CNA’s Deadly Paper Games and Outright Lies Condoned by the Department of Labor

How do AIG and CNA get away with telling so many lies and paying for so little ?  

They get help from those put in place to “ensure that workers’ compensation benefits are provided promptly and properly” 

The Department of Labor’s Jacksonville Florida District Office Director Charles D Lee, formerly of Liberty Mutual, gave his seal of approval to CNA’s lies by refusing to find them in default of an order that he signed himself.  It took seven years to get this order.

If Mr. Lee does not remember signing this order over two years ago he should.  While he signed the order for medical and indemnity probably without reading it, slapped a form cover letter to it,  he did not bother to determine the amount of back indemnity and interest owed which allowed CNA to not pay on time and escape the 20% per day penalty.   So few penalties apply and so little enforcement of those that do.

It took many telephone calls and finally assistance from Michael Niss, the Director, Division of Longshore and Harbor Workers’ Compensation Office of Workers’ Compensation Programs at the time,  to encourage him to do his job.  He was not going to do it just because an injured contractor had not received his check  and was trying to find out why.

The failure on the District Director’s part to find CNA in 18 a Default occurred despite having in his possession legitimate proof, letters from Doctors stating that they had never been approved and had in fact been denied payment.

Proof of CNA lies to the new Claims Examiner, who comes to us from KBR with a KBR attitude, are ignored by everyone in the DoL from herself, Charles D Lee, Kristina Hall, to Eric Richardson, Miranda Chui, to the DOL IG.

CNA never produced a receipt for paying back  years of Medical Care that they were responsible for and refused to provide but Charles D Lee determined that they did so based on their attorney saying  that they did. 

CNA paid for a small fraction of the past medical care, finally, 16 months after the order was signed.  While this is clearly a 16 month default during which time the claimant has this debt hanging over his head despite having an Order in place, CNA is not held responsible.  A receipt has never been produced.  Charles D Lee takes them at their word while their lies are in his hands.

No dollar value is applied to the damages caused by a refusal to provide medical care for years on end and so there is no penalty or recovery.

We talk with contractors everyday who have orders in place for medical that  never receive it. 

The lengthy efforts your attorney must go through to try, not necessarily succeed, to secure the medical care is considered to be “Janitorial” work by CNA that they should not have to pay for.

Why not continue with the Deadly Paper Games when it saves you so much money and the very people that are supposed to be looking out for the claimant condone these criminal actions?

No dollar value is applied to the temporary injuries which become permanent at the hands of CNA.

The hands of CNA, their claims examiners, and their attorneys are so gently stroked by the Departments of Labor’s Jacksonville District Office. 

The Blood is on all of their hands.

When do CNA’s Deadly Paper Games become outright lies to Department of Labor?

How about now DOL ????

Documents showed that CNA reported the highest profits margins, taking in nearly 50 percent more in premiums than it paid out in benefits.

CNA’s Deadly Paper Games

After having defaulted on an Order to provide medical to an Injured War Zone Contractor for over 15 months, after denying for six years prior, CNA provides a computer printout to the Department of Labor Claims Examiner who was charged with  investigating this Default.

Not to give undue credit here, the Claims Examiner was trying to remedy the default per her job description, not confirm that they were in default.

Here is a copy and paste of the body of the correspondence, the full document has been forwarded to the DoL IG for investigation along with computer printout they attached.

Dear Mr Lee

Pursuant to Claims Examiners Kristina Hall’s request of January 3, 2012 and as a supplement to our response dated January 9, 2012, please find enclosed a payment printout showing payments issued by CNA International to medical providers regarding Mr. Clark.  The enclosed printout also shows the recent reimbursement payment of $1,270.34.

Defendents will continue to adjust medical invoices when and as received with accompanying medical reports.
Sounds just like they are paying for Injured War Zone Contractors  Medical over the years.  The reimbursement was for Out of Pocket presented in 2009 and clearly 15 months post order.

Problem here is that these payments were not for provided medical.

One is for a final report, not diagnoses or treatment, requested by CNA prior to hearing , that really made the Doctor mad over wasting his precious time, and the rest are for Defense Medical Examination’s.  Pages 3 and 4 were with held  but we suspect they include the parade of DME’s that were demanded.

The very abusive DME’s that were required repeatedly and outside of his geographic area.  The ones that ALJ Paul C Johnson assisted CNA with.

Not only did CNA represent these DME’s as having provided medical care for this Injured War Zone Contractor when in fact they did not, they reinforced the lie by stating that they will continue to do so.

CNA is currently under investigation for just this kind of unlawful and Overly Zealous Defense in denying Defense Base Act Claims

Unless that is, the DoL IG failed to investigate previous requests or are simply failing to provide documents requested under the Freedom of Information Act.

