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Workers Comp Fraud in California and Ohio

04 Mar, 2012 WorkersCompensation.com

                               
California Fraud Case

Manuel Perales, 50, of Fontana, Calif., has been charged with two counts of workers compensation insurance fraud, according to the San Bernardino County District Attorney's Office.
 
 
Recently, members of the DA's Office, Workers Compensation Fraud Prosecution Unit, began an investigation into allegations of possible insurance fraud involving Perales. (WCxKit)
 
 
Perales reportedly sustained an industrial injury, while working for a local company. During the workers comp process, Perales withdrew his claim after being confronted with evidence that supported the incident was not true.
 
 
Although Perales withdrew his claim; he subsequently filed a second workers comp claim alleging that he sustained the same injuries, along with other industrial injuries, over a specific period of time, not including his original date of injury.
 
 
During this investigation evidence revealed that the allegations of workers comp insurance fraud were substantiated. As a result, an arrest warrant showing a bail amount of $100,000.00 was issued, charging Perales with insurance fraud. (WCxKit)
 
 
Later, Perales was located and arrested pursuant to the arrest warrant. He was transported, booked and housed at the San Bernardino County Sheriff's West Valley Detention Center to await trial in this matter. Perales is scheduled for arraignment some time in 2012.


Ohio Fraud Case

A Cleveland (Cuyahoga County) woman was sentenced recently for fraud after Ohio Bureau of Workers Compensation (BWC) investigators found she was working for a veterinary hospital and a local charity while receiving benefits for a workplace injury. Nancy Palmer pleaded guilty and must repay more than $8,000.

 

BWC's Special Investigations Department (SID) reports it received an allegation that Palmer had been working at a local veterinary hospital. Investigators found she had returned to work as a veterinary assistant while receiving Temporary Total Disability benefits.(WCxKit)

 

According to the report, Palmer was performing duties such as office work, assisting during surgeries, cleaning and taking care of animals. It was also found that Palmer was working as a telephone solicitor for a local charity.

 

Palmer entered a guilty plea recently to a felony count of workers comp fraud. The judge ordered Palmer to pay $7,457.72 in restitution and $1,000 for investigative costs. She was also sentenced to seven months in prison, suspended for 18 months of community control.(WCxKit)

Author Robert Elliott, executive vice president, Amaxx Risk Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. He is an editor and contributor to Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: Info@ReduceYourWorkersComp.com.

 


WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com

VIEW SAMPLES PAGES

MODIFIED DUTY CALCULATOR:  www.LowerWC.com/transitional-duty-cost-calculator.php

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.

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