, crimes are committed that result in workplace fatalities. The failure to follow or implement proper safety procedures was a calculated risk, a terrible misstep, or a downright criminal act. In the case of the worker who died when he fell from a scaffold, there has been speculation that he may not have been attached properly to his safety harness. In the tuna factory death, the managers were charged with violating safety regulations; they face fines as well as jail time for their acts. In the gas explosion, there are allegations that the explosion was caused by workers’ illegally tapping into the restaurant gas line to provide heat for upstairs tenants. Prosecutors were trying to determine criminality; whatever the final outcomes, it appears that in these three instances the deaths were preventable. 

According to OSHA rules, employers have the responsibility to provide a safe workplace. They must provide their employees with a workplace free of serious hazards and follow all safety and health standards. They must provide training, keep accurate records, and as of January 1, 2015, notify OSHA within eight hours of a workplace fatality or within 24 hours of any work-related impatient hospitalization, amputation or loss of an eye.  

While this may seem like a small step, anything that results in creating higher standards for employers or encouraging them to keep safety a priority is always a good thing. These three examples are only a small percentage of the workplace deaths that occur each year. While not every death is preventable, everyone is entitled to go to work and expect to leave safely at the end of their shifts.  

Catherine M. Stanton is a senior partner in the law firm of Pasternack Tilker Ziegler Walsh Stanton & Romano, LLP. She focuses on the area of Workers’ Compensation, having helped thousands of injured workers navigate a highly complex system and obtain all the benefits to which they were entitled. Ms. Stanton has been honored as a New York Super Lawyer, is the past president of the New York Workers’ Compensation Bar Association, the immediate past president of the Workers’ Injury Law and Advocacy Group, and is an officer in several organizations dedicated to injured workers and their families. She can be reached at 800.692.3717.

Hot Coffee

NYT Report: Woman Burned by McDonald’s Hot Coffee, Then the News Media

Most people don’t remember her name, but we regularly hear reference to the injury event, even after 20+ years.  This report from the New York Times shatters the myth of a “windfall” settlement. WATCH THE VIDEO – – WOW. – kc

 

In 1992, Stella Liebeck spilled scalding McDonald’s coffee in her lap and later sued the company, attracting a flood of negative attention. It turns out there was more to the story. 

More than 20 years ago, 79-year-old Stella Liebeck ordered coffee at a McDonald’s drive-through in Albuquerque, N.M. She spilled the coffee, was burned, and one year later, sued McDonald’s. The jury awarded her $2.9 million. Her story became a media sensation and fodder for talk-show hosts, late-night comedians, sitcom writers and even political pundits. But cleverness may have come at the expense of context, as this Retro Report video illustrates. A consumer affairs reporter for The Times reflects on how the world has changed since the lawsuit.  

Read the story here.

 

Photo Credit – New York Times

Uncategorized

CMS Alert: New Contractor for NGHP Recoveries and Benefits Coordination in ORM

Today’s post was shared by WC CompNewsNetwork and comes from www.workerscompensation.com

Today, July 1, 2015, CMS issued an alert which states that come October 2015, the Benefits Coordination and Recovery Contractor will be transitioning some of its recovery caseload to a new contractor which will be known as the Commercial Repayment Center (CRC). The CRC will be handling conditional payment recovery where CMS is pursuing recovery directly from a liability insurer (including a self-insured entity), no-fault insurer or workers’ compensation (WC) entity as the identified debtor. The BCRC will continue to handle conditional payment recovery where CMS is pursuing recovery from the Medicare beneficiary.

CMS notes that webinars and town halls will be scheduled in the comings months to provide additional information on this new process.

The alert also provides that come January 1, 2016, CMS will be utilizing ORM information to determine whether Medicare is able to make payment for those claims. CMS further notes that insurers and workers’ compensation entities that notify Medicare that they have ORM are strongly encouraged to report accurate ICD-9 or ICD-10 codes and that Medicare’s claims processing contractors will use this information to pay accordingly.

The alert can be found here: http://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/Coordination-of-Benefits-and-Recovery-Overview/Whats-New/Whats-New.html

I am hopeful that the transition of some of the workload to the new CRC will streamline the conditional payment recovery process to…

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Uncategorized

Opioid use decreasing in workers’ comp: What’s next?

Today’s post was shared by Workers Compensation and comes from www.propertycasualty360.com

Hydrocodone acetaminophen—marketed as Vicodin—is one of the most over-prescribed and over-used opioid pain relievers. (Photo: Shutterstock/David Smart)
Hydrocodone acetaminophen—marketed as Vicodin—is one of the most over-prescribed and over-used opioid pain relievers. (Photo: Shutterstock/David Smart)

Chronic pain is by far the most debilitating—and for claims payers the most costlycompensable condition in workers’ compensation, according to a new special report from WorkCompCentral.

