FECA fraud is not easy money
Posted 10/27/2011 Updated 10/27/2011
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by Debbie Gildea
Air Force Personnel, Services and Manpower Public Affairs
10/27/2011 - RANDOLPH AIR FORCE BASE, Texas (AFNS) -- U.S. Attorney General Eric Holder cautioned would-be cheaters that health care fraud is not easy money during a press conference earlier this year. That same warning goes for workers' compensation fraud.
The Federal Employees' Compensation Act provides compensation for employees who sustain injuries or illnesses as a result of their job. Such compensation is an important protection for federal workers, according to Marty Watson, the Air Force Personnel Center Chief of Injury Compensation, but when people abuse the system, everyone suffers.
Payments for injured federal workers total billions of dollars per year. In 2011, the Air Force paid $135,000,000 for its injured workers. A 2008 Air Force audit showed that fraudulent claims can be as high as 10 percent of the total.
Examples of FECA fraud include employees who provide medical evidence that they are unable to work as federal employees, but continue to work and receive unreported income. Employees who exaggerate medical complaints to doctors to receive work restrictions and who are later seen violating those restrictions during personal time are also committing FECA fraud. In addition, people who try to claim unrelated medical conditions or injuries under FECA, medical providers who bill the government for services not performed, and physicians who knowingly exaggerate a patient's limitations are all committing fraud.
According to Watson, FECA investigators have uncovered fraud and have been instrumental in the prosecution of claimants who were caught selling medications received through FECA benefits.
Prior to 2010, base-level civilian personnel sections administered the workers' compensation program. Today, AFPC administers nearly half of all Air Force workers' compensation claims, and will handle all Air Force claims by the end of 2012.
To balance the need for dedicated FECA stewardship with the potential for abuse, the Directorate for Civilian Force Integration is standing up a new team dedicated to fraud detection.
"We're teaming up with the Air Force Office of Special Investigations and the Department of Labor Office of the Inspector General to weed out fraudulent claims," Watson said. "Defrauding the government is a federal crime, and felonies come with a variety of consequences. Employees caught defrauding the government could face fines, prison time or both."
AFPC and its partners will use many tools to prevent fraud, including file and medical documentation reviews, surveillance, and interviewing neighbors and co-workers, and the center has already identified many suspicious cases that are under evaluation, Watson said.
She invites concerned taxpayers to report suspicious cases.
"You can be part of the solution by reporting suspected FECA fraud to the Air Force Office of Special Investigation," she said.
To report fraud, call the OSI 24-hour hotline at 877-246-1453, or send an e-mail to hqafosi.watch@ogn.af.mil.
For more information about compensation and other personnel issues, visit the Air Force Personnel Services website at https://gum-crm.csd.disa.mil. |
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