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 - February 28, 2013
Former Elected Official's Claim That She Is Illiterate Fails At Suppression Hearing (ME) - Former Chelsea selectwoman Carole Swan has lost her attempt to suppress statements that she made to investigators and will face federal fraud and extortion charges at a trial in April. Swan had claimed that the statements should have been suppressed because she could neither read nor write, although she served for 19 years as selectwoman, including as the chairwoman of the town board. Among the charges, Carole Swan is accused of filing false documents in order to obtain federal workers' compensation benefits. Read more
Son Runs Side Business After Injury At Parents' Business (MT) - Perry Joseph Penfield has been convicted by a jury of two felony counts of theft of worker's compensation benefits provided by the Montana State Fund. Penfield began receiving disability benefits after he injured his knee while working for his parents' business, Polson Paint and Glass. While receiving benefits, Penfield operated his own paint and siding company. Read more
Doctor Convicted Of Overbilling Workers' Compensation Insurer (TX) - Dr. Howard T. Douglas, III, M.D., and his company, Western Medical Evaluators, have been convicted on felony workers' compensation fraud-related charges and ordered to make $98,411 in restitution. Western Medical Evaluators provided functional capacity evaluations to injured workers in Texas, and Douglas and Western Medical Evaluators were found to have overbilled Texas Mutual Insurance Company for the time taken to perform such evaluations. Read more
Language Interpreter Pleads Guilty to Overbilling for Interpretive Services for Injured Workers (WA) - Barak Ramon has pled guilty to charges that he overbilled the Washington State Department of Labor & Industries for Spanish-language interpretive services. Ramon contracted to provide language interpretive services between injured workers and their doctors or other treatment providers. He used a variety of schemes to bilk the state including billing for hours he did not work, double-billing his mileage, and padding his bills. Read more
Ringleader of "Operation Dirty Money" Workers' Comp Check-Cashing Scheme Arrested (FL) - Domenick Pucillo, one of the ringleaders in the fraud schemes targeted as part of continuing enforcement efforts under "Operation Dirty Money", has been arrested and charged with filing a false and fraudulent document, forgery, uttering a forged instrument and operating an unlicensed money service business. Pucillo allegedly filed false documentation with the Florida Office of Financial Regulation seeking to become a principal of I&T Financial Services, LLC, a business that was set up to execute a large-scale check-cashing scheme for the purposes of evading the cost of workers' compensation coverage. Pucillo allegedly knowingly concealed the true identity of his business partner, a convicted felon, and instead listed a straw owner as the licensee of the business in order to obtain a license. Read more
Owner of Janitorial and Pest Control Company Sentenced For Insurance Premium Fraud (CA) - Teresa Reif, the owner of Genesis Building Services, Inc., a janitorial and pest control company, has been sentenced to jail, five years of probation, and ordered to pay restitution of more than $2 million as a result of her no contest plea to workers' compensation fraud for underreporting the company's payroll to its workers' compensation insurance carrier. Reif had misrepresented the number of employees at the company as well as its actual payroll when applying for workers' compensation insurance. Read more
Disability Does Not Stop Bus Driver From Making His Routes (OH) - Bryan Primmer has pled guilty to one misdemeanor count of workers' compensation fraud for working while receiving benefits. Primmer was found to be working as a school bus driver for the Logan-Hocking School District while receiving temporary total disability compensation. Read more
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