FMLA fraud can devastate a company, but companies should protect the integrity of their investigations to protect themselves.
The Family and Medical Leave Act (FMLA) provides working families balance to their lives when their circumstances take a turn. Whether it’s caring for new life in the household—such as a newborn or a foster child—or to care for an ailing relative, the 1993 act protects employees from being terminated from their jobs when they must take an extended absence for a specific set of reasons. However, abuses of FMLA are extremely common in the American workforce. While suspicions of FMLA abuse should be taken seriously by employers, companies must conduct thorough and unbiased investigations before terminating any employees. Businesses who do not follow protocol can open themselves up to expensive litigation.
In addition to protecting employees from termination during an extended leave, FMLA also requires their various insurance coverage remain in effect. This protection can be guaranteed for up to 12 weeks. According to the Department of Labor:
FMLA is designed to help employees balance their work and family responsibilities by allowing them to take reasonable unpaid leave for certain family and medical reasons. It also seeks to accommodate the legitimate interests of employers and promote equal employment opportunity for men and women.
FMLA applies to all public agencies, all public and private elementary and secondary schools, and companies with 50 or more employees. These employers must provide an eligible employee with up to 12 weeks of unpaid leave each year for any of the following reasons:
the birth and care of the newborn child of an employee;
placement with the employee of a child for adoption or foster care;
to care for an immediate family member (spouse, child, or parent) with a serious health condition; or
medical leave when the employee is unable to work because of a serious health condition.
The use of FMLA within these guidelines (with some exceptions) is designed to protect hard-working men and women from losing their jobs when their family suddenly requires their attention. Life can change so fast, and employees can rest easy knowing their jobs will be waiting for them when they are able to return in top-performing condition.
According to Charlie Plumb, an attorney who represents clients in all phases of management, abuse of this protection should be investigated, provided the employer has an “honest suspicion.” He goes on to say, “This honest suspicion standard is really intended to protect the employer against a claim they are interfering against FMLA leave and/or being retaliatory.”
A familiar scenario is one where an employee has been granted leave under FMLA for a serious illness or injury. The employer then happens to see posts from the employee on social media having fun out with friends, exercising, or driving. The employer might think, “If they’re well enough to do these things, they must be well enough to work.” While this might sound like an open and shut case from the employer’s point of view, Allen Smith of The Society of Human Resources Management, provides an example where this philosophy proved problematic:
“Joan Casciari, an attorney with Seyfarth Shaw in Chicago, said she handled a case that involved an employee who was put on FMLA leave for depression. The employer later discovered, through surveillance, she was doing Christmas shopping with her family and having a wonderful time. But her doctor confirmed “retail therapy” was consistent with her condition and the fact she could shop did not mean she did not require FMLA leave.”
Luckily for the employer in this anecdote, they did their due diligence and consulted a medical professional who could corroborate the circumstances of her FMLA qualifications. Some employers are far hastier. When employers do not conduct comprehensive and objective investigations into suspicious FMLA claims, they can open themselves up to lawsuits that can be devastatingly expensive and a public relations nightmare.
Vigilance of adherence to the guidelines of FMLA becomes manageable when Human Resource directors keep an eye out for certain patterns of behavior, such as absence patterns, especially when they coincide with non-work events (holidays or something personal that they may have mentioned in the past). Employers should also be suspicious of absences directly contradicting any medical certification in frequency or duration.
Once an employer has a reasonable suspicion of FMLA abuse, they should most certainly investigate. However, internal investigations into these kinds of abuses can be very messy for Human Resources and upper management. The aforementioned scenario involving “retail therapy” could have been a disaster if the company had not done their due diligence. Some employers are not so diligent.
Another scenario involving a maintenance worker at a nursing home and rehabilitation center panned out much differently. The employee in question noticed his superior was exhibiting a pattern of absence he found suspicious. He began reviewing surveillance footage to compare to his own personal log of her comings and goings in order to prove she was abusing company time. After discovering the independent investigation, the superior served a series of performance adjustments to the employee before terminating him. The termination came after the employee had submitted an FMLA request. The court found the dates of his termination tied in too closely with his request for FMLA, allowing the employee to take the case to trial.
Scenarios like these are why Human Resources and management should 1) be vigilant of FMLA abuse, and 2) conduct a thorough and unbiased investigation in order to ensure the company is protected from litigation. Many companies choose to handle investigations internally in order to minimize the amount of exposure. However, internal investigations spearheaded by current members of staff, will not only disrupt daily operations, but can also have negative effects like the case of the nursing home. The employee conducting his own investigation may have had honest suspicions of his superior’s misconduct, but he was certainly not a unbiased source to investigate.
Private investigators are probative routes often overlooked when a company has an internal investigation. There are many circumstances under which companies do not want to give up control over an internal investigation, and a private investigator is the definition of a third-party. However, the objectivity of a private investigator is the number one reason why companies should consider them as an option. The personal biases of the persons involved in the previous examples caused the investigation to go south. As an independent contractor, a private investigator’s only loyalty is to the truth. They are vital to ensuring an investigation is a transparent expedition for the truth. This goes a long way towards protecting a business from subsequent lawsuits or bad press.