Nine Years Ago Today, Still getting screwed over by CNA !

July 7, 2003

Nine years ago you get that phone call you hoped you’d never get

But hey they say, not to worry, the insurance company will take care of everything

Heart is breaking but not to worry

Everything, they say, will be OK

Good thing we’ve been paying for good medical insurance

No way of knowing that the “insurance” was Defense Base Act through CNA, a policy we had never heard of,  looked at, or signed for

Or that  Administrative Law Judge Paul C Johnson would deem his injuries to be alleged when denying him his rights under the DBA

One day we’ll look back at this and be so grateful for our blessings, for what we’ve overcome………

But one day never comes

What’s that in the way?

CNA 

CNA with the assistance of the Department of Labor District Office in Jacksonville

From failing to provide a medical evacuation and abandoning him to the military medical system to defaulting on the order to provide his medical care for nearly two years now after denying for six years.

CNA, their Claims Adjusters, their overly zealous legal representation, and the biased Department of Labor District Office have caused much more physical, mental, and financial  damage than there ever had to be. 

What should have been temporary disabilities have become permanent.

CNA has denied the looking back one day, the moving forward, the healing

If CNA had simply lived up to their responsibilities rather than playing paper games this family would have long moved on

And the US Taxpayers would not be paying ever more to the War Profiteers CNA and their “representation”

Documents showed that CNA reported the highest profits margins, taking in nearly 50 percent more in premiums than it paid out in benefits.

Defense Base Act War Hazards Act: Overly Zealous Representation in Defending Against a DBA Claim

employer/carrier’s inadequate or overly zealous representation in defending against a DBA claim may be grounds for denying all or some portion of a request for WHCA reimbursement.

So Mr Rayburn how many War Hazards reimbursements has the DFEC denied

in part or whole over the following

Overly Zealous DBA Insurance Company Defense Tactics ?

The use of repeated Defense Medical Examinations with Doctors Over Paid to produce a report detrimental to the claimant, to run them through the drill

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The claims process being drug out for as long as nine years with no end in sight while the defense racks up ever more legal fees, the insco keeps charging administrative fees, not to mention the claimants attorneys fee’s, while the claimant goes without  medical and/or indemnity

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Unnecessary mileage, airfare, lodging, expenses paid out due to due coercing claimants to travel as far as five states away to attend Defense Medical Examinations, Mediations, Depositions, Hearings

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The use of private investigators, some even criminals themselves, to stalk and intimidate injured contractors and their families far beyond simply confirming a claimants status

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The use of  Third Party Administrators to handle claims processes that could easily be done without the added expense and fees.

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Unnecessary fines and interest due to non payment or late payment of  indemnity

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The financial ruination of injured contractors and their families caused by the overly zealous controverting of legitimate claims

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The Temporary Disabilities which are now Permanent due to their failure to provide medical care under the guise of investigating clearly legitimate claims.  Now the US taxpayer is responsible for disabilities far beyond what they ever had to be.

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The PTSD Suicides caused by the Insurance Companies, their claims examiners, and their attorneys

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The break up of families caused the constant pressure and abusive tactics used by the Employer/Carrier

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The forced acceptance of inadequate settlements or stipulated agreements due to starving the claimant out for years on end and/or threatening the claimant and family that if they do not accept the inadequate settlement they will make them miserable for the rest of their lives (see The Weaponization of the Defense Medical Examination)

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Unfairly denying the claimants attorneys fees in order to discourage good attorneys from handling these claims

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FECA BULLETIN NO. 12-01

XI. Miscellaneous

1. DFEC requires, before acceptance of any WHCA reimbursement claim, that the employer/carrier has made only reasonable and prudent efforts in presenting all meritorious defenses against a DBA claim without regard to whether the case is eligible for WHCA reimbursement. An employer/carrier’s inadequate or overly zealous representation in defending against a DBA claim may be grounds for denying all or some portion of a request for WHCA reimbursement.

CECILY A. RAYBURN
Director, Division of Planning, Policy and Standards

CNA’s Deadly Paper Games, Just another CNA DBA Suicide in the making

It is certainly going to have the desired result. 

They are going to kill him and it is going to be soon. 

Before the year is out I believe this man is going to commit suicide.

PTSD Claims to be Expedited

CNA’s Deadly Paper Games do not begin or end with this Injured War  Zone Contractor

Nearly 14 months to the day of a Department of Labor District Director signing an Order approved by an ALJ stating that CNA must provide medical for a  severely Injured War Zone Contractor’s injuries, the details of which were gagged…..

