This Racketeer Influenced and Corrupt Organizations Act (“RICO”) case involves employees who sought workers’ compensation benefits under Michigan law after their claims were denied by the employer’s third-party administrator (“TPA”). The employees filed suit against their employer, the TPA, and the doctor who evaluated their injuries alleging that the defendants had conspired to fraudulently deny their claims.
NCLC filed an amicus brief urging the Sixth Circuit to dismiss RICO claims of plaintiffs attempting to circumvent the administrative process for obtaining workers' compensation benefits. NCLC argued that federal case law prohibits the use of RICO to resolve disputes that are entrusted to the exclusive jurisdiction of a regulatory agency. Workers' compensation disputes are a complex matter better left for expert administrative agencies, such as the Michigan Bureau of Workers' Compensation. NCLC warned that the misuse of RICO would undermine Michigan's regime for regulating workers' compensation awards.