When handling an investigation internally, employers are limited to what surveillance they can attain from their own equipment or social media. Private investigators are licensed to track individuals and photograph their activity in public. Persons who fraudulently claim to be out for injury can be photographed doing tasks directly contradicting their FMLA claim, like yardwork or lifting heavy groceries. In addition to tracking their public movements, private investigators may also conduct undercover operations in order to investigate any frauds. They are invaluable in this regard as they are not known to those within the company. Whether you’re looking for an FMLA weekender or an FMLA moonlighter, if someone has made a fraudulent FMLA claim, a private investigator is the most-equipped professional to prove or disprove the suspicion.
5 Ways Private Investigators Benefit Human Resources
Our brains are one of the defining parts of our anatomy that makes up who we are as humans, but without vital organs such as the heart, we cannot live to become who we were meant to be. The brain sends signals to the heart to pump vital fluids and maintain the health and fitness of the body in order to grow and develop. In a capitalist world of business and commerce, if a CEO is the brains of a company, certainly Human Resources is the heart. Before any employee can enter a company, they must go through HR, just as vital fluids must pass through the heart before reaching their destination. It is important for Human Resource representatives to be armed with knowledge to allow them to bring in the best and the brightest to contribute to their company. One of the ways HR can rest easy in their hires is by retaining the services of a private investigator to voire dire the candidate base, maintain a healthy work environment, and prevent employee fraud that would damage the company.
Hiring the Right People
If proper precautions are not taken, hiring a candidate who might soon be terminated can be very costly to a company. Even if the employee is making minimum wage at the time of their termination, a study from the Society for Human Resource Management estimated it can cost as much as $3500 to replace that employee. The higher the level of employment, the costs exponentially increase, with other estimates claiming that it could cost as much as 150% for middle-level employees and 400% for high-level. Therefore, hiring the correct employee on the first attempt can be critical. As the heart of the company, Human Resources are often overwhelmed with a myriad of tasks, which can make the vetting of potential employees fall lower and lower on the list of priorities. This is where the services of a private investigator will prove prudent. Private investigators can use their time and skills to perform background checks on employees, painting a clearer picture for HR representatives. This helps ensure the hiring of proper employees, which minimizes turnover, and greases the wheels of progress within a company.
Exposing Workplace Theft
A report by CBS News estimated that a typical business will lose 5% of annual revenue to employee theft. Employee Theft Solutions, a division of the Shulman Center for Compulsive Theft and Spending, has estimated that nearly one third of all corporate bankruptcies were the result of unfettered employee theft. Even more alarming, the U.S. Chamber of Commerce estimated that 75% of employed persons will steal from their workplace or employer and will continue to steal if not exposed. It is a staggering statistic that should garner scrutiny from the Human Resources department with regards to their own workforce. Bearing in mind that investigating the behavior of a single prospective employee could be very time consuming, imagine having to vet an entire staff in order to uncover a source of theft. With an average of 3-5 cases at any given time, private investigators have the time and access to resources that can help expose the perpetrator of theft in a company. In addition to checking security systems and interviewing witnesses, private investigators also have the advantage of being able to conduct undercover investigations in order to squeeze out the source of theft. These investigative services can help reinforce the wall that prevents employees from devastating a company with fraud.
Fraudulent Compensation Claims
A significant portion of the costs incurred annually by employees is attributed to worker’s compensation claims. As a member of Human Resources, it might be easy to trust every single worker compensation claim that comes through the pipeline. After all, yourself or a former superior may have hired the employee, and you trust one another’s respective judgement. However, it is naïve to assume every claim will be legitimate. Worker compensation claims can cost companies hundreds of thousands of dollars per fiscal year depending on the volume of claims. A recent statistic by the Employee Benefit Research Institute in 2014 estimated that it can cost companies as much as a $1.00 per every $100 of employee wages, which can add up very quickly. This is where a private investigator can be a godsend amidst pending litigation. Often in worker compensation claims, interviews are required with the claimant to get their version of events that led up to their injury. While members of Human Resources have many gifts, they may not be skilled in extracting the truth from an employee who might be committing a fraud. Private investigators work to get to the truth every day and can assist the HR department in protecting themselves within the letter of the law. With the resources and due-diligence of a PI vetting the claim, businesses can rest easy knowing that the claims coming through the Human Resources department have merit.
HR Investigation Integrity
With the growing problem of drugs in the workplace and the rise of the #MeToo movement, businesses are having more use for private investigators than ever before. A recent article by CNBC details how a rising number of businesses are hiring private investigators in order to identify predators in their workforce before an employee comes forward with claims of sexual harassment, discrimination, or threats.
“An ounce of prevention is really worth a pound of cure here, because the cost of potential drop in stock price, legal and PR cost — the possibility of regulators getting involved and regulating industries — they are enormous compared with the relatively modest expenditure in hiring folks like us in order to rule out this behavior,” said Nardello, CEO of Nardello & Co.
In addition to identifying these problems to save a business money, it is also imperative that any internal Human Resources department conducts a thorough, prompt, and lawful investigation. Just as private investigators can use their skills to identify predators, they can also protect any HR personnel from compromising the integrity of an investigation, protecting them from legal liability.
