Workers' Comp Fraud Blotter (12/15/2011) – Roller Coaster Mom Goes From Disneyland To Fraud Conviction

Workers' Comp Fraud Blotter (12/15/2011) – Roller Coaster Mom Goes From Disneyland To Fraud Conviction

Each week we'll be surveying what the media, state agencies, insurance companies, and others report in terms of workers' comp fraud. Just like a police blotter, our workers' comp fraud blotter lists recent arrests, charges, convictions and investigations.

 

Workers' Comp Fraud Blotter - December 15, 2011

School Employee Who Rode Disneyland Roller Coasters While Disabled Pleads Guilty (CA) - April Metzinger, who worked as a child development technician with the Hacienda La Puente Unified School District and claimed that she was injured while doing the Heimlich maneuver on a choking child and then ran into a pole while rushing the child to the hospital, has pled guilty and been sentenced to probation on a charge of workers' compensation insurance fraud. While she was claiming to be disabled, insurance investigators observed her camping out and carrying one of her children, as well as riding the coasters at Disneyland.   Read more

Roofer Working Off The Books After Back Injury Claim (NY) - John Czechowski collected $12,000 from the New York State Insurance Fund after he was classified as totally disabled for a back injury he suffered working as a roofer. However, investigators discovered he was working off the books for a contracting company while collecting the benefits. He is charged with third degree insurance fraud, grand larceny, offering a false instrument for filing and workers' compensation fraud.   Read more

Illegal Workers' Compensation Benefits Exceeded Seventy Grand (NY) - Anthony Thomas Tamburino III has been charged with workers' compensation fraud, offering a false instrument for filing, and second-degree grand larceny. He allegedly received more than $78,000 in improper workers' compensation benefits.   Read more

Don't Tell Your Girlfriend You Are Faking Your Injury For Warm Weather (NY) -  Aaron McElhinney is accused of collecting $11,600 in benefits from Chartis Insurance Company after falsely reporting that he suffered a work-related injury. Investigators found that he told his girlfriend and her mother that he was going to fake the injury so he could go to Florida. Co-workers corroborated that he did not hurt himself. He is charged with insurance fraud in the third degree and workers' compensation fraud.   Read more

Two False Claims For Same Injury Lead to Charges (CA) - Manuel Perales has been charged with two counts of workers' compensation insurance fraud. Perales reportedly sustained an industrial injury on July 15, 2010. During the workers' compensation 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' compensation 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.   Read more

Fraud Charges Are Not Sweet Music to Lead Guitarist's Ears (NY) - Steven Odum is accused of failing to disclose work activity as the lead guitarist with the "Steve Odum Trio" on reports he sent to the New York State Insurance Fund while collecting $11,300 in benefits after suffering an injury in 1988 while working at a residential child care institution. He is charged with offering a false instrument for filing in the first degree and workers' compensation fraud.   Read more

Paving Company Employee Double-Dipped With Construction Work (NY) -  William Ellis  admitted working for a construction company from 2004 through 2007 doing roofing, siding, plumbing and masonry while collecting $15,000 in benefits from the New York State Insurance Fund for an injury he suffered while working for a paving and excavating company in 1993.   Read more

Default Judgment Entered Against Non-Complying Company (ID) - A default judgment has been entered in the amount of $4,975 in favor of the Idaho Industrial Commission in a claim against Noteboom Property Services for failing to provide workers' compensation insurance.   Read more

Drown Was Swimming In Unlawful Benefits (NY) - Leonard Drown is accused of collecting $25,500 in benefits from Pennsylvania Manufacturers Association Insurance Company after claiming that he was not working because of an injury. Investigators found that he was, in fact, working while collecting the benefits.   Read more

Mover Lied To Keep Benefits While Working As Carpenter (NY) - William O'Neil is accused of collecting $1,790 in benefits from 21st Century North American Insurance Company while working for a moving company. He was collecting benefits after suffering an injury while working as a carpenter. He is also accused of giving false testimony at a workers' compensation hearing and causing a false independent medical examination report to be prepared and filed as part of his claim. He is charged with perjury in the first degree and workers' compensation fraud.   Read more

Waitress Served Food While Unable To Do Any Physical Work (NY) - Olga Shelestovsky is accused of working as a waitress while collecting $2,200 in benefits from the New York State Insurance Fund and claiming that she was unable to do any physical work. She is charged with offering a false instrument for filing in the first degree and workers' compensation fraud.   Read more

