Wyoming DWS Fights Fraud with Prevention and Enforcement Efforts

Cheyenne, WY (WorkersCompensation.com) - The Wyoming Department of Workforce Services's (DWS) Special Investigation Unit (SIU) is making important strides in its fraud prevention and enforcement efforts for Unemployment Insurance (UI) and Workers' Compensation fraud. The DWS Special Investigations Unit is in various stages of prosecution for 145 pending cases. DWS is working with Wyoming district or county attorneys to prosecute pending cases, the potential recovery of which is estimated to be nearly $2 million in Unemployment Insurance and Workers' Compensation fraud to be returned to the state through restitution if prosecution is successful.

Further, representing a best case scenario in successful Workers' Compensation fraud cases, DWS could yield a potential savings of more than $2 million in stopping current benefits and medical payments based on the reserves established by Micro Insurance Reserving Analysis (MIRA).

Since the department's reorganization, Director Joan Evans has placed an emphasis on fighting fraud and protecting taxpayer dollars.

“The department is dedicated to ensuring responsible stewardship of taxpayer money,” said Director of the Wyoming Department of Workforce Services Joan Evans. “Unemployment Insurance and Workers' Compensation are meant to be lifelines to people in need. Our commitment to oversight and program integrity is important in preserving these critical programs.”

DWS's full time Special Investigations Unit Manager Brian Jacobsen monitors the divisions of UI and Workers' Compensation for abuse and fraudulent claims. A former deputy sheriff with seven years of law enforcement experience, Jacobsen is a certified fraud examiner.

Fraud is among the most costly type of crime in the country and has a significant impact on the cost of employer Workers' Compensation premiums.

Common cases of UI program abuse include misrepresentation of the circumstances of separation from the employer and falsely claiming work searches while receiving benefits. Most fraudulent overpayments are the result of claimants working while receiving UI benefits and not reporting those earnings. Wyoming currently utilizes a wage verification cross-match program that identifies potential overpayments.

The three primary types of Workers' Compensation abuse are claimant, employer and medical provider fraud. Currently, analysts within the Workers' Compensation division flag possible abuse. Jacobsen is creating a data scanning program to electronically detect possible abuse.

The recovered UI monies will be returned to the UI Trust Fund which issues UI benefits to those who lose their jobs through no fault of their own. The recovered Workers' Compensation monies are returned the Workers' Compensation Fund which provides benefits for workers injured on the job.

In addition to these efforts to combat fraud, DWS has placed high priority on UI integrity efforts. The department is utilizing customer education and implementing strategies to combat abuse and overpayments.

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