Want to deal with insurance fraud? Then the collusion between workers comp judges and attorneys in California should be addressed. Massive case-rigging through gross fraud is what me and mine have uncovered in California’s workers compensation court system. Fraud by the system itself. Pull my case and I’ll show you.
Fraud can be both intentional and non intentional. The biggest challenge for stakeholders is having a tool that can map individual work injuries and standardize the results by applying rigor and statistical consistency to the medical opinions. The California Work Comp system is overwhelming and confusing for most physicians rendering care and medical legal opinions in the reports. Imagine if one medical provider assigns a 5% whole person impairment rating (wpi), and the second provider assigns a 17% wpi. That’s our current problem. With injury mapping tools, we can now quickly determine the completeness of the clinical ratable data sets to find out which opinion is the most accurate. Fortunately, work comp injury mapping for treatment benefit analysis, return on payor investment, and patient outcomes for benefit payments are now available. We no longer have to settle for “medical estimates”, because injury mapping moves the industry to “medical fact”. The big challenge going forward is to educate the stakeholders that injury mapping technology is now available in the work comp marketplace.
Why do you think there is so much WC fraud in California? Lack of laws? Laws not being enforced? Low level of causation for fraud? I am in the dissertation phase of my PhD and am wondering why there is so much WC fraud in California vs other states? Would love to hear some feedback!
Thank you in advance!
Want to deal with insurance fraud? Then the collusion between workers comp judges and attorneys in California should be addressed. Massive case-rigging through gross fraud is what me and mine have uncovered in California’s workers compensation court system. Fraud by the system itself. Pull my case and I’ll show you.
I agree with you Ronald, but 98% of the time the “collusion” is between on behalf of claimant’s and their attorney/treaters.
Over $6MM to LA County DA, and what do we see their office do to pursue WC fraud activity…diddly!
Fraud can be both intentional and non intentional. The biggest challenge for stakeholders is having a tool that can map individual work injuries and standardize the results by applying rigor and statistical consistency to the medical opinions. The California Work Comp system is overwhelming and confusing for most physicians rendering care and medical legal opinions in the reports. Imagine if one medical provider assigns a 5% whole person impairment rating (wpi), and the second provider assigns a 17% wpi. That’s our current problem. With injury mapping tools, we can now quickly determine the completeness of the clinical ratable data sets to find out which opinion is the most accurate. Fortunately, work comp injury mapping for treatment benefit analysis, return on payor investment, and patient outcomes for benefit payments are now available. We no longer have to settle for “medical estimates”, because injury mapping moves the industry to “medical fact”. The big challenge going forward is to educate the stakeholders that injury mapping technology is now available in the work comp marketplace.
Why do you think there is so much WC fraud in California? Lack of laws? Laws not being enforced? Low level of causation for fraud? I am in the dissertation phase of my PhD and am wondering why there is so much WC fraud in California vs other states? Would love to hear some feedback!
Thank you in advance!