Workers' Compensation

Workers' Comp Fraud Blotter (10/17/2013) – BBQ Restaurant Manager Told Doctors She Could Not Stand or Take a Bath or Dress Herself


Workers' Comp Fraud Blotter – October 17, 2013

BBQ Restaurant Manager Told Doctors She Could Not Stand or Take a Bath or Dress Herself (OH) – Alfreda Dozier has been ordered to pay $57,000 in restitution as a result of her guilty plea to felony workers' compensation fraud. Dozier had claimed that as a result of a workplace injury in Ohio, she could not stand alone, used a wheelchair, and needed assistance with activities such as bathing and dressing. Two doctors had opined that she was totally incapable of any sustained work activity and should not crouch, stoop, bend, kneel, lift or grasp objects at all. But investigators found Dozier working as a restaurant laborer and manager for Blue's BBQ and G-Daddy's Bar-B-Q in Kingsland, Georgia while intentionally concealing her work in order to continue receiving benefits. After she was indicted, she fled to Texas, but she was found through an Internet search and arrested and brought back for trial in Ohio.   Read more

Disabled Carpenter Caught On Video Cutting Tree Branches With Chainsaw (NY) – Hugh Coogan has been charged with worker’s compensation fraud, larceny, and perjury for working while receiving disability benefits from a work injury that he sustained while working as a carpenter for Eastern Mill Work. Video surveillance by the workers' compensation insurer showed Coogan climbing a ladder and using a chainsaw to cut tree branches, as well as carrying tools and equipment from his truck into multiple construction work sites.   Read more

Police Officer Helps Dad Commit Workers’ Compensation Fraud (NJ) – Trenton police officer Gaetano Ponticiello and his father, Filippo Ponticiello, have been indicted by a grand jury on charges of false swearing and workers’ compensation fraud. They are charged with making false statements under oath to a workers’ compensation judge in order to misclassify employees of the father’s business so that he could avoid paying workers’ compensation insurance premiums.   Read more

Insurance Auditor Headed To Jail For Coal Mine Workers' Compensation Insurance Fraud (WV) – Arville W. Sargent, a workers' compensation insurance premium field auditor for BrickStreet Mutual Insurance Company, has been sentenced to six months in jail for mail fraud and tax evasion involving a $7.1 million fraud scheme against his employer, the state's leading workers' compensation provider. Sargent engaged in a scheme to defraud BrickStreet by taking bribes to allow certain policyholders operating in the coal mining industry to drastically underreport their payroll during annual field audits he conducted on behalf of BrickStreet for the intended purpose of confirming that those policyholders were paying accurate workers' compensation insurance premiums.   Read more

Complaint About Child Support Deduction From Paycheck Leads To Workers Comp Fraud Conviction (OH) – Mario Scott has pled guilty to workers’ compensation fraud after he was found to be working in the State of Washington while receiving Ohio disability benefits. Scott’s illegal activity was discovered after he contacted his claims service specialist to complain that his child support was taken out of both his disability benefits and his employment wages. Investigators obtained evidence that Scott worked for several employers through a temp agency in the State of Washington while collecting his Ohio disability benefits.   Read more

Disability Did Not Stop Roofing and Home Repair (OH) – Donald Whitford has pled guilty to double-dipping and has been ordered to pay restitution. While recovering from a workplace injury and receiving disability benefits, Whitford was working as a roofer for Brunswick Home Improvement and also doing home repairs in a self-employed capacity.   Read more

Restaurant Owner Tried To Run His Steakhouse Without Paying Wages (NY) – Paul Hurley and Portmarnock Restaurant Corp., d/b/a Desmond's Steakhouse & Grill, have been charged with failing to pay wages to workers who were hired at various stages during the opening of the 7th Avenue restaurant. In addition, the defendants face charges stemming from filing a false application for workers' compensation insurance. When Desmond's Steakhouse & Grill opened, employees worked for weeks without pay, including managers, chefs, administrative staff, and servers, who were owed more than $100,000. Hurley promised his employees that he would pay them and asked them to continue working without pay.   Read more

