Category Archives: Unethical behavior

GoFundMe??? Really!!!

Here is a case of an injured worker who was denied work comp when he fell down some stairs at work, and now had to have his wife start a GoFundMe account.

A former co-worker of mine when I worked for a large insurance broker also fell going down stairs in the building we worked in, and he did not have this problem.

THIS IS UNCONSCIONABLE. THIS IS EXACTLY WHAT COMP IS FOR. FAMILIES SHOULD NOT HAVE TO GO BROKE IF SOMEONE SLIPS AND FALLS DOWN A FLIGHT OF STAIRS ON THE WORK PREMISES.

This is the result of too many cooks and too many lawyers mucking up the system, which forces the carriers or the employers to deny or seek the denial of benefits.

If any of you feel charitable, here is the link to the GoFundMe page:

https://www.gofundme.com/2n5y8apc

Now you know why I call my blog “Transforming Workers’ Comp”. This has to stop.

Medical malpractice at Pilgrim’s Pride…the poultry company?

It sounds like malpractice to me. That’s what I’ve been thinking ever since learning how the injuries sustained by poultry workers are treated (and not treated) at the company nursing stations.

Source: Medical malpractice at Pilgrim’s Pride…the poultry company?

Cut the C**P!

For my 300th article, I want to address the medical travel industry and its failure to rid itself of the crooks, liars, shysters, and phonies who prey upon the desperate.

Case in point, the article last Wednesday in the New York Times by Gail Kolata about one man’s experience getting stem cell therapy through medical travel.

This case is endemic of the industry’s impotence to police itself and get rid of those medical providers and hucksters who use slick promotional material to sell useless and often dangerous treatments or dubious procedures.

But what do you expect from an industry whose major organization is merely a conduit for funneling money into the pockets of the organization’s founders and their friends?

What do you expect from an industry that emphasizes attending conferences and not on standardizing the laws and processes for the provision of medical care across national borders.

When I started this blog over three years ago, I had high hopes that the industry would listen to what I had to say, and to at least consider offering medical travel to injured workers in the US. But as happened with the workers’ comp industry, no one has stepped up and offered to work with me.

I’m not mad at everyone in the industry. Many of you are very nice people and work very hard, but your focus is on such medical care as dentistry, cancer, cosmetic/plastic surgery, and other treatments not available in the US, or too expensive.

But helping those who are injured on the job, and many of whom are from many of the countries in this hemisphere who offer medical travel services, should be something some of you might want to do.

It was my hope that this industry would offer me a chance to change direction, but that has not happened, and now I am not sure if it ever will.  There does not seem to be any financial or employment opportunities here, just a lot of conferences and hyperbole.

Prove me wrong.


I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.

Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp.

I am also looking for a partner who shares my vision of global health care for injured workers.

I am also willing to work with any health care provider, medical tourism facilitator or facility to help you take advantage of a market segment treating workers injured on the job. Workers’ compensation is going through dramatic changes, and may one day be folded into general health care. Injured workers needing surgery for compensable injuries will need to seek alternatives that provide quality medical care at lower cost to their employers. Caribbean and Latin America region preferred.

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: richard_krasner@hotmail.com.

Connect with me on LinkedIn, check out my website, FutureComp Consulting, and follow my blog at: richardkrasner.wordpress.com.

Transforming Workers’ Comp Blog is now viewed all over the world in over 250 countries and political entities. I have published nearly 300 articles, many of them re-published in newsletters and other blogs.

Share this article, or leave a comment below.

Deaf, Dumb and Blind

It’s time once again for a rant. This rant is courtesy of my fellow blogger, Joe Paduda, who wrote an article today that criticizes members of the workers’ comp industry for not publicizing the positive things they do, but complain about all the negative press they have been getting.

As Joe writes, “Yep, it’s your fault that the popular press smacks you around, citing a few examples of alleged insurer screw-ups as proof that you’re all a bunch of cold-hearted, nasty, lazy incompetents motivated only by profit.

Joe was referring to reports from ProPublica, NPR, plaintiff lawyers, muckraking journalists and bloggers (including yours truly, as well as two women I have previously written about, and who are injured workers themselves), and calls for the industry to stop their bitching.

Most industry professionals may not realize that workers’ comp came into existence due to the writing of early twentieth century muckrakers as Upton Sinclair (The Jungle), Ida Tarbell, Lincoln Steffens, and many others.

He takes them to task for not publishing a case of the month, sending out a press release honoring an employee for going above-and-beyond in helping out an injured worker.

Joe says it is their fault because the reasons they don’t promote their good works are short-sighted, ignorant, and indefensible; in short, you are deaf, dumb and blind to reality.

From the day Edward Lloyd opened his coffee house in London in the 17th century, the insurance industry, and specifically, the workers’ comp industry has been dominated by Lloyd’s fellow countrymen and co-religionists.

The same holds true here in the US, but American pluralism (of a kind) has allowed some minorities to make it in the industry, but it is still mostly a white male, majority religion club (certain exceptions such as Saul Steinberg and Maurice Greenberg notwithstanding).

