PHILADELPHIA (KYW Newsradio) — A report from New Jersey’s comptroller says the state hasn’t adopted recommendations to address fraud and abuse within the workers’ compensation system.
An audit in 2020 by the New Jersey Office of the State Comptroller found the worker’s comp system was ripe for abuse, and it made seven recommendations to reduce fraud, waste and abuse.
1. Get legal guidance on how to accurately calculate compensation payments.
2. Formalize a system for reviewing calculations and reducing errors.
3. Find a better way to manage multiple claims to prevent potential abuse and to improve safety and accident prevention.
4. Formalize a system to determine when workers must return to the job and to identify people receiving overlapping benefits.
5. Do more case file reviews and monitor claimants’ work status changes better.
6. Revise policies and procedures to improve management of claims and to prevent abuse and improve safety.
7. Require vendors to provide supporting documentation regarding performance measurements, and perform independent reviews before disbursement of funds.
Acting Comptroller Kevin Walsh says his office revisited that report and found little to nothing has changed since then.
“And we were disappointed to find that none of the seven recommendations we made were fully implemented and that the state hasn’t taken the basic steps to protect $96 million in taxpayer funds.”
Walsh says there are some glaring problems and administrators have failed to perform basic oversight of benefits.
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“We looked at a group of employees that, on average, were out for 600 days — 20 months of work missing — and found that they were not even conducting quarterly reviews.”
Walsh says there is also no policy to deal with repeat claimants. He says there should be more scrutiny when someone is hurt multiple times doing the same tasks.
The New Jersey Division of Risk Management is the office in charge of worker’s comp, and in a statement officials say they agree with all seven of the comptroller’s recommendations and will make necessary changes, including moving to a cloud-based claims system next year with more automated features to flag certain claims.
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