May 10, 2007

Comp Fraud Follows a Different Drummer

Let's get down and funky. Valerie Scroggins is a drummer for ESG, a group she founded in the South Bronx with her sisters some 25 years ago. According to Wikipedia, ESG has been influential in a wide range of musical genres, including hip hop, post punk, disco, and dance-punk. Not exactly my taste in music, but who cares. Let's get down!

We read in the New York Times that Valerie, in her working life, drives a bus for the New York City Transit Authority. Or at least she did until last September, when she hurt her shoulder and went out on workers comp. Then the band went to Europe on tour - and Valerie went with them. An investigator for the self-insured Transit Authority drew the lucky straw and followed the band to Amsterdam and Dublin, where he filmed Valerie happily playing her drums.

"She's pretty good," remarked Charles Hynes, the District Attorney. Alas, the party-pooping Hynes has indicted Scroggins on charges of grand larceny and insurance fraud.

Ms. Scroggins lawyer, Stacey Richman, points out that Valerie had been put out of work by two doctors. As for the drum playing, Ms. Richman responded with a classic line that belongs in a Bartlett's for Attorneys: "I don't believe there's any movement that conflicts with the medical diagnosis." Heck, banging the skins just might be what the physical therapist ordered!

This slightly sordid tale brings to mind the original quote from Henry David Thoreau:

If a man does not keep pace with his companions, perhaps it is because he hears a different drummer. Let him step to the music which he hears, however measured or far away.

Which we paraphrase:

If a chick gets tired of driving the bus, perhaps she really is a drummer. Let her boogie to the music she makes with her sisters, very loud and very far away indeed.

At least until she's indicted. Makes me want to turn up the volume and play a couple of tracks from an old ESG album: "I can't tell you what to do" and "Crash."

Which brings to mind another Thoreau quote: Go confidently in the direction of your dreams. Live the life you have imagined. With one caveat: try to do it within the law.

| 3 Comments

3 Comments

There is fraud everywhere, my friend. It seems that it is always open season on injured workers, nearly all of whom are legitimately hurt.

Where are your tales about the injured worker who is denied care, has their benefits cut off, is sent to bogus insurance exams?

If Ms. Scroggins was known to be a lesbian or had HIV and you talked about her morals, your web site would have been taken down.

Unfortunately for injured workers, they are not a PC group; they are all assumed to be liars and malingerers.

Thanks for keeping the stereotype alive buddy.

If you read this blog with any regularity, Andrea, you will see that when it comes to fraud, we are pretty impartial. In fact, more of our posts have to do with employer, physician, and insurer fraud than employee fraud. But when employees commit fraud, we call a spade a spade because it's a crime that hurts the honest workers who are all too often treated with suspicion.

We're big champions of injured workers, Andrea - the premise of our business is helping employers to prevent injuries in the first place, but if injuries occur, ensuring that workers get top quality medical care and back to work and their normal lives as soon as possible. Treating injured workers well is not only the right thing to do, it's also less costly for employers than treating workers badly.

So while we are big champions of injured workers, we will continue to call out fraud, regardless of who is committing it.

Of course I can't prove it, but most of the benefits to SB899 has come from taking everything away from the IW, including their dignity. Most IW don't even get the initail $10,000 of treatment before denial.

If the IW could unionize, or if their WCAB filings were available so someone could do some real statistics and studies, the amount of employer fraud/denial, insurance fraud/denial, might really come to light.

Subscribe

Submit your email to be notified when this site is updated

Need help with your workers' comp program?

Monthly Archives

About this Entry

This page contains a single entry by Jon Coppelman published on May 10, 2007 11:01 AM.

Fleece on Earth, Ill Will to Independent Contractors? was the previous entry in this blog.

News Roundup" Cavalcade of Risk, networks, docs & drugs, scandal watch & more is the next entry in this blog.

Find recent content on the main index or look in the archives to find all content.

OpenID accepted here Learn more about OpenID