Employers Face RICO Claims For Workers Comp Denials

Insidecounsel.com reported on January 28, 2009 that the latest organized "crime," according to the 6th Circuit, is conspiring to defraud injured employees of their workers compensation benefits.
 

In the first decision of its kind, the appeals court recently stunned employment attorneys across America by holding that employers alleged to have schemed with their insurance carriers and/or physicians to wrongfully deny workers compensation benefits can now be sued for treble damages and attorneys fees under the civil fraud provisions of the Racketeer Influenced and Corrupt Organizations Act (RICO).
 

Although RICO originally targeted criminal organizations such as the Mafia and Hells Angels, the decision in Brown v. Cassens Transport Co. exposes businesses to RICO litigation and extensive discovery into their handling of workers compensation claims.
 

The 6th Circuit revived the RICO civil fraud claims of six truckers. They allege that their self-insured employer, Cassens Transport Co., along with the Cassens claims adjuster and the doctor who found them ineligible for benefits, committed mail and wire fraud in a scheme to wrongfully deny them benefits under the Michigan Workers’ Disability Compensation Act (WDCA).
 

The plaintiffs contend that the company deliberately selected doctors who could be relied upon to provide medical opinions supporting decisions to cut off or deny benefits..
 

The 6th Circuit paved the way for the suit to proceed by overturning a 2005 ruling by the U.S. District Court for the Eastern District of Michigan dismissing the action for failing to state a claim for available relief. The unanimous appeals panel ruled Oct. 23 that the plaintiffs had sufficiently alleged at least 13 predicate acts involving fraudulent communications by mail and wire, and that the plaintiffs lost workers compensation benefits and incurred medical care and attorneys fees due to the defendants’ alleged "pattern of racketeering activity."
 

Tyson Foods is granted Summary Judgment in RICO case

On February 13, 2008, Chief Judge Curtis L. Collier of the United States District Court, Eastern District of Tennessee, Winchester Division, granted Tyson Foods’ motion for summary judgment in a lengthy, vigorously contested civil case brought by a class of current and former employees at several chicken processing plants. The plaintiffs brought the lawsuit under the civil provisions of the Racketeer Influenced and Corrupt Organizations Act (“RICO”), 18 U.S.C. §§ 1962, 1964. The plaintiffs alleged that Tyson was a member of a conspiracy to knowingly bring illegal immigrants into the United States and employ them in violation of United States Immigration laws. This alleged conspiracy involved prolonged efforts to harbor and conceal these illegal immigrants from detection by the proper authorities. The plaintiffs claimed that, by hiring and harboring illegal immigrants, Tyson was thus able to pay less than the going market wage to its employees. As a result, plaintiffs, as legally-authorized employees, were paid less than they should have been as a result of Tyson’s use of illegal alien labor. Plaintiffs sought to recover damages in the amount of triple the difference between their artificially-depressed wages and the competitive market wages Plaintiffs should have been paid.

Judge Collier concluded that the plaintiffs failed to establish a RICO claim predicated on evidence showing Tyson had at least ten illegal aliens employed at each of its facilities, and that Tyson had actual knowledge each facility employed at least ten individuals who were unauthorized to work in the United States and were brought into the country for purposes of illegal employment.