And 3 1/2 months after Injured War Zone Contractor asked the District Director to find them in Default for not doing so……..

CNA produces a stack of  FAXES supposedly sent to Injured War Zone Contractors Doctors stating that they have “re-approved” payment of diagnoses and treatment, most of which were never approved, ever, much less “re- approved”.  In fact for most of the Doctors CNA denied diagnoses and treatment for blast injuries for many years.

Several Doctors stated that yes they received a FAX but that it did not mean they accepted the approval and that it did not guarantee payment.  Payment would have to made in advance.  CNA’s reputation for non payment is no secret.

The rest of the doctors state that they never received “approval” at all.

Unemployed and otherwise uninsured Injured War Zone Contractor pays for some visits via credit card as they are so vital.  Doctor then sends a bill to CNA for payment despite not having received an approval,  which CNA refuses.  Injured War Zone Contractors scheduled visits are then cancelled due to non payment by CNA.

These are deadly games CNA plays in order to continue to deny medical even after a hard won order is produced.

And who do they claim is vague, ambiguous, and whose claims are not supported by Facts, or should we say FAX?

It must be the very well respected and credentialed doctors, or the Attorney, or the Injured War Zone Contractor

This negligent paper game continues despite a recent medical report from February stating:

“I do not understand the entire bureaucracy issue.  He tells me that CNA has written to us and that we are approved for Workers’ Compensation.  We have no record to that effect.  We are just not going to be paid and they are not going to authorize treatment.  Bureaucracies have their problems but this almost seems to be purposeful.

It is certainly going to have the desired result.  They are going to kill him and it is going to be soon.  Before the year is out I believe this man is going to commit suicide.

And he’ll be just another CNA DBA Suicide.

Note:   CNA’s response is to ask for an informal conference.  Several informal conferences, a settlement conference with a Judge, orders signed by a Judge and the District Director, and yet another informal conference after an 18 month default is even a consideration???  Let’s just run this out until the end of year and we won’t have to worry about this guy anyway!!!!

Prosthetics for Injured War Zone Contractors?? Don’t get your hopes up…..

Contractors covered by CNA and others under the Defense Base Act must fight for years to acquire prosthetics, orthotic devices, artificial eyes, and sometimes never receive them at all.

The Department of Labor enables this negligence, often delaying informal hearings and/or siding with the insurance company attorneys causing delays of years on end.  Precious recovery time is lost.

The following article details the importance of getting amputees the proper prosthetics and on the road to recovery as soon as possible.

Prosthetics helping soldiers return to active lifestyle

FORT DRUM — Spc. Matthew R. Hayes stood frozen, not sure which way to move. With one soldier already lying on the ground injured, Spc. Hayes and other 10th Mountain Division soldiers now realized that the Afghan hill they had just climbed was riddled with an unknown number of nearly undetectable plastic land mines.

So the soldiers decided that the only way to avoid another casualty was to carefully retrace their steps to safety.

But Spc. Hayes didn’t know he was already standing on a land mine.

“I shifted to step off and it exploded,” he said. “I didn’t know what was going on — just a little confusion … dazed — I couldn’t do anything.”

He fell back on his shoulders. He didn’t feel pain — just a strong pressure on his right leg.

“I looked down and I just saw my foot shredded,” he said.

He quickly reached for his tourniquet to tie his leg tight and stop the bleeding. He began feeling weak, and yelled, “Medic!”

His mind raced ahead as to what might happen.

“I figured I’d lose it,” the 22-year-old soldier said.

He was right.

Within hours of that explosion last September, Spc. Hayes’ leg was amputated below his knee, adding his name to the list of almost 900 soldiers nationally who have had a major limb amputation as a result of explosions in Afghanistan and Iraq, according to an Army Medical Command spokeswoman. More than half of the 10th Mountain Division’s 278 soldiers killed in Iraq and Afghanistan have died as the result of improvised explosive devices and anti-tank mines.

Yet within months of that explosion, Spc. Hayes was taking his first steps with help of a prosthetic leg.

“It felt great,” he said. “It was weird trying to remember how to walk, I guess, not being able to use an ankle.”

Each similar success story can be credited to the advanced prosthetics technology that the U.S. government is investing in. Last year, for instance, Clarkson University, Potsdam, received a $1.4 million grant from the Army to develop a prosthetic leg that uses sensors that respond to the remaining leg muscles.

Roger R. Howard, of Howard Orthotics and Prosthetics in Watertown, said working with highly active soldiers wanting to maintain their lifestyles is a challenge he enjoys. His civilian customers are benefiting as well.

