Workers' Compensation

Workers' Comp Fraud Blotter (5/9/2013) – Fake Jobs Used To Trick Hospitals Into Giving Out Prescription Pain Pills

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 - May 9, 2013

Fake Jobs Used To Trick Hospitals Into Giving Out Prescription Pain Pills (WA) - Jose Ramon Amaya-Hernandez has pled guilty to three counts of obtaining a controlled substance by fraud and has been sentenced to 45 days in jail on each count to run concurrently. Amaya-Hernandez filed 53 work injury claims at a dozen Seattle hospitals over a three year period, stating that he was in pain due to a work related injury. The hospitals provided him with narcotic pain medications for the treatment of his claimed injuries, even though there were no records showing that he ever worked for any of the employers he listed on the claims.   Read more

Doctor To Repay $150,000 For Billing For Counseling Sessions Conducted By His Unlicensed Staff (OH) - Dr. Joseph Spare and the Marion Independent Physicians Association (MIPA) have agreed to settle a civil suit filed by the Ohio Bureau of Workers' Compensation with a payment of $150,000. Dr. Spare billed the agency for more than 1,100 psychotherapy sessions that were conducted by under-qualified staff members. The bills indicated that Dr. Spare conducted both counseling and medication management sessions for injured workers, but the counseling sessions were actually being performed by three of his staff members, MIPA employees who weren't licensed to provide counseling. Dr. Spare was only checking the patients' medication at the end of their counseling sessions.   Read more

Craigslist Ads Used To Snag Unlicensed Contractors In Sting Operation (FL) - A multi-agency sting operation has culminated in the arrest of eight contractors for operating without a license and failing to maintain workers' compensation insurance. Undercover detectives contacted the suspects, who were advertising on Craigslist, to perform work that required a contractor's license. The suspects responded to the sting house, an unoccupied single family home, and provided the undercover detectives with written proposals to do work. Arrested on both charges were Christopher Nazario, Harry Bynum, Adam Barnhart, Marcelino Loperena, James Pastor, Adam Pitt, Eric Wieszchowski, and Blair Goodrow. In addition, Scott Wieszchowski was arrested on a single charge of operating without a license.   Read more

Former State Senator Sued For Not Paying Workers' Compensation Insurance Premiums (ID) - The Idaho Industrial Commission has sued former state senator Mike Jorgenson, alleging that he has failed to pay his workers' compensation insurance for his restaurant, The Copa, since last December. Jorgenson, who has announced that he intends to close the restaurant, faces a potential penalty of at least $5,200.   Read more

VA Employee On Light Duty Worked At Her Liquor Store After Her VA Work Shift Ended (NY) - Amelia Jackson has been arrested and charged by criminal complaint with knowingly making false material statements and certifications and knowingly concealing outside employment in connection with an application for and receipt of Federal Employee Compensation. Jackson was employed at the VA Medical Center in Canandaigua, N.Y. when she claimed to have suffered a back injury while working with a patient. Subsequent information provided by Jackson indicated that she was medically limited as to the number of hours she could work each day and did not work outside of her federal job due to her injury. More than three years later, a VA employee went to Last Call Liquors and allegedly observed Jackson working in the store, which investigators later determined that Jackson owns and operates. Jackson was observed on several occasions going to Last Call Liquors following her four hour disability shift at the VA Medical Center.   Read more

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