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 - March 7, 2013
Trapped By His Own Deeds: Trapping Guide Caught Working Construction and Catching Bobcats While On Disability (MT) - Mark Sheehan has been convicted of theft by common scheme of worker's compensation benefits. Sheehan was employed at Riverside Sand & Gravel in October 2009 when he claimed to have sustained an injury to his left shoulder while operating heavy machinery and was awarded benefits. In January 2010, the Montana State fund received a call from Riverside Sand & Gravel expressing concern that Sheehan seemed unmotivated to return to work. Additionally, the caller said that in the weeks leading up to his injury, Sheehan complained to co-workers that his work impeded his ability to be a trapping guide. A game warden for Montana Fish, Wildlife and Parks confirmed later that Sheehan had harvested four bobcats in December 2009, despite claiming to be too injured to work. Subsequently, video surveillance showed Sheehan working at a construction site, despite having complained of ongoing shoulder pain to his doctor. Read more
Police Officer Ordered to Pay $15,528 For Misstatements About Her Back Injury (NY) - Camille Bishop, a former New Paltz police officer, has been sentenced to one year of conditional release and ordered to pay restitution of $15,528 after pleading guilty to attempted workers' compensation fraud. After becoming an officer, Bishop filed a claim for workers' compensation disability, stating that she had injured her back while moving a tree that had fallen on a road. At the time of the claim, as well as when she was hired, Bishop had denied having any prior back injury, even though she had been treated three years earlier for a back injury after an automobile accident. Read more
Eighteen Wheeler Rolls On Until Driver Stopped By Fraud Investigators (OH) - Christopher Galloway has pled guilty to illegally returning to work as a truck driver while receiving workers' compensation benefits for a prior workplace injury. As a result of a tip, investigators found that Galloway was working as an independent semi-truck driver. He admitted to the work activity and cooperated with the investigation. Read more
Fast Food Restaurant Employee Arrested At Her Workers' Comp Hearing For Filing False Claim (CA) - Maria Arrieta has been charged with multiple counts of workers' compensation insurance fraud and perjury for filing a workers' compensation claim for an injury that she allegedly sustained at home. Arrieta claimed that she was injured while working at a McDonald's Restaurant when she slipped and fell while removing a case of meat from the freezer. But nine days before the day when she said that she fell at work, she had seen her personal physician and told him that she had sustained her foot injury at home and not at work. Arrieta was eventually arrested at the Santa Ana Workers' Compensation Appeals Board while she was awaiting a hearing in her workers' compensation case. Read more
He's Not A Hero To The Workers' Compensation Board (GA) - Robert Sims has been charged with insurance fraud for making false statements as to the cause of an injury. Sims, a supervisor for the Highway Emergency Response Operator (HERO) unit, filed a claim for workers' compensation after he said that he hurt his knee when he fell out of a HERO truck. He allegedly hurt his knee, though, during an agility test when he was seeking employment with the Clayton County Police Department. Read more
Four Years Of Fraud Leads To $205,000 Loss (NY) - Sean McPhail has been charged with insurance fraud and offering a false instrument for filing. He is accused of unlawfully collecting over $205,000 in workers' compensation benefits that he was not entitled to. Read more
Investigators Surfed the Internet To Discover That Widower Remarried (MT) - Robert Leighton Canoy has been charged with felony theft for continuing to collect spousal death benefits after he remarried. When his wife, Betty Canoy, died from a workplace injury with the Montana Department of Transportation, he became eligible for death benefits for 10 years or until he remarried. In April, 2011, Canoy remarried, but he failed to notify the State Fund of his change in status, which went unnoticed until investigators found a newspaper announcement of his marriage on the Internet. Read more
Judge Slaps MMA Fighter on the Wrist, Causing Prosecutors To Object To Noodle's Sentence (CA) - Raphael Davis, the former Los Angeles City firefighter and mixed martial arts fighter known as "The Noodle", has been sentenced to probation after he paid $30,000 in restitution and completed 200 hours of community service for filing a false workers' compensation insurance claim. Davis participated in mixed martial arts fights as "The Noodle" while filing false workers' compensation claims from his firefighting job. After placing Davis on probation for three years, the sentencing judge reduced his felony conviction to a misdemeanor despite objections from the prosecutor. Read more
Towing Company Owners Failed to Toe the Line and Kept Operating Without Insurance (WA) - Sandra and Billie Rouse, the owners of A1 Towing Service, have been ordered to pay nearly $23,000 in restitution and fines after pleading guilty to charges that they continued to employ workers in their towing business after the state had prohibited them from doing so. In 2011, their certificate of industrial insurance for A1 Towing Service was revoked for nonpayment. After that time, though, the Rouses continued to have employees using company trucks pick up and deliver various vehicles, including vehicles at the scene of accidents. Read more
Picture This: Photographer Caught Working The Camera While Out On Disability (OH) - Richard Ketcham has pled guilty to operating a photography business from his home while receiving workers' compensation benefits. Investigators received an allegation that Ketcham made comments indicating he might be working while receiving temporary total and living maintenance benefits. The subsequent investigation revealed that Ketcham earned profits from his photography business while collecting those benefits. Read more
Tow Truck Driver Pleads Guilty to Double-Dipping (MT) - Gareth Lea has pled guilty to felony theft for illegally collecting workers' compensation benefits for a work related injury. State investigators discovered that Lea was working in the construction industry and operating a tow truck at the same time he was receiving the workers' compensation benefits. Read more
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