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Audit Shows More Than 60% Of NJ Workers’ Comp Claims Were Improper

The Office of the State Comptroller (OSC) recently released a report showing some 2/3 of Workers’ Compensation payments were incorrect. The report sampled reports and payments through the Workers’ Compensation program from 2012 through 2015. It detailed how many incidents had no follow-up or repeat violations from single facilities. In one case the same gate at a single facility generated 23 claims and cost the state upwards of $1.5 million dollars.

workers compensation

“The workers’ compensation program is supposed to address some of the root causes of the injuries,” said Acting State Comptroller Kevin Walsh. “What we identified … was an overall systemwide failure to focus on that obligation.”

Out of 554 payments reviewed more than 60% were shown to have problems. Many workers were awarded too much or too little.

Walsh found the state lacks a consistent method for evaluating payments and instead shows that they are often calculated in an “ad hoc employee-by-employee way.”

The state has indicated that changes are forthcoming which may include enhancements to payment templates, better recommendations to facilities with repeat claims, and other recommendations. Some changes are expected within 90 days.

“One of the things that we do when we do an audit like this is evaluate down the road whether recommendations have been followed, and that’s certainly something that we’ll do in this instance,” Walsh said.

Sources: https://nj1015.com/nj-workers-comp-audit-2-out-3-claims-improper-potential-for-abuse/