“Any time there’s a war, the government puts a lot of money into research and development,” he said, “and as a result of that we have manufacturers coming out with newer systems at a much faster pace than ever. The computers are getting better, and the hardware is getting … lighter.”

Please read the entire article here

U.S. Insurance Firm CNA Neglects Survivors of Iraqi Translators, May Face Criminal Charges

U.S. insurer faces criminal probe over Iraqis’ unpaid death benefits

By T Christian Miller at ProPublica   May 23, 2011  and The LA Times

An administrative law judge has referred a U.S. insurance company for criminal investigation after the firm failed to pay benefits owed to survivors of Iraqi translators killed while working for the American government.

Under a federally funded program, Chicago-based CNA Financial Corp. provides insurance coverage to contractors killed or injured while working overseas for the United States. The slain translators were helping to train Iraqi police recruits.

Instead of paying out benefits, however, CNA withheld information from the federal government and avoided making payments to nine families who lost relatives in a 2006 attack, according to court files and interviews. One widow lost her home, unable to keep up payments after her son and other translators were ambushed by insurgents in the southern city of Basrah, one of her attorneys said.

In a ruling this week, administrative law Judge Daniel Solomon ordered CNA to begin making payments to the families. In an unusual move highlighting the government’s concern over potential fraud, the judge also told the Labor Department, which oversees the program, to investigate whether the insurance carrier should face criminal charges. A Labor spokesman said the agency would “fully investigate” the allegations to determine whether to ask the Justice Department to prosecute the case.

CNA said it was also looking into the case.

“We are investigating the matter and will take all appropriate actions,” said Katrina Parker, a company spokeswoman.

Attorneys for the families said they believe CNA withheld documents to avoid making payments.

“These were people who helped the U.S. in Iraq,” said Agnieszka Fryszman, an attorney for the families. “Their families were kicked to the curb when they were most in need of help.”

CNA’s failure to pay out benefits underscores the continuing problems with the Defense Base Act, essentially the workers compensation system for overseas federal contractors.

The system was little-used until the wars in Iraq and Afghanistan sent hundreds of thousands of private contractors onto the battlefield. All told, the government has paid out nearly $1.5 billion in premiums since 2001.

Reporting in 2009 by ProPublica, the Los Angeles Times and ABC’s 20/20 [1] revealed deep flaws in the program. Workers fought long battles for medical care, including such things as prosthetic devices and treatment for post-traumatic stress disorder. Foreign workers, including Iraqi and Afghan translators, often did not receive payments or treatment. The Labor Department seldom took action to enforce the law. One official called the system a “fiasco.”

Congress subsequently held hearings [2] that showed that American insurers were reaping large profits from the program. Documents showed that CNA reported the highest profits margins, taking in nearly 50 percent more in premiums than it paid out in benefits.

The case decided this week began on Oct. 29, 2006, when insurgents boarded a bus and killed 17 Iraqi-born translators working in Basrah for Sallyport Global Services, a logistics and security contractor. The insurgents later scattered their bodies around the city.

Under the law, CNA was responsible for paying death benefits to the translators’ dependents. CNA paid when translators had children and spouses, according to interviews and court records, but not to other survivors. Several translators had no children, but supported parents or other family members.

In such cases, the Labor Department demands proof that survivors relied on contractors’ earnings. CNA hired investigators who interviewed nine families, confirmed their eligibility, and even set up bank accounts. But CNA withheld portions of the investigators’ findings when it submitted the claims to the Labor Department, court records show.

One CNA file shows that the slain translator had supported his mother, a widow, since his father was killed in the Iraq-Iran war. The town council even issued a statement of support, confirming the translator was his mother’s “sole provider.” Another CNA file shows that another translator killed in the ambush was sole support for his family, which “could be described as very poor.”

But those pages were missing from the information CNA submitted to the Labor Department. As a result, Labor officials accepted CNA’s declaration that there were no dependents to pay in any of the nine cases.

The translators’ attorneys at Cohen Milstein, a well-known Washington firm doing pro bono work on the case, estimated that CNA owed a total of about $500,000 to the nine families. Instead, CNA paid about $45,000 into a special federal fund set up to help support the workers compensation system.

The company subsequently recovered some of that money plus additional fees under an obscure law—the War Hazards Compensation Act—that allows insurance carriers to recoup costs for contractors killed in hostile acts, court documents show.

In one case, CNA paid $5,000 into the special fund and $518 to a translator’s family for burial expenses, but was reimbursed $9,289 by the federal government for investigating and handling the claims.

A Sallyport official said the company believed that CNA had made payments to all of the translators’ families except one, which declined to accept money because of security concerns.

In an emailed statement, the company declined further comment due to the litigation. It said it would “continue to monitor the situation and support the families within our remit.”