FL: Former Restaurant Worker Charged with Work Comp Fraud

Panama City, FL (WorkersCompensation.com) – Former Po’ Folks restaurant worker Andrew Davis was arrested in late September for allegedly defrauding the restaurant’s insurance company for more than $20,000 in work comp benefits. He claimed that he suffered a lower back injury in 2016 while moving furniture for Po’ Folks and received a work comp payment of $21,487 from Retail First Insurance Co. 

According to Florida’s Department of Financial Services (DFS), investigators reported that Davis knowingly made false accounts during the hiring process that would ultimately set him up to receive workers’ compensation benefits. He allegedly maintained the lie that he had not received any workers’ compensation for his previous back injury and now faces a charge of felony work comp fraud for declaring that he hurt his lower back while working at the restaurant.

In a news release, investigators said, “Davis’ history of two prior workers’ compensation claims, that both resulted in civil action, would show an advanced knowledge of his medical claims history. Had Davis disclosed this information during his pre-employment questionnaire, Retail First Insurance would not have been exposed to this loss. Davis continued to hide these lies during the claim and medical treatment process.”

WorkersCompensation.com received a copy of Davis’ arrest warrant. The document said that in the spring of 2016, Davis completed a pre-employment application for Po’ Folks, and within the packet was a medical questionnaire that pertained to prior work-related injuries. When asked if he had ever received work comp, he stated yes for an incident in 2005. His foot was allegedly injured, but he failed to list the incident from 2010 where he claimed to have hurt his back.

Another section of the questionnaire asked Davis if he had ever sprained or injured his back. His answer was no even though he claimed work comp benefits for a back injury. Since he did not list this information for his employer, he was able to be approved for work comp benefits from Retail First.

On May 19, 2016, Davis went to Bay Medical Center, after “…lifting and moving heavy furniture weeks ago,” and a further assessment showed a “lumbar strain.”  He was recorded later by field adjustor Dwight Merrick in a voluntary statement. Again, when he was asked if he’d injured his back, he stated no, and answered with another no when asked if he had been hurt in the middle of his back or neck, previously to the incident at Po’ Folks. 

Davis told the adjustor, “No, I ain’t never been hurt.” And then when questioned if he had any prior work comp claims, he said, “None that I know of.” Then a few minutes later, the adjuster asked him one more time about having any other claims in the past. Davis finally told him about an incident when he worked for Bell South in which he was assigned to dig cables. The ground allegedly collapsed on his feet, but he still denied any kind of back injuries while working.

During the claims process, Retail First had a thirty-party claims investigation company step in, and when additional court records were obtained, Retail First discovered Davis had reported two work comp claims in 2004 and 2010. One claim pertained to another incident at Panama City Toyota.

Davis reported an injury to his right shoulder, lower back, tailbone, and right hand while working for the dealership. When asked why he denied he had any prior lower back injuries by investigators, Davis said that he only knew he injured his “tailbone” in a previous claim, and did not realize that that consisted of his lower back.

Once those records were obtained by Retail First, a notice of denial was issued for Davis’ work comp claim, and stated that the former employee of Po’ Folks had falsely provided information about his prior work comp history. 

Lance Tomkins III, Publication Information Officer for the Division of Investigation and Forensic Services, told WorkersCompensation.com, “We do not have a projected date at this time (for sentencing). The State Attorney’s Office determines the timeframe as to if and when Andrew Davis would be sentenced.” 

The State Attorney’s Office and did not return requests for comment by press time.  

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