An Objective Eye
Human Resources: It’s in the name. Whenever there is a problem between coworkers, a discrepancy in payroll, or simple maintenance of a healthy work environment, the human resources department is where employees will turn to address issues in their job. And while members of HR do their best to solve these problems from an administrating and mediating position, they cannot always be objective. After all, HR is just as much a part of the workforce as any other employee, and all of the same implications of camaraderie and friendship can apply. By the same token, HR can also have negative relationships with the subjects of their investigations, which can influence their judgement. These biases can have a toxic effect on office morale, and employees might not feel as though they can trust Human Resources to be fair and impartial when addressing workplace issues. When there is no trust, the important relationship between HR and other departments breaks down. As is the case with many investigative scenarios, a private investigator is always the perfect second set of eyes to have when examining these issues. Without a stake in the outcome of any internal investigation, private investigators can remain unbiased as they conduct interviews, collect evidence, and reach a conclusion in regards to the veracity of any claim.
It is important for any Human Resources department to safeguard themselves against the many challenges—both internal and external—they encounter on a daily basis in their company. Retaining the services of a private investigator can go a long way to taking pressure off an already busy department, as well as providing an objective third-party perspective that will positively benefit companies as they grow and develop. If CEOs are the brains of a company and the Human Resources department is the heart, certainly a private investigator would be the immune system; identifying problems and staving off possible infection in order to maintain the health and productivity of any work environment.
We expose more of ourselves on a daily basis than at any other time in history. Most people have some form of social media an enterprising sleuth could build a profile based off of just by pressing the “older posts” button. There’s been a lot of news about wiretaps lately, but something under most people’s radar are the Smart TV’s and toys that have been listening to their owner’s conversations.
While it’s scary enough to consider how many things in your home could be listening in on you this very moment, what’s even more concerning is how quickly you can lose control of these devices and extorted to get them back. And it’s not just individuals having their devices and data taken from them, it’s also hit schools, hospital and private businesses hard over the last year.
One of the most common forms of extortion today is the use of “ransomware” to lock people or companies out of their electronics and data. Ransomware is a term for a particular kind of hacking that’s been on the rise as internet reliance has increased. Victims of ransomware typically receive a message on their device’s display saying something to the effect of “pay us this money and we’ll give you back your data.”
In an interview with CNN, South Carolina public school administrator Charles Huck, highlighted the dilemma presented by ransomware when he said, “You get to the point of making the business decision: Do I make my end-users — in our case teachers and students — wait for weeks and weeks and weeks while we restore servers from backup? Or do we pay the ransom and get the data back online more quickly?”
If the targets of ransomware want their systems or data back then they don’t have much choice, but to pay the fee. The hackers have repeatedly targeted hospitals since their technology working is literally a case of life or death there is significant pressure on the hospitals to simply pay the ransom.
When Hollywood Presbyterian Medical Center had some of it’s communication devices taken over by hackers last year, the criminals demanded $17,000 to be paid in bitcoin. The hackers asked for that amount, because it’s low enough most places will pay under the impression it’s the quickest way to get it all over with.
“The malware locks systems by encrypting files and demanding ransom to obtain the decryption key. The quickest and most efficient way to restore our systems and administrative functions was to pay the ransom and obtain the decryption key,” Chief Executive Allen Stefanek said when the LA Times asked why they paid the hackers. “In the best interest of restoring normal operations, we did this.”
One of the scarier things about ransomware is this is only the beginning. The FBI reported ransomware to be a $1 billion industry in 2016. In a follow-up storyCNN reported:
At that rate, ransomware is on pace to be a $1 billion a year crime this year. The FBI told CNN that the number “is quite high” because a few people “reported large losses.”
The agency also said that the losses could even be bigger once other related costs from these extortion schemes are factored in. Plus: Some victims may choose to pay and not report the crime.
Paul Roberts, founder and editor of a website called The Security Ledger told CNN, “The ransomware criminals understand this. Their business in some ways is a volume business so they don’t set their ransom so high that you can’t pay it. They set it at a level so they can get their money and move on to the next victim.”
This crime has even made its way into consumer electronics like smart phones and TVs. Last Christmas a photo of an LG TV stricken with ransomware went viral.
The hackers demand far less money to relinquish control of personal devices, but $500, especially if it’s on Christmas Day after you’ve spent money on gifts, is still a lot. In December, Slatereported:
“Ransomware works by taking over a system until a user pays a fee, often in the form of cryptocurrency or digital gift cards. One recent high-profile ransomware attack shut down much of San Francisco’s public transit system while another targeted a Hollywood hospital. More mundane ransomware has been reported on Android devices since at least 2014, and Frantic Locker first began to show up on phones in 2015.
Keep your systems operating systems up to date and don’t download files that aren’t from trusted site to help avoid ransomware. If you do all these things and still end up under attack, contact your systems administrator or the manufacturer of your device. Take precaution, because ransomware isn’t going away anytime soon.
David Schroeder, Blog Writer, Lauth Investigations International
