Special agents of the Postal Service Office of the Inspector General (OIG) are contracted to “safeguard postal revenue” and are supposed to “operate with integrity, be a model of ethical behavior, and treat people in a fair and respectful manner.”
When it comes to workers compensation fraud, however, these law enforcement officers often employ questionable tactics and exercise little fiducial responsibility: They have been cited by the Department of Labor (DOL) for violating federal regulations while conducting fraud investigations involving injured workers. Agents also have been performing claim management functions rather than ascertaining whether crimes occurred.
It’s unlawful for investigators to ask physicians about a claimant’s work tolerance limitations. This is a Health Resource Management (HRM) task, not an essential action of an official investigation; therefore, 20 CFR 10.506 applies. The regulation limits employing agencies to written contact with physicians treating injured workers covered by the Federal Employees Compensation Act (FECA).
The Employees Compensation Appeal Board (ECAB) found special agents using techniques that prejudice physicians against their patients in an effort to obtain desired medical opinions. Fearing that they, too, will become targets of investigation, physicians often fail to advocate for their patients.
The ECAB concluded that discussing investigations and sharing evidence with doctors “poisons the well,” which makes new medical opinions tainted and unpersuasive. (ECAB FS 11-863, September 26, 2012).
Where surveillance video is offered for the purpose of gaining a medical opinion, the employee must be notified, provided a copy if requested, and afforded an opportunity to explain the events depicted. (J.M., 58 ECAB 478, 486 (2007); Frederick Nightingale, 6 ECAB 268 (1953)).
But agents frequently use edited, secret surveillance to coerce doctors into agreeing to false accusations that their patients are exaggerating their limitations. Agents often make deceitful statements, employ misleading tactics, and engage in entrapment to justify charges against claimants for making false statements about their abilities. These scams cause OWCP to wrongfully terminate benefits and shamelessly destroy lives. That hardly qualifies as “operating with integrity” or treating people in a “fair and respectful manner.”
OIG agents portray injured workers as malingerers and can easily convince juries that don’t understand the FECA to indict their prey. Procuring questionable indictments bolsters the OIG’s conviction rate and increases cost-avoidance calculations and financial recovery figures. How else can they justify their own costs?
USPS OIG Chart is for “FY 2014 covering Oct , 2013- Sept 30, 2015”
Agents count on a large number of the accused pleading guilty to lesser misdemeanor charges. The OIG calls these “pre-trial diversions.” Indicted by their peers and driven by fear, OIG victims often trade their future FECA benefits to avoid imprisonment, hefty fines, felony records, loss of employment and costly legal fees. Veterans also risk losing their VA benefits.
To seal the deal, prosecutors and agents agree that they will not mandate restitution of benefits. This, in essence, is a con, because pleading guilty to a false statement charge counts as misdemeanor fraud. Guilt of any fraud, felony or misdemeanor, not only permits OWCP to stop all future benefits, it permits OWCP to aggressively pursue full restitution of all FECA benefits previously received.
The unsuspecting claimant has been duped into repaying what could be hundreds of thousands of dollars when medical treatment, wage loss compensation and schedule awards are factored into the equation. Only a universal settlement, one that applies to all, can potentially thwart reimbursement obligations.
In Fiscal Year 2015, the USPS appropriated $243.9 million to fund the OIG, resulting in the return of $10.7 million to the Postal Service and 23 workers compensation fraud convictions (less than 1/6 of one percent). Safeguarding revenue or waste and abuse?
To learn more about your rights during USPS OIG Fraud Investigations, review the Industrial Relations article in September/October 2009 issue of The American Postal Worker.
– See more at: American Postal Workers Union
USPS OIG Chart covering Oct , 2013- Sept 30, 2015″
If I take free money pursuant to a claim that I am medically unable to perform productive work, then I should be subject to surveillance and scrutiny. If I am truly a basket case, I have nothing to fear from any investigation. However, if I could do something productive, e.g work at McDonalds or 7-11 without violating my 5 pound lifting restriction, I should be doing that.
When a person who could work won’t work, it hurts everyone, including the idle person. Even the religious pilgrims came to the conclusion that all must work if they could, and adopted their “don’t work, don’t eat” policy. They apparently had their own problems with workers comp claimants.
Beautiful article at the perfect time. Thank you.
We all work with someone who does nothing and gets paid. Management did nothing to stop it in the first place. l know it happens because management made it easy as management did. They made it easy so people just took advantage. People just do not want to work and we have all worked with people who even try to sucker us into helping them make their case look bigger than life itself. To me it is unreal how people will stand around all day and do nothing because they had a back a spasm 10 years earlier and lied about it and now have to stand around all day on our dime while we do all their work. In fact 90% of us will not tolerate or enable others who are just lazy. I do not think these people understand what a dim view others have of them as they lie there way through life when all they need is a placebo. That is not really the biggest issue in my mind.
What makes me shudder. The real systematic problemo here is the P.O. committed almost 250 million dollars to fight this fraud and recovered less than 10% in return. That is management in action. This stuff all got out of control because of management and when they go to fight it they have to resort to tactics that are just as bad if not worse than the individual that is miss representing a diagnosis to get out of working to receive 100% disability until they pass way. Man oh man it just keeps getting worse
if you have worked at the PO over 15 years you know that a lot, not all, of these lite duty/limited duty/IOD are scam jobs by people who would rather game the system than do a days work. one guy at out plant has been out 7 years “with a bad back” but people run in to him at the mall popping wheelies on his 500 pound motorcycle……..one of many! rules say they should send these people to a 3 doctor exam, their doctor, post office doctor, and a third neutral doctor from the county health department. all three vote after exam and 2-1(or 3-0 lol) vote wins it for employer/employee. never see the PO use this to go after the scammers-buts its in the ELM.
Did you ever think the man was on narcotics and was feeling good that day or that it was not him you saw you think and the three doctor thing is just one doctor the patients the other two are paid to go against you you can not win with the thugs from the gov the will lie cheat steal and do whateba they want to screw the patient but if you do somthing wrong they are all over you what do you think oig means figure it out