The FECA FIU works with the Corps’ Human Resources Directorate, DA’s Civilian Human Resources Agency, and DA G-1 to implement a program of proactive claims management. This includes frequent reviews of potentially fraudulent injury claims, and the auditing of subordinate commands programs for signs of abuse while maintaining a sustained observance of USACE’s overall workers’ compensation program. The FECA FIU continues to set the example as the Corps’ subject-matter experts (SME) in the field of investigating workers’ compensation fraud and abuse, and ensures the pursuit of every avenue available to reduce costs related to the USACE FECA program.
To assist subordinate commands, the FECA FIU participates in workers’ compensation working groups throughout USACE. These working groups are directed by the Office of the Secretary of the Army and USACE command. Each district, division, and lab should have its own workers’ compensation working group. The FECA FIU is available to participate in these working groups at the command’s request. The unit is capable of providing a fraud SME who can attend the meetings in person or via teleconference. The SME can help discuss potentially fraudulent claims and share processes and best practices used throughout USACE.
Workers’ compensation fraud and abuse are often considered a victimless crime by commanders and supervisors. For years, the workers’ compensation program was considered a “dumping ground” for unsatisfactory or unwanted employees, and there was no or little effort to bring injured employees back to work. Injured employees were stigmatized as being unwanted or less effective because they were on workers’ compensation and away from the workforce for long periods of time. The cost of this type of abuse was commonly overlooked by commanders since costs related to employees who were civil funded were paid by Headquarters USACE. Although ICPAs verify the personnel on the workers’ compensation rolls annually, there is no direct action required by the subordinate commands to pay the compensation bill. The funds used to pay the annual compensation bill are taken straight off the top of the construction general funds at the Headquarters USACE level, leaving less for projects.
Recently, through the efforts of the FECA FIU, a former USACE employee pled guilty to one count of violation of Title 18, U.S. Code Section 1920; “False Statements Regarding Federal Workers’ Compensation Benefits.” The former employee had claimed his elderly mother as a dependent despite the fact that she was never his dependent and had been deceased for several years. This blatant fraud allowed the employee to receive 75 percent of his salary from DoL tax free as opposed to the 66.6 percent he would have received with no dependents. The plea agreement states that the employee knowingly and willfully made false statements to DoL OWCP to received benefits he did not deserve.
If the individual had not pled guilty to the single count, he faced possible conviction of six counts for violations of Title 18, Section 1920. The conviction could have included penalties of imprisonment for up to five years and a fine of up to $250,000 for each count. The plea allowed the individual to repay $47,803 of fraudulently received compensation, and uncontested permanent removal from the compensation rolls, saving USACE an additional $833,092 in lifetime compensation costs.
FECA fraud affects us all in a negative manner, and every employee has a responsibility to report any incident of fraud or abuse, no matter how small or seemingly insignificant.
To report suspected workers’ compensation fraud, contact the FECA Fraud Unit through the Operations Office of the FECA Fraud Investigation Program at (601) 631-7285, by email at john.kisner@us.army.mil, or contact the FECA FIU Fraud Hotline at (800) 831-2018.
This article first appeared in the 2011-2012 edition of the U.S. Army Corps of Engineers: Building Strong®, Serving the Nation and the Armed Forces publication.