Moral Hazard (Southern Fraud Thriller)

Home > Other > Moral Hazard (Southern Fraud Thriller) > Page 4
Moral Hazard (Southern Fraud Thriller) Page 4

by J W Becton


  Ever.

  I flicked open the folder and scanned the documents it held, wondering how a “simple workers’ comp” case had made it to the DOI in the first place. Usually, fraud departments of insurance companies handled these issues in house, or they farmed out to private investigators. The state workers’ comp board handled the larger, more complicated crimes, but this was now in DOI hands.

  Why?

  Scanning farther down the page, I thought I found my answer.

  I looked up at Ted, one finger poised over the date of the suspect’s first workers’ comp payment and another over the date of the beginning of the first fraud inquiry.

  “This investigation has been going on for five years? That’s impossible.”

  It seemed totally improbable that any workers’ comp fraudster, no matter how competent, could evade detection for so long and in spite of so many anti-fraud measures built into the system. Defrauding workers’ comp involves more than just limping at the right time and convincing the bosses that you’re really injured.

  If the suspect—Randy Blissett, an employee of the Georgia Transportation Department—had faked his injuries successfully for seven years, he was working pretty hard at maintaining his cover. In order to receive benefits, he’d have to meet plenty of requirements, stipulations, hurdles, and other assorted minutiae set up by the insurance company. A doctor would have to examine Blissett at least every three months to determine his fitness to work, and even if his injuries truly prevented him from returning to his previous job—which, according to the file, was working on a road crew running a cold planer, whatever that was—the GTD would have tried to place him in an office position or in another job he could physically manage to do.

  “Not impossible,” Ted said in a grim tone. “It’s happening right before our eyes. The state of Georgia has paid more than $2.5 million on Randy Blissett’s claim—that’s including indemnity, medical benefits, and legal and investigative fees. Two years into his treatments, sporadic reports that he was faking his injuries began to trickle in.”

  “And his injuries were legit?” Vincent asked.

  “Yes, caused by an accident on the job. He complained of back pain that was precipitated by a herniated disc in his lower back. After six weeks of physical therapy and pain medication, Blissett required back surgery to repair the disc. The damaged portion was removed successfully, but since then, he has been suffering from pain that supposedly renders him unable to run his machine or to do any other work at the GTD.”

  I winced. Back injuries are notoriously difficult to prove or disprove, even with modern medical diagnostic technology. Some types of injuries don’t show up on scans, and doctors are loath to risk a malpractice suit by sending someone back to work in error.

  Either that or this doctor was committing fraud too, which was a distinct possibility.

  “In the last year or so, neighbors have reported that Blissett is physically active at home,” Ted said. “Unfortunately, these fraud reports have yet to be substantiated despite the fact that numerous investigators from Southeastern’s fraud department and a well-respected private detective have tried to ferret him out. So your job is to acquire proof that Blissett is physically capable of working. You won’t have much of a budget to work with, I’m afraid, but I have faith that you’ll find a way.”

  The lack of funds wasn’t a big surprise based on the previous money lecture, but Ted was assigning us a case that dozens of other investigators had failed to solve over the past five years and giving us zero money to boot. It sounded like a recipe for failure to me.

  Vincent apparently disagreed. He grunted and flipped a few pages before closing the folder.

  “Sounds like a straightforward surveillance detail. Shouldn’t be a problem.”

  He sounded confident that we would succeed where others had failed. It was our specialty, after all, but stressed as I was already, I couldn’t resist adding the obvious caveat. I looked at Ted.

  “No, it shouldn’t be a problem, unless, of course, there’s something you’re not telling us about this guy. Is he homicidal, for instance? Or maybe he has a dark past or hidden secret? Or is working for a nefarious crime boss?”

  Matilda snorted, and the rest of the employees tried to cover their giggles, but Vincent laughed out loud. Ted frowned humorlessly at me.

