Sunday, July 28, 2002

Spokane

Investigation methods reveal frauds
People lying about workers' compensation injuries often get caught by agents using surveillance

Richard Roesler
Staff writer

OLYMPIA _ The wheelchair-bound man told his doctors he couldn't walk, the result of a crippling job injury.

Investigators proved otherwise, secretly filming the supposed paraplegic as he scampered up ladders and climbed through a window to answer the phone at a house he was putting siding on.

Another man was supposedly housebound by an agonizing back injury suffered on the job. An investigator with a snowmobile-mounted camera shot the man snowmobiling, chopping wood and building
snow forts -- while boasting to his children how he'd fooled the state into paying him every month for his supposed disability.

There are 30 field investigators statewide policing Washington's workers' compensation claims, which pay workers injured on the job, as well as spouses of those killed. Some 163,000 employers pay into the system, which covers nearly 2million workers.

The agents rig up surveillance cameras, pore through court, bank and employment records, and interview doctors and neighbors. They'll creep through underbrush in camouflage with binoculars, or film from parked cars or through the windows of a neighbor's home.

The vast majority of people getting workers' compensation are legitimately suffering and disabled, investigators say. But those faking injuries or secretly continuing to work on the side can cost the system hundreds of thousands of dollars. Last year, L&I uncovered nearly $3.3million in workers' compensation fraud.

"They're stealing from everyone," said fraud adjudicator Lynda Cochran. The agency also uncovered millions of dollars more in underpayments by employers and more than $350,000 in over-billing by vocational and health care providers.

Workers' compensation is intended to cover an injured worker's medical care and partly make up for lost wages while he or she recovers. The payments are usually 60 to 75 percent of a worker's wages. Employees are supposed to go back to work as soon as they're able.

Spokane investigators won't yet talk details, but say they recently won an order for a Spokane man to pay more than $450,000 in restitution and penalties for collecting benefits while secretly working.

"They figure that the world owes them, or it's just flat greed," said Paul Powell, an investigations supervisor in Vancouver.

State workers' compensation benefits are tax-free, and if someone's illegally working on the side as well, they're essentially getting a double income.

"They actually work harder at malingering or to cover up the fact that they're working than they would if they went back to their old job," said Powell.

"Recently, we seem to be getting a rash of these things. I don't know whether it has to do with the decline in the economy or what," said Joe Kimball, investigations supervisor at the Spokane office, which routinely sends its agents to Colville, Clarkston and into North Idaho.

He said the office is currently working 16 fraud cases, as well as doing 43 routine checks on claimants. In the past five months, the Spokane office alone has won restitution orders for $632,665.

"What we do benefits the taxpayers, keeps employers' rates down, and improves the quality of care for injured workers," said Lee Benford, chief of investigations at L&I's headquarters in Tumwater. "In many jobs, you don't see your end product. In this one, you do."

People will go to bizarre lengths to back up a claim. A Yakima-area man in the early 1990s hired someone to blow off most of his leg with a shotgun. Another man cut off his own thumb. Another would dislocate his own shoulder on the job, Powell said, then go to the doctor and request a specific brand of narcotic painkiller. He repeated this nine times before moving to Oregon.

One of the biggest recent cases involved a Seattle man who was finally nabbed at the Spokane Interstate Fair. His name is Bobbie Lee Chaffin, but according to case records, Chaffin used at least five Social Security numbers and nearly a dozen aliases. He was Mike Meadows, Roberto DeSilva and Dr. Michael LaSalle, among other identities.

Chaffin started collecting workers' compensation in 1985, after a head injury that he said left him with debilitating tremors. His doctor wrote in 1995 that Chaffin had "severely diminished mental capacity," relying on a helper for even the simplest daily tasks. Chaffin lived in an old house in Seattle, with three junked cars and an old trailer gracing the front yard, according to the case records.

During much of the time he collected state disability benefits, however, Chaffin was secretly running a thriving business as a hypnotist at carnivals and fairs. He advertised in newspapers across America, and deposited nearly $800,000 in the bank over seven years, much of it apparently from hawking hypnosis tapes to help people relax, lose weight, or stop smoking, the case records say.

Investigators finally videotaped him running four booths at the Spokane fair. When he returned to Seattle, they went to his home to serve papers on him. He pretended not to be home, then tried to get away in his car, the case records say. Two agents stopped him.

"As soon as I said `Labor and Industries,' he began to shake his right hand as if suffering tremors," one of the investigators wrote in his report. "Prior to that, there was no sign of any tremors." Last year, the 65-year-old Chaffin was ordered to repay nearly $354,000 to the state.

About 10 phone and e-mail tips come in each day to L&I headquarters. They come from angry ex-spouses, employers, investigators in other states and from neighbors. Many tips come from people who are truly disabled and are upset that someone else is fooling the system.

Border areas present particular problems, since workers can collect benefits in Washington, then secretly work in Oregon or Idaho. A former Spokane Bakery Supply salesman collected benefits for nearly two years in the mid-1990s. He claimed he suffered headaches, blurred vision and back pain stemming from a fall during a delivery at the Coeur d'Alene Resort. Yet investigators found him working as a salesman, truck driver and backhoe operator in Idaho. He was ordered to repay more than $48,000.

Some cases involve dead workers' spouses. When Tacoma mechanic Loren Bernard died in a work-related accident in 1970, his disability pension went to his wife, Sharon Bernard. Years later, investigators learned that she had apparently remarried in 1972, which disqualified her from receiving her dead husband's benefits. Now a Minnesota resident, she was ordered to repay nearly $435,000.

It's getting harder for people to hide second jobs, Powell said, due to computerization and a growing trend among states to share information with each other. For people faking injuries, he said, it's hard to constantly maintain the charade.

An agent caught one man with a supposedly disabled arm when he unthinkingly reached up to brush rain off his hair.

"You can't do anything illegally all the time and not trip up," Powell said. "They always do. You can't be this other person 100 percent of the time."

•Richard Roesler can be reached at (360) 664-2598 or by e-mail at srwestside@attbi.com.


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