Employer Misrepresented Drivers As Independent Contractors (TX) – Ramco Group, LLC has been found guilty of workers’ compensation fraud charges by a Texas jury. Evidence at the trial showed that Ramco misrepresented the number of employees and payroll associated with the company by falsely representing certain drivers as independent owners and operators for its workers’ compensation insurance that was issued by Texas Mutual Insurance Company.   Read more

Chiropractor Must Figure Out To Pay Over $800,000 In Restitution While In Prison (OH) – Joseph Yurigan, D.C., a chiropractor who treated injured workers in Ohio and West Virginia, has been sentenced to 18 months in prison and ordered to pay restitution of $836,065.93 after pleading guilty to health care fraud and tax evasion. Yurigan was found to have routinely and consistently billed multiple insurance providers for services that he never provided after an investigation that included the FBI and the United States Treasury Department as well as state authorities.   Read more

Injured Worker Told Co-Workers That He Fell At Home, Not At Work (OH) – Bruce Weimert filed a workers’ compensation claim, stating that he fell at work. But he told his co-workers that he had fallen at home. Weimert was ordered to pay a fine as a result of his guilty plea to falsification for filing a false claim.   Read more

Thumbprint Proves Forgery Of Workers’ Compensation Check (OH) – James Putman has pled no contest to forgery, and Juanita Kneisley has pled no contest to attempted forgery after cashing a workers’ compensation check that did not belong to them. They cashed the check at a Stop & Go carryout. Kneisley presented a Polaroid picture of herself as identification to the carryout clerk, who also had Kneisley place her thumb print on the check.   Read more

Demolished Mobile Home Video Demolishes Fraudulent Workers’ Compensation Claim (OH) – After serving 42 days in jail, John Perkins pled guilty to workers’ compensation fraud. Investigators caught him on video demolishing mobile home trailers for Rogers Services while he was collecting temporary disability benefits for a previous workplace injury. The video showed Perkins tearing down the trailers using various tools and equipment, loading materials into a dumpster, and taking scrap materials to scrap yards.   Read more

Towing Company Owner Operated Without Insurance (OH) – Douglas Bevis has been ordered to pay $10,109.75 for worker’s compensation premiums that he failed to pay while he operated Bevis Towing without workers’ compensation coverage. Bevis allowed his coverage to lapse and failed to bring it into compliance despite the efforts of the Employer Fraud Team to work with him for compliance.   Read more

Probation For Fraud Conviction Requires Future Employment (OH) – Randall Bridges has been ordered to maintain employment as a condition of his probation after pleading guilty to workers’ compensation fraud for double dipping. Bridges was found to be employed as a sales person/independent contractor for Global Childcare Resources while he was also receiving temporary total disability benefits for a prior workplace injury.   Read more

Fraudsters Receive Reduced Time In Jail For Cooperation With Prosecutors (WV) – A federal judge has sentenced Jerome Russell and Frelin Workman to 30 months in federal prison and Randy Workman to 15 months in federal prison after they pled guilty to tax evasion. They had faced up to 25 years in prison. Jerome Russell and Frelin Workman had underreported their payroll for their company, Aracoma Contracting LLC, with the assistance of an auditor at their workers’ compensation insurer. Prosecutors requested that the defendants be given credit in sentencing because they provided information on other similar payroll schemes, on a kickback scheme involving a coal mine superintendent, and on a gambling ring. Read more

Check Stolen When Claimant Moved From Apartment But Continued To Get His Mail There (OH) – An injured worker reported that someone in his previous apartment had stolen and cashed his workers’ compensation benefits check. The injured worker had moved out of the apartment but was continuing to pick up his mail at the apartment. The investigation found Jeffrey Bostic stole the $2,423.25 check and forged the claimant's name on the back of the check. Bostic made arrangements to deposit the check into a friend's bank account and later had the friend withdraw the funds. Bostic was ordered to make restitution after he pled guilty to forgery.   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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