I know people in my family and in our extended social circle who have worked for insurance companies, and the highest level they have attained has been below that of the top executives. My first job in workers’ comp was with a company whose executives were not members of that club, but my boss was, and that was a reason some of us claims people were mistreated by him. Sheer resentment that he was not a member of the tribe and thus the board of directors. Let’s not pretend it does not exist. Why do you think some companies are called, “white shoe” companies?

Here is my take on this:

  1. You are resistant to change unless the change comes slowly, and from sources you trust and can control or dominate.
  2. As evidenced by Joe’s writing, you are unwilling to accept criticism from anyone who is not a member of the club or is from the lower ranks, or even someone who is on the outside looking in, as I am.
  3. You refuse to offer those with a passion for making workers’ comp better and opportunity to do so, and have laid off the best, brightest and hardest working people to save money on employee benefits, to cut payroll, costs, or because everyone else is laying people off, so why should you be any different. One of my LinkedIn connects writes a lot about millennials going into insurance, and many of you have complained online that you can’t find talented people. That’s because they are out looking for work.
  4. You refuse to accept any new idea, no matter who gives it, no matter what it is, and even have the nerve to criticize the idea and the person who promotes it. You continue to do the same things over and over again, and expect different results.
  5. You have elevated the laws, regulations, rules and statutes to the level of sacrosanctity, and that has frozen the industry in time, if not in place.
  6. Not one of my LinkedIn connections in the industry or in the insurance and risk management arena, who are hiring managers or executives have ever complimented me personally, save Joe, on my knowledge, my writing, or my passion for improving workers’ compensation. Crickets…
  7. You must dump the adversarial attitude pervasive among carriers, TPA’s, service providers, physicians, and employers. Not all injured workers are crooks. Treat them accordingly, and help those who really need help. Get emotional when you hear a sad story and work to fix it.
  8. STOP USING MEDICAL PROVIDERS WHO DELIBERATELY INJURE WORKERS, BOTH MEDICALLY AND EMOTIONALLY BY LYING TO THEM, DENYING THEM TREATMENT, OR JUST BEING GREEDY. Punish them by refusing to pay them or turning them into the legal authorities.
  9. Lastly, listen to the outsiders, even though they don’t have a job title, or are publishing anecdotal evidence of how bad some workers have been treated. Resist the snake-oil salesmen of opt-out like ARAWC and ALEC, whose agenda is both political and economic. They believe in an economy much like that when Edward Lloyd opened the coffee house. Ever wonder why Texas, and now Oklahoma are the only two states with opt-out? Because they are both states whose leaders in business and politics believe in laissez-faire, free market (free to the capitalist) capitalism. Don’t believe me? Here’s what Dwight Eisenhower said to his brother in a letter in 1954:

“Should any political party attempt to abolish social security, unemployment insurance, and eliminate labor laws and farm programs, you would not hear of that party again in our political history. There is a tiny splinter group, of course, that believes you can do these things. Among them are H. L. Hunt (you possibly know his background), a few other Texas oil millionaires, and an occasional politician or business man from other areas. Their number is negligible and they are stupid.”

The Koch Brothers are just like the Hunts were back then, so be careful about opt-out expansion. It is a ploy to abolish the progressive reforms the muckrakers helped to create.

That’s all I have to say. It’s up to you to change course and make things better, but know this, we are not your enemies. We want to help, and I want to help you now.  Don’t be deaf, dumb an blind to us.


I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.

Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp.

I am also looking for a partner who shares my vision of global health care for injured workers.

I am also willing to work with any health care provider, medical tourism facilitator or facility to help you take advantage of a market segment treating workers injured on the job. Workers’ compensation is going through dramatic changes, and may one day be folded into general health care. Injured workers needing surgery for compensable injuries will need to seek alternatives that provide quality medical care at lower cost to their employers. Caribbean and Latin America region preferred.

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: richard_krasner@hotmail.com.

Will accept invitations to speak or attend conferences.

Connect with me on LinkedIn, check out my website, FutureComp Consulting, and follow my blog at: richardkrasner.wordpress.com.

Transforming Workers’ Comp Blog is now viewed all over the world in over 250 countries and political entities. I have published nearly 300 articles, many of them re-published in newsletters and other blogs.

Share this article, or leave a comment below.

The Miasma of Fraud

One last post before you celebrate Thanksgiving.

Business Insurance’s Stephanie Goldberg reported today, that five people have been charged  with workers’ comp insurance fraud in California, and that the insurance commissioner called it, “one of the largest workers’ compensation insurance fraud cases we have ever seen.”

In July, 2014, I wrote two articles about fraud in California, “The Stench of Fraud: Why Workers’ Comp Can No Longer Be a Closed System” and “The Stench of Fraud, Continued.”

Charged in the case was the former CFO of Pacific Hospital, James L. Canedo, two orthopedic surgeons, a chiropractor, and Paul Richard Randall, a health care marketer.

They were charged with illegally referring more than 4,000 patients for spinal surgeries, and generated more that $580 million in fraudulent bills during an eight-year period, according to the US Department of Justice, in a statement released yesterday.