  “There should be no unknown crime bosses or homicidal maniacs to uncover. No whodunnit or trickery of any kind,” Ted assured me, still frowning. “Blissett has no record of assault, reckless driving, or psychotic behavior, so I think the two of you should be able to make it through this case without any unexpected incidents.”

  “Then why has it been so difficult to get proof against this guy?” Vincent asked before Ted could move on to the next assignment.

  “Blissett is good at hiding,” Ted said, his tone indicating that this fact should be obvious.

  I found that answer insufficient. Supposedly, everyone and their brother had taken a crack at this guy, and yet no one had been able to prove that he was faking his injuries. The chances of that? Slim to none.

  There had to be more to the story, only Ted didn’t seem to agree.

  “You and the Chief are better than those investigators who have tried and failed to catch him in the act. I have faith that you can get the evidence and keep yourselves out of trouble this time.”

  I winced. I was pretty sure Ted had just jinxed us.

  Five

  “Gee,” I said to Vincent as we wound our way back to the second floor of the DOI to go over our new assignment. “With an exciting workers’ comp case lined up, you’d think Ted had something against us.”

  Vincent shot a wry smile over his shoulder and shrugged.

  “Yeah, he seems pretty determined to keep things lower profile around here. Not that I mind all that much. I’ve been enjoying this little vacation from the whack jobs we normally end up dealing with.”

  I smiled. Only Vincent would consider surveillance to be a vacation.

  Under normal circumstances, surveillance was anything but a holiday. It usually meant hours crammed in a car that was too hot or too cold, eating too much junk food, and taking too few bathroom breaks. That was no vacation. At least not to my mind.

  I much prefer a nice indoor facility with, well, indoor facilities.

  God, how I hoped for indoor facilities this time.

  I grimaced but decided that Vincent was right. If indoor facilities were my greatest desire, then I seriously needed to reevaluate my priorities. In comparison to some of our previous cases, which involved an assortment of desperate murderers and psychos, this didn’t sound so bad.

  But before I could concentrate on Blissett, I needed to get one thing over with.

  “I’ll be a minute,” I told Vincent’s back as I veered toward my office. “I’m just going to call Helena. We can go over the case when I’m done.”

  He nodded and disappeared through his door, and I went into mine, shutting it firmly behind me. I leaned against the solid plane of wood for a moment.

  This was it: the first step. And with each subsequent step, I would lose a bit more control over the outcome of my situation. I was voluntarily putting my future in other peoples’ hands and burdening them with the truth in the process. Eventually, I would have no control over my fate. I would have no power other than the truth.

  I hoped it would be enough.

  But I was afraid it wouldn’t be. This was the real world, not fantasyland. I broke the law, and I should pay for it. Wasn’t that what I demanded of Clayton Leslie Slidell?

  The same should apply to me.

  I closed my eyes and heard faint echoes of my mother’s voice in my head, the way it had sounded when I was much younger, telling me not to borrow trouble. That worrying wouldn’t make a lick of difference, and that as long as I told the truth, I would be set free.

  I pressed my fingertips against my forehead, wishing I didn’t have to rely on faint echoes of support. I wished I could h
ear my mother’s actual voice comforting me right here and now.

  Aware that I was quickly slipping into panic mode, I took a deep breath and tried to slow my whirling mind.

  At that moment, I simply needed to make a dinner date with my best friend. That was it. The truly scary stuff—admitting to the authorities what I’d done—would come later. Best not to think of that yet. Focus on the here and now.

  So I dialed Helena’s cell phone and reminded myself not to come across as the Grim Reaper. I forced a smile to my lips and hoped it might somehow come across in my tone.

  “How about dinner tonight? My treat,” I said, using the voice I often used with Tricia and sounding far too cheery to my own ears.

  Apparently, it fooled Helena.

  “Oh, great idea! Tim’s visiting his parents for a couple of days, and Violet is soaking up massive amounts of spoiling as the only grandchild, so I’m totally free.”

  “Seven o’clock? You choose the place.”

