In Iowa, businessman Dinesh Sethi, owner of DES Staffing Services was sentenced to 57 months of imprisonment for his fraudulent scheme to avoid paying over $750,000 in workers compensation premiums to Travelers and Liberty Mutual Insurance companies. Sethi was also sentenced to a 5 year supervised release term and $778,940 in restitution by Chief Judge James E. Gritzner. Sethi orchestrated the creation of two shell companies, Staffing professionals and KDM Staffing, in order to move his DES employees over to them to avoid the higher workers compensation premiums DES owed due to its claims history. In addition Sethi directed his CFO, Randy Stringer, to incorrectly move payroll amounts to job classifications with lower premium rates. After Sethi initiated an FBI investigation on his CFO for embezzlement, Stringer was prosecuted and has served his imprisonment time. Later, Stringer provided documentation to the FBI concerning the payroll shifting and the shell corporations, which were used to prosecute Sethi. ...

Workers’ compensation insurance providers base their businesses on number crunching and taking on risk. The better the information going into their calculations, the better they are able to create insurance products that meet the needs of business owners. Recently, The Argo Group, an international underwriter of specialty insurance and reinsurance products signed a deal to receive workers compensation injury reporting services from ISO. ISO is an international provider of commercial property/casualty insurance products. ISO will collect workers compensation injury claims information and manage the insurer’s report of injury information. The technology used will allow ISO to capture the claim data as the event soccur and to pass it on to electronic data interchange (EDI) sates in which Argo write workers’ compensation insurance. The EDI reporting is recommended by the International Association of Industrial Accident Boards and Commissions (IAIABC), but all jurisdictions in the U.S. don&rsq ...

Recent research attempted to calculate industry savings that could be found by replacing more exotic long-acting pain killing narcotics ones that contain morphine, with the continued goal of maintaining proper pain management for the patient. 402,000 cases of injured workers who had filled at least one narcotic prescription from 2002-2010 were examined by Express Scripts, Inc. By comparing what narcotics were prescribed, they found frequent us of the more expensive long-acting pain management drugs like oxymorphone or oxycodone, rather than lower-cost long-acting morphine-containing drugs. These long-acting drugs are designed to address chronic pain over time. Many experts believe that rather than going right to the long-acting drugs, patients should be prescribed lower cost short-acting narcotics containing oxycodone/acetaminophen or hydrocodone/acetaminophen. With proper monitoring of pain, a later switch to long-acting drugs may be appropriate. If a switch to long-acting pain killers is necessitated, th ...

In a survey of 3,500 employers, Zywave documented major concerns from businesses that returned the surveys, 59 percent were “very” or “somewhat concerned” about the ability contain costs in 2012. Areas beyond cost control that were of concern included: Keeping a limit on increasing exposures Renewals Rising fraud behaviors Carrier stability The Zywave’s most recent Workers' Compensation Safety Survey covered 20 lines of business, focusing primarily on: Manufacturers (17 percent) Health care and social assistance providers (15 percent) Construction (13 percent).  Responses came from a variety of staff positions in the companies: Human resource personnel (36 percent) Finance staff (19 percent) CEOs or presidents (16 percent),  Some 57 percent of those participating reported workers' compensation premiums under $50,000 annually. Almost half (48 percent) reported a premium increase in the past year, whi ...

Missouri Gov. Jay Nixon vetoed legislation that was intended to make workers’ compensation the exclusive remedy for most occupational diseases and to cap employee liability for workplace accidents. The Missouri S.B. 572 would workers’ compensation the only solution to occupational diseases. The only exceptions were to be cases involving the exposure to toxic chemicals, radiation and other substances caused by a 3rd party. It would also shield co-workers from being sued for workplace injuries or deaths that would be covered by workers’ compensation, with the only exception being negligence. Gov. Nixon sent a letter to the Missouri Legislature explaining: “Current law appropriately recognizes the severity and duration of these types of occupational diseases, which may take years or even decades to manifest themselves, by allowing affected workers broader redress through access to the civil justice system,” the letter reads. “Taking this right away from workers suffering f ...