Many of the claims were paid by the California work comp system, the rest by the federal government.

Canedo and Randall have pled guilty, and the other three have agreed to plead guilty, and under the terms of their plea agreements, each defendant could face prison terms and be required to pay restitution to their victims.

The US Attorney’s office for the Central District of California said in a statement that Canedo faces 10 years in prison and at least $20 million in restitution.

The scheme consisted of kickbacks of $15,000 for each lumbar fusion surgery, and $10,000 for each cervical fusion surgery, according to the US Attorney’s statement.

The ongoing investigation, dubbed “Operation Spinal Cap”, discovered that some of the patients lived hundreds of miles away from Pacific Hospital, and closer to other qualified facilities, the patients were not informed that medical professionals were offered kickbacks for referrals, and that insurers had paid the hospital more than $226 million for the surgeries.

Once again, we see that workers’ comp, especially in California, but also in other states, is like a fetid pool of rotting vegetation and other foul matter, so that what was once called a stench, is now a miasma that hangs over the surface of the system.

It does not have to be like that. It can be better. You can find an alternative to expensive surgeries and illegal payoffs, if only you would consider new ideas and new possibilities.

Or you can continue to breathe in the foul air. The choice is yours.

 

 

 

Challenges Facing Work Comp

In three weeks, members of the medical tourism industry will gather in Puerto Vallarta, Mexico to attend the 6th Mexico Medical Tourism Congress.

You may recall that I was invited and attended the Congress last year, and was invited again this year. However, due to personal and financial reasons, I am not attending this year.

I am however, posting my PowerPoint presentation below for your viewing, with narration by yours truly. I hope you find it interesting and informative.

Challenges Facing Workers’ Comp (PowerPoint)

Challenges Facing Workers’ Comp (video)

 

OSHA Finds 31 Serious Violations at Aluminum Foundry

Recent reports by OSHA and NPR/ProPublica (see my post, “Workers’ Comp Besieged: Independent Views of the Problems Workers’ Comp is Facing“) have exposed the ugly truth about the workers’ comp system that some in the industry a) have known about for years, b) did not want to hear and criticized the reports for their inaccuracies and failures, or c) took this as a wake-up call to do better in the future.

While it is true that the majority of claims ( let us use the 80/20 rule as an example) are handled properly, the 20% that are not handled properly are of great concern to a great number of people, especially the injured workers themselves who bear the brunt of bad medicine, bad lawyers, bad employers and bad claims and risk management personnel.

But the real heart of the problem is not the system we created nearly a hundred years ago to protect the health of workers, but with the ideology that underpins the entire American capitalist system, and that now is experiencing a recrudescence in our political process and in the business culture of the 21st century.

What I am referring to is the value system (or meme) that many large and small employers have that says that the health and safety of the worker is not as important as the right of the owner to make as much money as they can, no matter what happens to the worker. And at the heart of that meme is the drive to maximize shareholder value or to improve the bottom-line, at any cost.

This meme harks back the beginning of the industrial revolution, and there is no greater example of the disdain some employers, especially small or mid-size employers have towards their workers, that can be found in an article today on Workers’ Comp Insights.com.

The article, by Dave Battinieri, “OSHA Tags KS Aluminum Foundry with 31 Serious Violations” reported that workers were exposed to chlorine gas while forging aluminum blocks at a foundry in Prescott, KS, mainly because they were never trained on how to handle or store the gas.

A complaint was filed in September 2014 that prompted an OSHA inspection. Upon inspection investigators found confined space hazards at Custom Alloy Sales 34P LLC.

In their inspection, OSHA found 31 serious violations and proposed penalties of $160,200. The workers were never trained on how to handle dangerous chemicals being used around the foundry, and they were not protected from various machine parts. Also, there were also forklifts in use that had defects as well.

The employer, Custom Alloy has contested the violations and fines and now the case may go before an Independent Occupational Safety and Health Review Committee.

So the problem is not only with the state statutes, or with lawyers, or with medical providers, or even service providers such as third party claims administrators, etc.

The problem is with the employer who thinks because he’s a capitalist or because he is in business, that no one has a right to tell him how to run his business or what safety protocols to follow. And while it is true that much of the work environment has gotten safer as better technology has replaced the old ways of manufacturing products, this example shows that there are still companies that are run by outdated 19th century value systems.

The challenge for all of us is not just to improve the workers’ comp system, but to change the business culture so that businesses like Custom Alloy do not put workers into harm’s way. And that a certain political party who will remain nameless, but not blameless for taking the country back more than a hundred and fifty years, does not get the chance through legislation or through their friends in big and small business, to turn the clock back to the 19th century.

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I am willing to work with any broker, carrier, or employer who is sick and tired of being bled by the Wall Street vulture capitalists and the entire medico-legal system known as workers’ comp, to save money, and to provide the best care for their injured workers or their client’s employees, while at the same time, helping to break the monopoly of the American health care cartel.

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: richard_krasner@hotmail.com. Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp. Connect with me on LinkedIn and follow my blog at: richardkrasner.wordpress.com. Share this article, or leave a comment below.