"60 Minutes" looks at Workers' Compensation Fraud, Chiropractors Caught in the Scam
On April 12, 1992, ABC's "60 Minutes" featured a segment on the $3 billion per year workers' compensation ripoff. The focus was on the networks that have been established between attorneys, MDs, DCs, psychiatrists, and others designed to manipulate consenting workers to defraud the workers' compensation system. As Leslie Stahl put it: "Now scam artists working out of fly-by-night law offices and back-alley medical mills have devised a scheme to teach you how to fake job related injuries. The doctors get the money, the lawyers split the fees."
As part of their investigation, the "60 Minutes" team used an undercover person called "Barbara." Barbara was equipped with a hidden microphone; her boyfriend's hat was equipped with a hidden video camera.
Barbara and her boyfriend stood outside the unemployment office where they were quickly approached by a "capper." A capper is a person who solicits people to feign injuries as part of the scheme. For their service, the scam network pays cappers an average of $450 per person "hooked."
On a promise of getting more money than she would from unemployment compensation, Barbara was taken by the capper to a legal office. There (based on her description of her job duties), she was told what symptoms she had by a paralegal. Many of the symptoms were the type that would normally suggest chiropractic care: neck pain, shoulder pain, lower back pain, stiffness, constant headaches, etc.
Barbara was then scheduled to see seven doctors: a psychiatrist, a chiropractor, and five others.
At this point, "60 Minutes" interjected an interview with a chiropractor who used to work in a medical mill. The DC described the process of an initial visit with an MD followed by referrals and shuffling between other doctors in the fraud network.
Barbara is then shown in a chiropractor's office, after she has been x-rayed, receiving a "one minute exam." Before the x-rays are examined, Barbara is told she is scheduled for daily visits for the first two weeks, followed by visits three times per week. The diagnosis by the DC was a sprain/strain with a damaged tail bone.
All through the event, Barbara was seen by one psychiatrist, two or three chiropractors and (presumably) a few medical doctors. Unfortunately, the MDs were no longer included in the report after their mention by the DC who had worked in a "mill." Barbara received a total of thirteen treatments with modalities by the DCs. Throughout all of Barbara's treatment, she never complained of a single symptom except for a headache on one of the days of treatment. One chiropractor reported Barbara as "temporarily totally disabled."
Barbara was initially examined by a "legitimate chiropractor" prior to the investigation. This DC, when asked, was not shy about confirming that the treatment and diagnosis of the other chiropractors were fraudulent.
Ultimately, the entire news team went back to the offices of the chiropractor, the psychiatrist, and the attorney. The principals were not there, but the office staff was duly intimidated.
The parting comments included two very important points:
Policing this kind of fraudulent behavior by health care providers is the job of the "medical boards" and they apparently aren't doing their job.
Insurance costs for workers' compensation fraud are passed on by larger premiums.
These points left the uninformed observer believing that the health care providers (particularly chiropractors and psychiatrists) are incapable of regulating and policing themselves and must ultimately be investigated by law enforcement agencies. It also caused employers to wonder just how much of their enormous workers' compensation premiums are to compensate for health care fraud.
This "60 Minutes" segment could have been worse for chiropractic, but it also had the potential for putting the profession in a more positive light. If the DC who had worked for the "medical mill" had in fact been the one to expose the fraud network, chiropractors could have been the heroes. Instead, the program portrayed chiropractors as part of the conspiracy.