Landscaper Underreported Wages To Cheat On Workers' Compensation Premiums and Taxes (CA) - Vincente Sotto, the owner of Vincent Sotto Landscaping and Vincent Landscaping, has been charged with workers' compensation insurance fraud and employment tax violations. Sotto is charged with underreporting his payroll for several years in order reduce his workers' compensation insurance premiums and his payroll taxes.   Read more

Village Employee Who Cut Down Tree Collected Scrap To Sell While On Disability (NY) - Charles Foster collected $22,800 in benefits after hurting his leg when cutting down a tree while employed by the Village of Hoosick Falls in February 2010. However, investigators found that he was managing a storage facility and running a scrap metal business while collecting the benefits from the New York State Insurance Fund. He is charged with workers' compensation fraud.   Read more

Employee Injured While Lifting Her Big Dog and Not the Dog Food At Work (OK) - Timberlynn DeGraffenreid has pled guilty to one count of workers' compensation fraud. The trial judge imposed a 7-year deferred sentence and ordered her to pay $6,225 in restitution. DeGraffenreid had filed a claim for injuries sustained while lifting a 50-pound bag of dog food at work. However, during an investigation, medical records revealed that she had actually injured herself at home after lifting her 90-pound dog.   Read more

Community College Tutor Also Worked At Race Track While Receiving Benefits (NY) - Lee Kittle collected $22,600 in compensation from the New York State Insurance Fund after suffering an injury while employed at a mill in 1993. He was found to be working at Schenectady County Community College as a tutor and the Saratoga Race Track as a teller. He gave authorities a written confession. He is charged with offering a false instrument for filing in the first degree and workers' compensation fraud.   Read more

Subcontractor At Construction Site Where Worker Fell and Died Is Arrested (CT) - John Dosky, the owner of American Building Group, has been charged with failure to pay wages that were due to an employee who died when he fell from a roof at the Chelsea Piers construction complex and the deceased employee's two brothers, who wanted to use their paychecks to pay for a funeral. The Connecticut Department of Labor had previously issued a stop order against Dosky's business because it had misclassified employees as independent contractors and failed to maintain workers' compensation insurance for its employees.   Read more

Injured Knee Leads To Inflated Wage Claim (NY) - Kemberlei Senke is accused of claimant fraud for collecting $26,000 in benefits issued by the New York State Insurance Fund between June 2009 and January 2011. She reported suffering a knee injury while employed by Artistry in Wood. The investigation disclosed that she falsified reports to the NYSIF to inflate her wages and employment status. She is charged with insurance fraud in the third degree, offering a false instrument for filing in the first degree and workers' compensation fraud.   Read more

Home Health Aid Was Not All That Sick Herself (NY) - Cheryl LaQuay is accused of fraudulently collecting $53,000 in benefits from the New York State Insurance Fund between Oct. 2006 and Sept. 2011, while working as a home health aide. She is charged with insurance fraud in the second degree, offering a false instrument for filing in the first degree and workers' compensation fraud.   Read more

Staffing Company Appeals $51 Million Adverse Jury Verdict In Workers' Compensation Lawsuit (CA) - A jury has ruled in favor of the State Compensation Insurance Fund and found that Select Staffing underpaid its workers' compensation insurance premiums by $30 million. The trial court added interest and punitive damages to the verdict. The firm had claimed that its employment practices were legal and plans to appeal the verdict.   Read more

State Employee Forgot To Mention That He Was Coaching While Receiving Workers' Comp (NY) - Willie Dixon collected benefits from the New York State Insurance Fund for an injury he reportedly suffered while working for the New York State Office of Family and Children Services in May 2010. An investigation revealed he failed to disclose on work activity reports that he was employed as a coach while collecting $4,700 in benefits. He is charged with insurance fraud in the third degree and workers' compensation fraud.   Read more

Delinquent Tenant Charged with Forgery of Workers' Compensation Letter (CT) - Randal Lee Ruelle has been arrested for allegedly using a forged letter in an attempt to convince his landlord that he would receive a Workers' Compensation settlement that would be used to cover unpaid rent and utility expenses and spare him from being evicted. According to the arrest warrant application, the letter and signature of the Workers' Compensation commissioner were later determined to have been forged.   Read more