  “Hmm,” Hels murmured. “How about Bleu? I feel like letting you spoil me.”

  I winced. Bleu was not exactly known for its casual dining atmosphere. I glanced down at my attire—plain gray trousers, a v-neck sweater, and black boots—and hoped it was chic enough not to embarrass Helena. Removing certain accessories—namely, the gun and badge—could only improve my odds.

  “Never been there,” I said, “but I’m game.”

  “Great! See you there.”

  There. That was done. At dinner, I would get Helena’s advice on the best way to move forward.

  Meanwhile, I needed to focus on things that were under my immediate control, and as far as I could tell, the only thing that fell into that category was the Blissett case.

  Determined to dismiss all negative thoughts from my head, I slid my phone into the holder on my belt and headed for Vincent’s office. I found him wedged behind his desk, office phone in hand. Based on his side of the conversation, it seemed that Vincent was getting a head start on acquiring an up-to-date copy of Blissett’s medical records. Usually, state laws made the acquisition of medical records extremely difficult, but when an individual begins receiving workers’ comp funds, he waives his right to doctor-patient confidentiality related to the injury in question. So we didn’t need a warrant or subpoena.

  While keeping tabs on the phone conversation, I opened the case file and flipped through the pages until I found the section that documented what could only be described as Blissett sightings.

  I studied the details and photos of the man over the years, hoping something might jump out at me, some anomaly in his behavior.

  At first blush, the file provided a record of behaviors one might expect to find for a legitimately injured worker. Early on, investigators had observed Blissett leaving his house for doctor’s appointments only. His wife and son ran errands and took care of daily chores. This seemed natural. His injury necessitated surgery, and that meant a lengthy recovery. No one expected him to run out for a gallon of milk.

  After his divorce was final, Blissett began to take on day-to-day responsibilities. Left on his own, he started driving short distances to the supermarket or hardware store, where he almost always shopped with the aid of a motorized cart.

  I stared at the page.

  Trips to the hardware store. Those stood out. People didn’t purchase home improvement supplies unless they intended to complete said improvements. The neighbors reported hearing the sounds of hammers and electric saws, but no work trucks were present. Somehow the projects got done. If Blissett were capable of manual labor, then he might also be able to return to work. But where were the videos or photos of him wielding a hammer?

  Granted, the man had not been under constant surveillance, but still, something seemed off. Why couldn’t anyone show evidence that Blissett was able to perform manual labor?

  “Idiopathic pain,” Vincent said, his voice invading my thoughts.

  I wrenched my gaze from the file and stared at him, eyes glazed. Evidently, my partner had been off the phone for some unknown amount of time. I wondered if he’d been trying to carry on a conversation with me. How embarrassing. Usually, I wasn’t quite so focused on my internal monologues.

  I really needed to get it together.

  I flushed and finally managed to ask, “Uh, what?”

  “The doctor says that Randy Blissett experiences idiopathic pain.”

  I set aside the file and narrowed my eyes at Vincent. “And that means?”

  “Pain of unknown origin.”

  “Translation: they can’t explain the pain.” I rolled my eyes.

  “Precisely, but the doctor believes Blissett is not faking.”

  “How did he reach that conclusion?”

  “He listed a number of reasons, but it boils down to the fear that Blissett might not have healed properly from the surgery. The doctor doesn’t want to send him back to work and risk further debilitating injury.”

  I raised an eyebrow. “That’s all he gave us?”

  Vincent nodded. “That was basically the extent of it.”

  “What do we know about this doctor?” I asked.

  “Clean as far as we know.”

  “He’s made a lot of money off Blissett,” I pressed. “How do we know he’s telling the truth?”

  “Blissett’s had a second opinion,” Vincent said, turning the computer monitor to reveal a list of state-approved medical practitioners.

  “And a third and a fourth,” I noted.

  “Given his complaints of pain, they all agree that returning to work would put his health at too great a risk.”

  “How physically demanding is running a”—I pulled the file back toward me and riffled through a couple of pages—“cold planer? He sits in a cab and drives it, right? It’s not like he’s laying asphalt by hand.”

