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 - September 20, 2012
Sharon Stone Pleads Guilty to Workers Comp Fraud After Faking Her Age By 30 Years (WA) - Sharon L. Stone has pled guilty to first-degree theft and welfare fraud for using her aunt's social security number to obtain a job at Rainier Vista, a senior care facility, and then receiving wage replacement and medical benefits for a back injury after working only five days. In order to hide her own criminal history, which included convictions for welfare fraud, possession of stolen property, and drug violations, Stone used her aunt's social security number on her job and workers' comp applications, even though the aunt was 30 years older than Stone. Read more
Glass Man's Double-Dipping Streak Is Broken (CA) - John Jose Ramirez has been charged with felony workers' compensation fraud for running his own business while receiving workers' compensation benefits. Ramirez hurt his knee in 2008 while working for Andy's Glass & Window Co., and the owner of that business later observed Ramirez operating his own glass business while he was receiving those benefits. Read more
Employee's Fall From Roof Alerts State to Audit Owner of Uninsured Roofing Company (WA) - David Rau has been charged with felony false reporting for failing to report for nine years that he had employees at his Davey's Roofing business. During that time, Rau was able to evade paying about $150,000 in workers' compensation premiums and penalties. After an employee fell from a roof in 2010 and was awarded workers' compensation benefits, an audit revealed that Rau did not have insurance to cover the employee's injuries. Read more
Disabled State Bridge Engineer Sure Could Swing That Sledge Hammer (ME) - Clinton J. Ashby III has been found guilty by a jury of workers' compensation fraud for lying to his doctors and his employer about his ability to work so that he could collect disability benefits. Ashby maintained that he could not work as a supervisor because he was disabled, but surveillance videos showed him swinging a sledge hammer, using a crow bar, and running heavy equipment. Read more
Former School Superintendent Sent To Prison For 135 Months For Taking Insurance Bribes (NJ) - Michael J. Ritacco, the former superintendent for the Toms River Regional School District, has been sentenced to federal prison for mail fraud and tax fraud for taking between $1 million and $2 million in bribes and other benefits while purchasing insurance for the district, including workers' compensation insurance. Ritacco and his co-schemers agreed to use middlemen, shell companies, sham consulting contracts, and third-party payments, to secretly pass hundreds of thousands of dollars in cash bribes and other payments to Ritacco. Read more
Disorganized Billing Translates Into Theft Charge For Interpreter For Disabled Workers (WA) - Betsaida Sosa has been charged with first-degree theft and making a false statement in an application for payment for allegedly using a fictitious address, overlapping times, and erroneous appointments in billing for $30,352.59 of services to the Washington Department of Labor and Industries. Sosa provided language interpretation services for injured workers needing medical care, billing for both her services and her mileage to various appointments. She claims that she did not deliberately overbill, but rather that she was neither "well organized" nor a "good business person". Read more
Employer Ignores Checks He Bounced For His Workers' Compensation Premiums (OH) - Keesh Edwards, dba Keesh Inc., has pled guilty to a felony count of workers' compensation fraud for allowing his businesses' workers' compensation coverage to lapse. His checks for payment for his workers' compensation premiums bounced, and he failed for three years to submit the required semi annual payroll reports. Even after he was notified of the bounced checks and missing reports, he continued to operate his business without workers' comp coverage. Read more
Don't Fake an Injury at Work When You Are Being Watched by Soccer Referees and Scorekeepers (OH) - Travis Ametrano has pled guilty to a misdemeanor count of workers' compensation fraud for filing a false claim. Ametrano alleged that he was injured when he slipped on ice while walking into work, but investigators found that he was actually injured during an indoor soccer game hours before reporting to work. Referees and the scorekeeper from the game positively identified Ametrano by photograph as a player that injured his leg during a game on Sunday, the day before he reported his work injury. Read more
Snowplow Operator Was Double-Dipping As He Tried To Snow the Bureau of Workers' Compensation (OH) - Chester Fusco has pled guilty to working while receiving benefits. While receiving temporary total disability benefits for a work-related injury, Fusco operated a snowplow in the winter and was paid in cash for his services as an independent subcontractor for Cooper Contracting and Bauer Construction. Fusco plowed commercial properties for these companies between November 2008 and February 2011. Read more
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