Workers' Comp Fraud Blotter (6/12/2014) – Roof Falls In On Roofing Company Owner Who Lied and Is Now Is Headed To Jail

Workers' Comp Fraud Blotter (6/12/2014) – Roof Falls In On Roofing Company Owner Who Lied and Is Now Is Headed To Jail

 

Workers' Comp Fraud Blotter – June 12, 2014

Roof Falls In On Roofing Company Owner Who Lied and Is Now Is Headed To Jail (NJ) – Charles Kelcy Pegler Sr., the president of Roof Diagnostics, Inc., has been sentenced to six months in jail for insurance fraud. Pegler stole $265,044 from the New Jersey Casualty Insurance Company by creating the false impression that his company was not a roofing company, that it did not employ roofers, and that it did not install, maintain and/or repair roofs. In addition, he stole $134,087 from another insurer by assuring the insurer that subcontractors performed all of the roofing work provided by his firm.   Read more

Farm Foreman’s Fascinating Fraud Featured Double-Dipping and Identity Theft (CA) – Jorge Silva has pled guilty to multiple charges for illegally receiving workers’ compensation and state disability benefits. After Silva lost his job as an irrigation foreman at a cattle ranch, he claimed that he had received cumulative injuries during his twenty years of employment at the ranch. Although he stated under oath that he was not working, investigators found him working at another ranch. In addition, he received state disability benefits by using a Social Security number that belonged to someone else.   Read more

Letter Carrier With Disability That Made Her a Prisoner In Her Home Was Able To Take Cruises (NY) – Maria Chmielewski has been charged with larceny and insurance fraud for allegedly collecting illegal workers’ compensation benefits. She claimed that an incident at work caused PTSD and panic disorder that prevented her from working or driving and made her a prisoner in her home. But she was shown on video taking cruises and driving her car.   Read more

Business Owner Receives Suspended Jail Sentence For Lapsed Workers’ Compensation Coverage (OH) – Ronald Larlham, the owner of RGS Automotive, has been sentenced to serve 180 days in jail, of which 179 days were suspended and credit was given for one day served, as a result of his guilty plea to workers' compensation fraud. Even after compliance officers attempted to work with Larlham concerning his lapsed workers’ compensation coverage, he continued to operate his business illegally.   Read more

Security Company Owner Failed To Pay Workers’ Compensation Insurance and Remit Employee Taxes (CA) – Alberto Hernandez, the owner of Salinas Valley Private Security, has pled no contest to workers’ compensation fraud and tax violations. Investigators found that Hernandez had operated his firm for two years without any workers’ compensation insurance and had failed to pay taxes he collected from his employees.   Read more

Corrections Officer Ordered To Perform Community Service For Workers’ Compensation Fraud (NY) – Steven LaPlaca, a corrections officer at the Watertown Correctional Facility, has pled guilty to fraud and larceny and will perform 100 hours of community service as a part of his sentence. LaPlaca provided false information concerning an injury that he claimed to have received at work.   Read more

Doctor Once Again Convicted Of Overbilling Workers' Compensation Insurer (TX) – Dr. Howard Douglas, III, M.D., has again been convicted of workers’ compensation fraud for overbilling Texas Mutual Insurance Company for functional capacity evaluations. Dr. Douglas was previously convicted for overbilling by his company Western Medical Evaluators. Investigators found additional evidence that Douglas used three other companies he created, North Texas Medical Evaluators, Marconi Physical Performance Testing, and Nolan Physical Performance & Neurodiagnostics, to also overbill Texas Mutual.   Read more

Architect Threatened To Deduct Workers’ Compensation Insurance Premiums From His Employees’ Paychecks (CA) – Architect Robert Gunn has pled guilty to failing to register as an employer and to failing to maintain workers’ compensation insurance. Gunn told his employees that he did not have worker’s compensation insurance, but if he purchased it, he would deduct the premiums from their paychecks. When an employee was then injured, Gunn paid for his medical treatment. Investigators found Gunn and his employees working on a remodeling project for a rental property.   Read more

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.

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