Workers' Comp Fraud Blotter (1/2/2014) – Firefighter Who Claimed Sexual Harassment From Drug Test Urine Sample Now Charged With Faking Ankle Injury

Workers' Comp Fraud Blotter (1/2/2014) – Firefighter Who Claimed Sexual Harassment From Drug Test Urine Sample Now Charged With Faking Ankle Injury

 

Workers' Comp Fraud Blotter – January 2, 2014

Firefighter Who Claimed Sexual Harassment From Drug Test Urine Sample Now Charged With Faking Ankle Injury (FL) – Jeremy DeRosa, a firefighter/paramedic for the Town of Palm Beach, has been charged with workers’ compensation fraud. DeRosa is alleged to have exaggerated the pain from an ankle sprain when he claimed that he could not return to light duty work. Although his doctor ordered him to wear an air cast, he was seen wearing flip-flops. DeRosa’s attorney said that he was not only not guilty, but that he was innocent. In 2012, DeRosa filed a sexual harassment complaint against the town because he was required to be under the direct observation of the assistant fire chief while he was providing a urine specimen for a drug test.   Read more

Owner Of Roofing Company Claimed That His Company Did Not Do Roofing Work (NJ) – Charles Kelcy Pegler Sr., the president of Roof Diagnostics, Inc., has been indicted for allegedly stealing more than $265,000 by providing false and misleading information to the company’s workers’ compensation insurance carrier. Charles Pegler is alleged to have stolen $265,044 from New Jersey Casualty Insurance Company by creating the false impression that his company was not a roofing company, that it did not employ roofers, and that it did not install, maintain and/or repair roofs.   Read more

Tree Trimming Business Owner Heading To Prison: No Workers’ Comp Insurance For Employee Killed By Wood Chipper (CA) - Jose Luis Guerrero, the owner of Jose Martinez Tree Service, Inc., has been sentenced to five years in prison for under-reporting his payroll to the State Compensation Insurance Fund in excess of $2 million by illegally paying cash to his employees in order to reduce his workers' compensation insurance premiums. In 2007, employee Gabriel Gonzalez was killed when his body accidently went through a wood chipper. Guerrero filed an insurance claim against his SCIF policy to collect benefits for Gonzalez's family without ever having paid an insurance premium on Gonzalez's wages.   Read more

Eleventh Circuit Upholds Conviction Of Letter Carrier Who Competed in Triathlons While on “Light Duty” (FL) – The United States Court of Appeals for the Eleventh Circuit has affirmed the conviction of Jacqueline Myers for worker’s compensation fraud. After Myers sustained a back injury while pulling a container of food out of the back of her postal vehicle, she was placed on light duty by the postal service, which consisted of sitting in an office and reading training manuals. While on light duty and receiving medical treatment for her back injury, Myers continued her long-standing practice of running in competitions and participating in triathlons. One of Myers's physical therapists testified that the level of pain that Myers reported was inconsistent with her ability to compete in running events. Myers told one of her doctors that she was in constant pain, was not getting better, and could not bend, even though she was competing in triathlons, which required her to bend over a bike for miles at a time.   Read more

Disabled Worker Operated Gun Business While Receiving Workers’ Compensation Benefits (OH) – Charles Newland has pled guilty to workers’ compensation fraud after investigators used video surveillance to prove that he was working while he was collecting temporary total, living maintenance and living maintenance wage loss benefits. Investigators posed as customers and found that he was selling firearms, archery, and hunting equipment and supplies from his business near his home.   Read more

Failing To Report Return To Work Results In Probation For Ten Years (RI) – Marta Rangel has been placed on probation for ten years after pleading no contest to obtaining money under false pretenses for collecting over $10,000 in workers' compensation insurance benefits while she was employed. Rangel failed to report that she had returned to work and failed to report her earnings while she was employed at Homecare Advantage and simultaneously receiving workers' compensation benefits from an earlier injury.   Read more

Business Owner Owes More Than $68,000 In Unpaid Premiums (OH) – Michael Bassinger, the owner of Freight Lease, Inc., was found to be operating his business without the required workers’ compensation insurance coverage since 2009. As a result of his conviction for failure to comply, Bassinger must repay more than $68,000 he owes in unpaid premiums. Bassinger stated that he knew that he was in violation of state law and had submitted payroll reports and made a few sporadic payments, but he had not previously entered into a payment plan that would allow reinstatement of his policy. He has now made a $50,000 down payment on the unpaid premiums.   Read more

Construction Company Owner Who Let Coverage Lapse a Second Time Must Pay Up Or Go To Prison (OH) – Todd Bittner, the owner of Bittner Construction, must pay $54,934 in unpaid premiums and reinstate his workers’ compensation coverage, or he will be sent to prison for two years. Bittner pled guilty to workers’ compensation fraud for operating his company since 2007 with lapsed coverage, the second time that he had done so. If he pays the unpaid premiums, he will perform 500 hours of community service instead of heading to prison.   Read more

Recipient Of Benefits Double-Dipped At Grocery Chain (OH) – Timothy Hunter has pled guilty to workers' compensation fraud for working while receiving benefits. Investigators found that Hunter knowingly worked for The Kroger Company during the same period that he received benefits, and he failed to notify the Bureau of Workers’ Compensation or his physician of his employment.   Read more

Pretend Ironworker Obtained Narcotics at Three Dozen Emergency Rooms and Urgent-Care Clinics (WA) – Robert B. Boyer, Jr. faces 25 felony charges alleging that he faked on-the-job injuries to fool hospitals and clinics into prescribing him narcotics. Robert Boyer is accused of visiting more than three dozen emergency rooms and urgent-care clinics throughout Western Washington to get prescriptions for Vicodin, Percocet and other painkillers. He pretended to be an ironworker when he showed up at the hospitals and clinics with visible cuts and other injuries that he said he suffered in construction accidents. He filed 51 bogus workers’ compensation claims and left the left the hospitals and clinics with more than $134,000 in unpaid medical fees.   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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