Carpenter Converted To Landscaping After Slip and Fall (NY) - Sergio Cortez collected $6,800 in benefits from the New York State Insurance Fund after claiming he suffered a slip and fall injury while working as a carpenter for ABD Stratford LLC in September 2009. However, investigators found that he was working as a landscaper while collecting benefits. He is charged with insurance fraud in the third degree and workers' compensation fraud.   Read more

Employee Claimed He Was Hurt At Work On Day When Business Was Closed For Holiday (OK) - Johnny Lee Crowder has been was charged with one count of workers' compensation fraud. Crowder is alleged to have filed a claim for injuries to his left hand when he tripped and fell while working. During the investigation, investigators discovered discrepancies in his claim and medical records. On the day in question, the business was closed for a holiday and the ambulance picked him up at home and not at work as he had claimed.   Read more

No Benefits After Claim For Ice Injury Was Frozen By Witnesses (NY) - James Roy is accused of attempting to collect benefits after falsely reporting that he suffered a work-related injury while employed by a tool-making company. He claimed that the injury occurred when he slipped on ice in the company's parking lot, but witnesses contradicted his claim. He never received compensation because his claim was discovered to be false before benefits were issued. He is charged with workers' compensation fraud.   Read more

Police Officer Who Falsely Claimed He Was Shot By Burglar Sentenced to Two Years In Jail (CA) - Jeff Stenroos, a police officer with the Los Angeles school system, has been sentenced to two years in jail and five years of probation for insurance fraud and workers' compensation fraud that resulted from his hoax where he claimed that he was shot by a burglary suspect outside of a school. During the 10 hour manhunt for the fictitious burglar after Stenroos called for help, nine schools were locked down.   Read more

No Horsing Around Allowed When Trying To Collect Disability (NY) - Susan Gridley started collecting benefits after an injury she sustained while working at a horse farm in 1986. She later failed to disclose on work activity reports submitted to the New York State Insurance Fund that she was working as horse boarder and trainer while collecting $4,700 in benefits.   Read more

NCIS Investigators Catch Workers' Compensation Fraud (SC) - David E. Morris has been indicted by a federal grand jury on seven counts of theft of government property. An investigation by the Department of Labor-Office of Investigations and the Naval Criminal Investigative Service found that Morris improperly received Navy Workers' Compensation Benefits.   Read more

Widow Must Have Thought Dead Hubby's Checks Were Meant For Her (NY) - Kimberly Harrington is accused of cashing her dead husband's workers' compensation benefit checks totaling $2461.90. The checks were issued by the New York State Insurance Fund. She is charged with grand larceny in the fourth degree.   Read more

Court Orders Home Improvement Contractor To Pay Restitution to Injured Employees (VT) - Donald Bevins, who operated Twin City Roofing and Around the Clock Property Maintenance, has been ordered to pay a combined total of $79,623.08 in restitution to two of his former employees. While Bevins was operating his businesses without workers' compensation insurance and in violation of a Vermont Department of Labor Stop Work Order, two of his employees were seriously injured while working and each suffered tens of thousands of dollars in uninsured medical bills and lost wages.   Read more

Never Work For A Doctor While On Disability (NY) -  Jeffrey Hamblin reportedly suffered a knee injury while employed as a truck driver for HR Logic/Doberts Dairy in November 2001. An investigation revealed he was employed as a general contractor for Painters Plus and worked for a doctor while collecting $7,700 in benefits from Liberty Mutual Insurance Company. He is charged with falsifying business records in the first degree and insurance fraud in the third degree.   Read more

Man Who Claimed Constant Pain With Limited Mobility Was Able To Clean His Swimming Pool (OK) - Charlie Jones has been was charged with one count of workers' compensation fraud. Jones filed a claim for injuries to his right arm and hand that were allegedly sustained while working and was awarded permanent total disability benefits. In a later medical re-evaluation, Jones claimed he suffered from constant pain with limited mobility, but investigators observed him feeding animals and cleaning his pool with no visible signs of pain or decreased mobility.   Read more

Ankle Injuries At Home Don't Qualify For Work Disability Benefits (NY) - Patricia Wilcox started collecting benefits from the New York State Insurance Fund after claiming she suffered a broken ankle while working as a teacher's aide at the Chenango County Head Start program. Investigators found that her injury actually occurred at her home. She fraudulently collected $12,900 in benefits. She is charged with falsifying business records in the first degree and workers' compensation fraud.   Read more

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