Chicago Police DepartmentSpecial Order S08-01-09
Medical Integrity Section
Issue Date:04 May 2018Effective Date:04 May 2018
Rescinds:20 August 2009 Version of E03-01-09
Index Category:Professionalism
I.Purpose
This directive:
  • A.establishes the Medical Integrity Section (MIS) as a component of the Confidential Investigations Division, Bureau of Internal Affairs.
  • B.defines the responsibilities of the MIS relative to investigations of members participating in any medical program.
II.The Medical Integrity Section
  • A.Medical Integrity Section personnel will:
    • 1.investigate allegations of fraud, waste, or abuse by any participant in any medical program.
    • 2.comply with all Department directives, applicable collective bargaining agreements, and local, state, and federal laws when conducting its investigations.
    • 3.recommend corrective action in cases where allegations of malingering , medical abuse , medical fraud , or waste are sustained (e.g., fitness for duty evaluation or disciplinary action up to and including discharge). For sustained cases, MIS may also recommend criminal prosecution or the initiation of civil or administrative actions to recoup losses.
    • 4.maintain confidentiality in all phases of the investigation. Under no circumstances will an MIS investigator comment on or allow individuals not assigned to MIS to view unit files of any investigation without the express approval of the Chief, Bureau of Internal Affairs.
    • 5.conduct complaint investigations involving medical integrity issues.
  • B.MIS may investigate:
    • 1.allegations that a member is:
      • a.malingering ;
      • b.committing medical abuse ;
      • c.committing medical fraud ;
      • d.not following proper medical polices or procedures.
      • e.engaged in activities inconsistent with their work restrictions or the reasons they are in a Department medical program.
    • 2.injuries or illnesses that result in a member being in a medical program for a period of time inconsistent with standard medical care.
    • 3.written requests by command staff indicating a member has engaged in medical fraud, waste, or medical abuse when accompanied by appropriate justifications and documentation.
    • 4.on the recommendation of the Chief, Bureau of Internal Affairs; Director, Human Resources Division; the Medical Director; the Medical Administrator; or the Commanding Officer, Medical Section, based on a totality of the circumstances including, but not limited to, identified patterns of inappropriate medical usage.
    • 5.when a member has five or more medical events in a twelve-month period.
    • 6.complaints to the MIS received through the Department email, miu@chicagopolice.org, alleging violations of a Department medical program policies or procedures.
      NOTE:
      No anonymous complaint made against a Department member will be made the subject of a complaint investigation until verified.
Authenticated by: KC
Eddie T. Johnson
Superintendent of Police
17-070 EW
GLOSSARY TERMS:
1. -
Deliberate exaggeration of a physical or psychological impairment in order to remain in a Department medical program longer than medically necessary even if initially placed into a medical category for legitimate reasons.
2. -
Excessive or improper use of a medical program which includes, but is not limited to when a member:
  • A.requests placement in a medical program and is not ill or injured.
  • B.works secondary employment while on the medical roll.
  • C.claims to have a recurrence of an IOD injury when the member does not have a good-faith basis to make such a claim.
  • D.has an excessive number of or exhibits a pattern of medical events of a non-serious nature.
3. -
Intentional misrepresentation or deception, either oral or written, with the intention of receiving unwarranted medical benefits such as classification in an IOD status, payment of medical benefits, or admission into a medical program. Medical fraud includes, but is not limited to:
  • A.making a false claim of injury or illness.
  • B.misrepresenting one's ability to perform police functions.
  • C.providing false, inaccurate, or incomplete information in order to remain on the medical roll or in a limited duty status.
  • D.making a false report indicating that a non-IOD injury is an IOD injury.
  • E.altering medical documentation (e.g., medical certificates, doctor's notes, prescriptions).
4. -
Expending or causing Department resources to be expended in a careless, incompetent, or unjustified manner.
5. -
Medical absence for one or more consecutive days.