Wednesday, November 26, 1997

Governor
Tommy G. Thompson

Secretary
Linda Stewart



Contact
David Blaska
608/267-4400
e-mail: blaskd@mail.state.wi.us
fax: 608/266-1784


Worker's comp fraud is low

Worker's compensation fraud is unusually low in Wisconsin - six-tenths of one percent of all reportable claims. That's far less than in other states.

Last year, 152 cases of fraud were alleged, up 9 from 1995. But only 11 of those allegations merited being referred to the district attorney for prosecution - down 5 from the year before. The $175,389 thought to be fraudulently claimed was only one-third the amount of the previous year.

Worker's Comp fraud allegations
199419951996
Allegations95143152
Referred to D.A.71611
Value of Fraud*$45,355$480,210$175,389
*referred to district attorney for prosecution

Gregory Krohm, administrator of the Wisconsin's Worker's Compensation Division, cited four reasons for low fraud levels:

  1. Diligent reporting and claim investigation by insurers;
  2. Encouragement of early return to work by employers and insurers;
  3. Strong labor market conditions make fraud less desirable than honest work;
  4. Ethical worker's comp attorneys who would detect and report colleagues promoting fraudulent claims.

Instead of setting up a specially funded and staffed program, Wisconsin's program acts as a fraud clearinghouse. If the case seems to have enough facts to warrant an investigation, it is referred to an insurer or self-insured employer for further investigation. The Division reviews the investigation to make certain it is complete and will likely meet the expectations of the district attorney.

Most fraud allegations are made anonymously, by telephone, and from people who identify themselves as former friends or spouses, relatives, co-workers, or neighbors of the person alleged to be committing fraud. Those allegations usually don't pan out. For example, in 50 of the 152 allegations no worker's compensation payments were even being made. Many of the allegations are vague with no basis for an investigation.

The Worker's Comp World Wide Web site contains information about the program, tips for recognizing and combating worker's compensation fraud, statistics about fraud in Wisconsin, and links to other fraud databases.
Go to the "Fraud in WC" link at: http://www.dwd.state.wi.us/wc/