  “According to his doctor, Blissett can’t remain long in one position, even seated, which rules out not only the cold planer but also a desk job.” Vincent began to read from the monitor. “Despite continued physical therapy, he has trouble lifting, turning, and bending. Sometimes he reports difficulty standing up from a seated position and tingling in his legs.”

  Which brought me back to the hardware orders and unsubstantiated reports that Blissett did manual labor around his house.

  “As late as last week,” I said, pointing to a place on the file, “neighbors confirmed that they heard the sound of saws and hammers coming from his yard. No work trucks have appeared in his driveway, so he’s not likely to be hiring workers. If that’s the case, then he’s doing the labor himself, but no one has been able to get actual proof of it.”

  “How is that possible?” Vincent wondered aloud as he began typing something into his keyboard. “We’ve got to be missing something.”

  “It’s not as if people haven’t been trying to get proof. According to the files, Terrance Workman, the head fraud honcho at Southeastern, has sent numerous company investigators after him. Plus, he hired private investigator Jacob Dawe.”

  “Something else has to be at play here, and I think I may have found it.” Vincent turned his computer so I could see the aerial photos he’d pulled up.

  “This is Randy Blissett’s address,” he said, pointing at the image on the screen.

  Randy Blissett’s house was located in an older section of Mercer, just on the outskirts of downtown, that contained a mishmash of older single-family homes, free-standing small businesses, shopping centers, and one high-rise apartment building. If you count ten stories as a high rise, that is.

  According to Mercer standards, that was practically a skyscraper.

  Blissett’s place stood right on the boundary between a residential neighborhood founded in the 1950s and the small businesses from every era that dotted the stretch nearer to the main highway. From what I could tell, the property appeared well maintained, but it was small, about a quarter of an acre.

  Then Vincent switched to street view. “He’s got a privacy fence. Tall one.”
>
  No wonder investigators were having problems. His privacy fence encompassed the entire backyard. If Randy were working there, no one at street level could see him. Not legally anyway.

  Not even LEOs can just walk onto someone’s private property and take pictures. There’s a little thing called reasonable expectation of privacy. In order to take surveillance photos that can be used as evidence in court, investigators either need a warrant or have to capture the photos while on public property or in a private place where they are legally allowed to be.

  Unless Randy worked in his front yard, no one would be able to prove that he was capable of work.

  I watched as Vincent clicked to a topography map and panned around the area.

  “Maybe we can find a local high spot. Get a decent view from above.”

  Knowing the area well, I pointed to a section of the map.

  “There’s a slight rise toward the highway,” I said as I drew my fingertip along a line of hardwood trees. “We could try there, but I bet those trees aren’t going to do us any favors.”

  “Then we’ll get creative.”

  Vincent sounded undaunted, leaving me to wonder if he intended to go Paul Bunyan on the arboreal barrier.

  “A helicopter would be nice,” I mused.

  “A helo would be fun, but I doubt Ted will spring for that.”

  “Bummer,” I said, only partly joking. A helo would have been fun.

  And God knows I needed some fun.

  Six

  Since the helicopter option was out, we hopped into Vincent’s 1970s-era GMC pickup and drove toward Randy Blissett’s house, stopping for a bite to eat along the way. Usually, I relished a leisurely lunch, but today, I wanted to remain busy. If I didn’t distract myself, my restless mind returned to forbidden subjects.

  Vincent drove in silence, and I glanced sidelong at him and thought about sliding across the bench seat. It would be nice to get some comfort from him without having to use words.

  Instead, I slid my hands into my coat pockets and leaned against the door. Our relationship was currently in a one-step-forward-two-steps-back phase. We’d shared some heart-bursting kisses, but then life inserted itself between us. I started spending a lot of time with my mother and Tricia, and he devoted his time to his son. We’d both pulled back out of necessity. Or maybe out of self-preservation.

 

‹ Prev