Workers Compensation Insurance Fraud Blotter

A survey of what the media, state agencies, insurance companies, and others report in terms of workers’ comp fraud, listing recent arrests, charges, and convictions.

Criminal complaints and indictments are accusations only. Defendants are presumed innocent until proven guilty.

A former nursing aide in New York State was arrested on multiple workers’ compensation fraud charges after he allegedly returned to work at a North Carolina hospital.

The arrest lead to the man’s arraignment on charges of offering a false instrument for filing, insurance fraud, grand larceny and violating the Workers’ Comp. Law – all felonies.

Investigators said the alleged defendant began receiving compensation payments for an injury he suffered in 2004 while working as a nursing personal care aide at the Finger Lakes Developmental Disabilities Service Office in Rochester, NY, part of the New York State Office of Mental Retardation and Developmental Disabilities.

The aide, classified in New York as permanently partially disabled, said he injured his lower back attempting to prevent a patient from falling to the ground. The investigation revealed, however, that he returned to work at Dorthea Dix Hospital in Raleigh, NC, as a healthcare technician during 2007. Investigators also learned that during 2008 he filed again for workers’ comp. benefits, claiming he injured his finger while working at the North Carolina hospital.

“Workers’ compensation fraud hurts businesses and honest working men and women across our state in the best of times, but places a further strain on our economy in the tough times we are facing now,” NYSIF Chief Deputy Executive Director Francine James said. “We continue to crack down on workers’ compensation fraud because to do otherwise would be to fail in our commitment to the businesses and people of New York.”

Investigators said the claimant sent signed statements to NYSIF indicating he had not returned to any type of work while receiving workers’ compensation benefits from NYSIF, but allegedly collected more than $9,000 in NYSIF benefits while employed following his injury. (workersxzcompxzkit)

At the time of his arrest, investigators he was collecting workers’ compensation benefits from both NYSIF and the State of North Carolina. Investigators estimated the potential future savings on his NYSIF claim to be $135,582. The investigation was conducted by NYSIF in cooperation with the New York State Insurance Department Frauds Bureau and the Office of the Workers’ Compensation Board Fraud Inspector General.

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