The Year in Review: Top 10 Workers’ Comp Fraud News Stories

The Year in Review: Top 10 Workers’ Comp Fraud News Stories

Workers’ compensation fraudsters come in all shapes and sizes. Here are 10 news stories from 2011 that caught our eye:

1. Grandpa Used Granddaughter to Sell His Workers' Compensation Drugs (OH) - Donald Fisher has pleaded guilty to one count of deception to obtain a dangerous drug, a fourth degree felony. Investigators found that Fisher was having his granddaughter use and sell narcotics prescribed by his workers' compensation physician. Between May 2010 to March 2011, Fisher gave his adult granddaughter 10 Opana and 10 Percocet pills each week to traffic on the street in exchange for sexual favors, and the granddaughter sold the Opana for $50 per pill and the Percocet for $12 per pill and split her profits with Fisher. Read more

2. Claimant Caught On Video Roofing Before Attending His Workers' Comp Hearing (OH) - Daniel Uribes has been sentenced to jail, with credit for time served, and ordered to pay restitution in a fraud case after investigators from the Ohio Bureau of Workers' Compensation captured video not only showing him working a roofing job while receiving benefits, but also leaving the worksite to attend a hearing on his workers' comp case, and later returning to finish the job.   Watch the Video and Read More

3. Police Officer Who Shot Himself to Be Fired After Guilty Verdict (CA) - Jeff Stenroos, a police officer with the Los Angeles school system, has been found guilty of insurance fraud and workers' compensation fraud for his participation in a hoax where he claimed that he was shot by a burglary suspect outside of a school. The superintendent of the Los Angeles Unified School District has called Stenroos a disgrace and said that as a result of the conviction, Stenroos will be fired from his job.   Read more

4. “Ax Men” Reality Star Pleads Not Guilty to Theft of Disability and Pension Benefits (WA) – Logger James Frank Smith, who has appeared regularly on the History Channel’s “Ax Men”, has pled not guilty to seventeen counts of theft that allege that he unlawfully worked while receiving workers’ compensation benefits and a disability pension. A doctor who viewed some of the shows stated that Smith did not appear to have a disability and was able to do remarkable things.   Read more

5. County's Workers' Compensation Claims Administrator Used Funds For Playboy Mansion Visit (PA) - The United States Court of Appeals for the Third Circuit has upheld the prison sentence imposed upon Charles Costanzo, a partner in Executive Claims Administration. Costanzo and his firm were hired by the Lackawanna County commissioners to administer the county's workers' compensation fund. Costanzo was found to have stolen $647,260 from the county, and he used some of the funds to take one of the county commissioners on a trip to the Playboy Mansion to meet Playboy Magazine publisher Hugh Hefner and his Playboy Bunnies.   Read more

6. Doctor Sentenced for Lying About Employee's Disability and Inability to Work for Him (VA) - Vu Q Tran, M.D., has been sentenced to one year conditional discharge and ordered to pay $18,000 in restitution to the New York State Insurance Fund. The sentence was imposed after Dr. Tran pleaded guilty to disorderly conduct in satisfaction of the workers' compensation fraud charges pending against him. The case involved the workers' compensation insurance claim of a former employee. Dr. Tran had reported that the employee was totally disabled and could not work. In fact, she was employed by Dr. Tran at the time.   Read more

7. Owner Of Durable Medical Equipment Supply Company Guilty of Submitting Fraudulent Workers’ Compensation Bills (TX) – Kay Ann White, the  owner and operator of Electra Enterprises and Electra Med, has pled guilty to submitting fictitious bills pursuant to the Texas Workers' Compensation Act and the Federal Employees' Compensation Act for products that she did not actually sell or deliver to customers. She admitted to submitting almost $1 million in false bills.   Read more 

8. Former Owner of Temporary Employment Agency Sentenced for Under-the-Table Scheme (MA) - John Mahan, a former owner of Commonwealth Temporary Services, Inc., has been sentenced to six years and four months in prison for his role in running a $30 million under-the-table payroll scheme. The scheme avoided more than $9 million in federal and state payroll taxes and workers' compensation insurance premiums. Mahan under-reported the payroll of Commonwealth Temporary Services, which supplied hundreds of temporary laborers to businesses throughout Eastern Massachusetts, by paying more than $30 million of the company's payroll in cash.   Read more

9. Son Pleads Guilty to Forging College Enrollment Paperwork in Order to Receive Death Benefits OH) – Joseph Archer has pled guilty to forging college enrollment verifications in order to continue receiving death benefits from his father’s death after Archer turned 18. Archer submitted false paperwork indicating enrollment in several college classes in order to continue receiving payments, although he either failed to attend, or never enrolled at all.   Read more

10. Unlicensed Doctor Pleads Guilty to Unlawfully Conducting Workers’ Compensation Medical Examinations (OH) – James E. Mann, who lost his license to practice medicine after being convicted of overprescribing prescription medicines, has pled guilty to three counts of mail fraud. Mann personally conducted medical examinations of workers’ compensation claimants and fraudulently signed the names of licensed physicians to the examination forms.   Read more

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