$9.5M Lost In ‘Massive’ Worker Compensation Scheme

The Department of Justice charged 28 individuals in the Texas area Monday with allegedly defrauding $9.5 million from federal workplace injury programs.

The alleged scheme involved a mass network of professionals and healthcare clinics. Those involved targeted worker compensation programs at the Department of Labor (DOL). Medical professionals got workers to fake or exaggerate injuries to qualify for government assistance. They were also assisted by a claims representative within the department. The Office of Worker Compensation Programs (OWCP) was the main office within the department scammed.

“These charges are the result of a two-year investigation led by special agents with the U.S. Postal Service Office of Inspector General and the Department of Labor Office of Inspector General,” U.S. Attorney John Parker said in a statement. “This office will continue to vigorously pursue those who fraudulently obtain benefits at the expense of those who have a legitimate need.”

Programs under OWCP help to provide those injured at work with wage replacement benefits, medical treatment and vocational rehabilitation among other related benefits. The scheme began with government employees at the U.S. Postal Service and Veterans Affairs (VA) but grew to include many more individuals.

To be approved for benefits, an injured workers would first have to be reviewed by a DOL claims examiner. The examiner could either reject or accept the claim. After that, a medical professional could treat the injured workers and bill OWCP for the expense. The scheme included the necessary medical professionals and government officials to get the alleged fake claims approved.

“[They] have been charged with various crimes related to their roles in a massive health care fraud scheme,” the Justice Department report noted. “Signed plea papers were filed today for each of the 28 defendants indicating their intent to plead guilty. Arraignment dates have not yet been set for those pleas.”

Larry Washington and Dr. Robert Mandell were among those charged with providing fraudulent medical services. Both ran AAA Mental Health among several other mental health and rehabilitation clinics. Washington recruited and paid patients to exaggerate workplace injuries so he could keep billing the government for services. Richardson provided the fraudulent psychological reports which were crucial to qualify for government compensation.

Washington also ran Mind Spa, Inc. were further fraudulent claims were made. Henrietta Price and Willie J. Atkins were licensed professional counselors allegedly helping to further the scheme at Mind Spa, Inc. From there, the scheme included more professional within a network of healthcare providers.

The Inspector Generals for the U.S. Postal Service Office and Department of Labor led the investigation. They were assisted by the Internal Revenue Service Criminal Investigation, U.S. Treasury Office of Inspector General, Social Security Administration Office of Inspector General and the U.S. Department of Veterans Affairs Office of Inspector General.

The Department of Veterans Affairs (VA) has already been the subject of scrutiny over a 2014 scandal that left dozens dead. An investigation into the scandal found veterans died waiting for care. The delays in care and questionable treatment practices resulted in federal investigations and a public outcry.

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