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WCD
investigates fraud and system abuse complaints on employers, medical
providers, insurers, attorneys, and vocational providers. (Fraud
or abuse by injured workers is investigated by the insurer.)
In
order to strengthen our investigation process, we changed our intake
method.
The
Benefit Consultation Unit (BCU) is now the primary recipient of
incoming fraud complaints. Staffed full-time with highly skilled
workers compensation experts, BCU will provide quick responses
on questions that require brief, timely intervention, or where sharing
accurate information with a worker, employer or insurer will immediately
resolve a concern. BCU will also track complaint patterns, to surface
issues that may indicate larger system problems.
More
complicated investigations will be referred to the Investigations
and Sanctions Unit. WCDs Lead Investigator will determine
what resources and technical expertise are needed for each inquiry,
and will quickly assemble a response team of appropriate staff.
This enables WCD to be more nimble and flexible, with better coordination,
to solve issues of public concern.
To
report alleged fraud or system abuse, contact BCU at 1-800-452-0288.
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