The report chronicles the way opioid use greatly expanded in workers’ comp over the last 20 years, then halted and is now in retreat as a result of increased criticism and research into its efficacy. The report also provides practical suggestions to rethink the approach to chronic pain—that is, pain that persists beyond expected healing time.

Opioids are defined as medications that relieve pain by reducing the intensity of pain signals reaching the brain, for example, hydrocodone (Vicodin), oxycodone (OxyContin, Percocet), morphine and fentanyl. Although some use the term “narcotics” to refer to these drugs, it’s a less precise term.

Startling statistics

Generally, most medical care for injured workers poses “trivial” or no iatrogenic risk (risk that medical treatment will inadvertently cause illness or death). This is not the case when opioids are used for ongoing treatment, however. According to the report, workers on a medium-to-high dose of opioids for a year experience about 1.75 deaths per 1,000 patients per year. By comparison, the riskiest jobs in the U.S., such as logging…

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Ports

Northwest Seaports Recognized for Environmental Practices

Ports of Tacoma, Seattle honored for air, water and habitat improvements.

The sustainability commitments of the ports of Seattle and Tacoma have once again earned Inbound Logistics Green Supply Chain Partner honors.
 
Two of seven U.S. ports selected, Tacoma and Seattle were recognized for their efforts to reduce seaport-related emissions through the Northwest Ports Clean Air Strategy, restore habitat and find innovative solutions to manage stormwater runoff.

The trade magazine honored 75 organizations from various trade sectors, including ports, truckers, railroads, shipping lines, freight forwarders and air cargo carriers.
 
“The 75 Green Supply Chain Partners is a very select group, and we found the ports of Seattle and Tacoma to be among those companies that are truly ‘walking the walk’ when it comes to supply chain sustainability,” said Felecia Stratton, editor of Inbound Logistics. “The G75 list represents 75 visionaries who have demonstrated a long-standing history of driving efficiencies in their customers’ operations and an internal commitment to be as lean and green as possible. Inbound Logistics is proud to honor the port of Tacoma and Seattle among this important group of industry-changing leaders.”
 
The complete list of honored partners is featured in the magazine’s June issue.

 

Photo credit: Kevin Krejci / Foter / CC BY

Employers

Colorado Company Settles with WA L&I Over Back Pay to Washington Workers

Fifteen workers will receive more than $100,000 in back pay from a firm testing and treating utility poles in Grant and Franklin counties.

The payment is part of a settlement with the Washington State Department of Labor & Industries (L&I) and Intec Services Inc. The Fort Collins, Colo., company paid workers below the prevailing wage as part of public works contracts, according to agency notices of violation that Intec appealed.

Under the settlement reached in late May, Intec will be allowed to move ahead with a Seattle City Light contract. The firm will test and treat some 65,900 wood utility poles, and treat an additional 15,900 wood poles under a six-year, $6.27 million contract.

“We want to make sure that workers receive the pay they’re entitled to for the work they do on public projects,” said L&I’s Jim Christensen, Prevailing Wage Program manager. “The settlement provides these workers with the wages owed to them under the law and allows the company to proceed with work on a large contract with a better understanding of prevailing wage.”

The state’s prevailing wage act protects workers on taxpayer-funded projects by assuring they’re paid at specific rates for specific types of work.

L&I works to ensure all employers comply with the prevailing wage law and have a level playing field in obtaining public contracts, Christensen said. Under the settlement, Intec does not admit to any wrongdoing on how it classified and paid its employees.

In October and November 2014, L&I issued Intec separate notices of violation for utility pole work the company did for the public utility districts in Franklin and Grant counties. For the Franklin County PUD, Intec will pay nine workers $15,990.80 in wages owed for work done under a 2011 contract. For the Grant County PUD, Intec will pay $92,017.25 to six workers for work in 2011 and ’12.

Intec paid workers as “laborers,” a lower pay level than the correct “power line construction electrician” and “groundperson” wages. The settlement includes an agreement that clarifies how Intec will structure its crews in compliance with state prevailing wage law for its contract with Seattle City Light.

The agreement calls for Intec to use a crew of up to four workers with its Seattle City Light contract. The crew would include a working supervisor, paid wages of a journeyman power line construction electrician. Assistants will be paid groundperson wages under the same job heading. 

