By RYAN MORGENEG
Those hoping to take advantage of their workers’ compensation benefits by faking or prolonging injuries will now have to think twice, thanks to the special investigations unit of the Workers’ Compensation Fund of Utah.
Three years ago, the WCFU created a detective fraud division to investigate the suspicious injury claims of Utah workers.
“Our special investigations unit has saved $6 million since its creation in 1993,” said Joel Campbell, a retired police detective who heads the unit.
State law requires businesses to have workers’ compensation insurance. “Fraud brings higher insurance premiums to Utah businesses, and many smaller-business owners are unable to pay the higher premiums,” said Lisa Klein, a claims adjustor for WCFU. “This is devastating for the Utah market.”
“The problem starts when a person gets used to getting a paycheck for doing nothing,” Klein said. “It’s too tempting to get a job or fake reoccurring symptoms to prolong benefits.”
One example of “double dipping,” another term for this type of fraud, occurred at a local university where a doctor claimed that a back injury had left her permanently unable to walk. On her way to a doctor appointment, a private investigator shot video of her getting out of her car, walking to her trunk, heaving a wheelchair out and sitting down in it.
At a later preliminary court hearing where she was attempting to sue WCFU for no longer paying her benefits, the tape was shown to the judge. She immediately dropped her case against WCFU.
Over ten private investigators are on call to assist the WCFU at anytime. “Our unit has almost a 100 percent conviction rate,” Campbell said.
Tom Callanan, vice president of marketing at WCFU, said, “To give you an idea of the success we’ve had, our fraud investigators have 46 criminal convictions and 22 cases pending.”
“This year 15 people have been convicted, compared to last year’s 11. Ninety-nine percent of the people in Utah are honest about workers’ compensation. Our investigation unit deals with the 1 percent who are not,” he said.
The WCFU fraud hotline takes calls for tips on potential fraud. The number is 1-801-288-8329. Names will be held confidential
