MTA DRIVEN TO CHECK WORKERS' COMP FRAUD.

Byline: Troy Anderson Staff Writer

Long burdened with the highest workers' compensation costs of any transit agency in the nation, MTA officials have started to try to get a handle on the runaway costs and clamp down on fraudulent claims.

Only two employees have been convicted for filing fraudulent claims in the last three years out of more than 1,400 cases identified as suspicious.

Metropolitan Transportation Authority workers have filed about 9,000 injury claims since 1998. But only 16 cases were referred to the District Attorney's Office for criminal prosecution. Two were rejected, two were prosecuted and 12 are pending.

Meanwhile, the MTA's costs for workers' compensation increased 51 percent in the last five years, from $35.4 million to $53.4 million per year. The MTA expects to spend $59 million this fiscal year.

``It just sounds to me like the MTA has found yet another way to rape the taxpayers,'' said Jon Coupal, president of the Howard Jarvis Taxpayers Association. ``Given the phenomenal costs of workers' compensation for the MTA, one would have to be a fool to think there was not rampant fraud going on.

``And the big question taxpayers have is once the fraud is uncovered are people actually going to go to jail or are they going to get a slap on the wrist?''

MTA officials acknowledge that many cases of fraud go undetected. So they have dropped their contract with a private company that reviewed claims and are now having their own security coordinate with investigative firms in the hopes of uncovering fraud.

On a second front, MTA officials want to make the workplace safer to prevent injuries. In recent days, the MTA signed a five-year contract with DuPont Safety Resources, based in Newark, Del., to focus on creating a safer work environment for the 10,000 employees.

``We're trying to make this a safer place to work,'' said MTA's new Chief Executive Officer Roger Snoble. ``DuPont is one of the safest companies in the world and can help us be the same.''

Officials say the increased costs are partly attributable to expanded bus and rail operations but are mainly due to higher medical expenses, more lost workdays due to injuries and rising premiums for insurance. Workers' compensation provides payments to employees for on-the-job injuries or occupational disease.

In one of the cases prosecuted, an MTA bus driver claimed he suffered a back injury while adjusting a mirror on his bus but denied having any prior back injuries. An investigation determined he had been treated for back injuries extensively in the past. He pleaded guilty to workers' compensation fraud and was ordered to pay $200 restitution and serve 200 hours of community service.

In another case, a bus driver filed a claim for stress resulting from a reported armed robbery. But on-board cameras did not show any robbery. She pleaded guilty to multiple counts of workers' compensation fraud and was ordered to pay $6,684 in restitution, perform 250 hours of community service, given five years of probation and time served for four days in jail.

The most common injuries employees claimed in 2001 resulted from traffic accidents, repetitive motion, lower back problems from sitting for extended periods, slips and falls, lifting, adjusting equipment and unprovoked assaults by riders.

``People get injured sitting in their seats for a long time,'' MTA spokesman Marc Littman said. ``The vast majority of the claims are legitimate.''

Kymberleigh Richards, director of Southern California Transit Advocates, said workers' compensation fraud has not been scrutinized adequately by the MTA.

``I won't be surprised that once it's under scrutiny they will turn up things that have been overlooked before,'' Richards said.

Richards said the San Fernando and west San Gabriel valleys' push to create their own bus systems - called transit zones - has forced the MTA to take a hard look at how much it's spending on workers' compensation claims.

``One important factor in the creation of the zone is the agency cannot wind up harmed because of the costs,'' Richards said. ``It appears that even if zones are created, the MTA will keep the workers' compensation costs. That has caused greater scrutiny of the process. I'm sure this has all come about because of greater scrutiny because of the zone applications.''

MTA Chief Financial Officer Richard Brumbaugh said if the zones are created, the MTA and the zones will share their equal portions of the workers' compensation costs.

Brumbaugh explained that the MTA's high costs are also a result of the amount of time employees are off work due to injuries. That has increased in recent years, rising from 96,000 days in the 1999-2000 fiscal year to 108,000 days last year.

He said the MTA has started a safety program to reduce lost days and there are many factors for the high costs.

``First, California is a high-cost workers' compensation state. Second, since the system was deregulated in 1995, it has resulted in an extremely tight market.''

According to the MTA, DuPont helped dozens of companies worldwide reduce their workers' compensation costs, including New York City Transit, an agency five times larger than the MTA that saw its lost-time injuries decrease by 50 percent over the last five years.

``It is very clear to us that MTA is very serious about taking the right steps in creating a safer workplace,'' DuPont President James A. Forsman said.