 

Photo credit: Maxwell GS / Foter / CC BY

government, Legislation, Workers' Compensation

“Independent” Medical Examinations in Workers’ Compensation (Anything but “Independent”)

Today’s post comes from guest author Thomas Domer, from The Domer Law Firm.

“I thought their doctor Independent Medical Report was the last word on my case. I didn’t know any better.” 

This statement from a client I just met sums up the experience of many injured workers unfamiliar with the workers’ compensation process in Wisconsin (and many other states).

An insurance company or self-insured employer may request an injured worker submit to reasonable examinations by a physician, chiropractor, psychologist, dentist, podiatrist, physicians assistant, or Advanced Practice Nurse Practitioner of its choice. Wis. Stat. §102.17(1)(b). This examination is usually referred to as an Independent Medical Examination or “IME” although “adverse medical examination” more accurately reflects the process.  An Independent Medical Examination may be requested by the insurance company or self-insured employer in order to determine whether the claim is compensable and the extent of the disability or the necessity and type of treatment. 

Since only about one in ten injured workers in Wisconsin is represented by an attorney, nine out of ten unrepresented workers are not aware that the insurance company’s “IME” is actually an adverse exam by a doctor hired by and paid by the insurance company to issue his report. Although IME examiners would deny they routinely render an opinion in favor of the insurance carrier, my forty years of experience suggests just that. For many years lawyers representing injured workers have been proposing the terminology “Adverse Medical Examination” apply to give represented and unrepresented workers a more fair assessment of the process. Many IMEs make hundreds of thousands of dollars annually performing these examinations. At one of these examinations, my client overheard the IME physician (who had rented a motel room) speaking to a prospective young doctor trying to convince that doctor to perform IMEs. “This is a great practice.” He said.  “All you have to do is review the medical records, meet with the worker for a few minutes, and deny the claim. And for that you can charge $1,500.” Although my client’s testimony to this effect was barred, the underlying accuracy of his testimony is undisputable.

Beware the “Independent” Medical Examination.

Fraud

Man Used Seahawks’ Names to File Claims & Get Drugs

Jail time for Spokane-area man who used Seahawks’ names to get drugs 

A Spokane Valley man has been sentenced to six months in jail for faking on-the-job injuries and using Seahawks players’ names to get narcotics and other prescription drugs.

Spokane County Superior Court Judge Harold Clarke also ordered Jeffory Leonard Mock to repay the eight Spokane-area hospitals and clinics that he scammed to get drugs. Restitution to the facilities, and to the Department of Labor & Industries, is estimated at nearly $17,500. The 34-year-old pleaded guilty in April to four felony counts of obtaining a controlled substance by fraud.

The Washington Attorney General prosecuted the case based on a Washington State Department of Labor & Industries (L&I) investigation.

 

Fake workplace injuries to back, buttocks

Mock visited the medical facilities at least 17 times from March 2013 to May 2014, where he obtained Valium, hydrocodone and other prescription drugs, charging papers said. Each time, he falsely claimed he was working when he injured his back, buttocks or another part of his body.

As part of the scheme, Mock wrote sham names on L&I workers’ compensation forms that he completed at the hospitals and clinics. He used variations on his first name or another first name that usually started with “J.” For the last name, he typically signed the surname of a Seattle Seahawk or another pro ball player or coach.

Mock names included Sherman, Okung, Bledsoe and Largent

Among the last names of football players and coaches he used were: Harvin, Largent, Sherman, Mora, Richardson, Hollenbeck, Robinson, Okung, Marino, Bledsoe and Henderson.

Mock would claim he was injured while working for a moving, roofing or interior design company or retirement home. However, L&I investigators found that four of the employers he listed on forms didn’t exist. 

L&I began investigating the case when a real business listed on a form said the reports might have been filed by a former employee: Mock. A handwriting expert examined the bulk of the injury accident reports, and confirmed that each one matched samples of Mock’s writing.

Workers' Compensation

Washington State Workers’ Compensation Payments Up as of July 1st

For most workers injured before July 1, 2014, time-loss and pension benefit payments will increase by 4.168 percent based on the change in the state’s average wage, as announced by the Department of Employment Security on June 24.

State law requires that benefits be recalculated each year to reflect the change in the state’s average wage from the previous calendar year.

The increase also applies to pension benefits paid to family members of those who died because of a work-related accident or disease.

As a result of the increase, the new maximum monthly benefit will be $5,482.90, or 120 percent of the state’s average monthly wage. Less than 4 percent of L&I claimants receiving wage-replacement benefits collect the maximum.

The increase becomes effective July 1, 2015.

 

Photo credit: brizzle born and bred / Foter / CC BY-SA

Published by Causey Wright