Workers' Comp Fraud Blotter (1/23/2014) –School Boards Director Created Dummy Company For Fraudulent Workers’ Compensation Claims

Workers' Comp Fraud Blotter (1/23/2014) –School Boards Director Created Dummy Company For Fraudulent Workers’ Compensation Claims


Workers' Comp Fraud Blotter – January 23, 2014

Former Texas Association of School Boards Director Created Dummy Company For Fraudulent Workers’ Compensation Claims (TX) – Herman Wilks, the former Department Director of Workers’ Compensation Claims Administration for the Texas Association of School Boards, Inc., has pled guilty to mail fraud after stealing over $500,000. Wilks’ duties included the supervision of setting up member school districts' workers' compensation claims, adjudicating medical bills and carrying out the utilization, management and pre-authorization functions required by the workers' compensation statutes. Wilks submitted fraudulent workers’ compensation claims on behalf of Medco Implantable Supply, a dummy company he created for the sole purpose of carrying out his fraudulent scheme, for products and services that were never actually ordered, provided or rendered.   Read more

California Trucking Company Owner Listed Drivers As Arizona Employees To Reduce Premiums (CA) – Ricardo Casillas, the owner of California-based Casillas Transportation Services and Desert Express Transportation Lines, has pled no contest to insurance and tax fraud in a scheme to pay lower workers’ compensation premiums and state payroll taxes. Casillas created a shell company in Arizona and listed his 15 to 20 California employees as Arizona drivers who did not drive in California and only drove short hauls. In reality, 90% of the driving by his drivers was done in California. Eventually, Casillas even dropped his Arizona workers’ compensation insurance.   Read more

Disabled Flight Attendant Was Serving Food on the Ground While Receiving Benefits (OH) – Brieanna Younglove has been ordered to make restitution of $3,852.43 as a result of her guilty plea to workers’ compensation fraud.  Younglove was working as a restaurant server while she was receiving benefits and recovering from an injury that occurred when she was a flight attendant.   Read more

Company Owners and Collection Manager Charged in $36 Million Hot and Cold Overbilling Scheme (CA) – Jeffrey Campau, Abraham Khorshad, and Landen Mirallegro, the founders of Aspen Medical Resources, LLC, and Ryan McCracken, the collection manager for the company, have been charged with defrauding over $36 million from insurance companies in an overbilling scheme. Aspen was formed as a durable medical equipment company to rent out a machine similar in function to an ice pack or heating pad, which provided both hot and cold modalities to alleviate inflammation and/or pain for patients. The owners are accused of fraudulently overbilling workers’ compensation insurance carriers for this machine in two ways: for rental of one machine as two separate hot and cold machines, and for renting the hot and cold units which were valued at less than $500 for as much as $15,500 to $17,500 per patient. McCracken is accused of aggressively attempting to collect for payments and filing liens when payments were not made.   Read more

Injured Worker Sought Pain Pills From Multiple Drugstores (OH) – Nicholas Thompson has been granted intervention in lieu of conviction on charges of deception to obtain dangerous drugs and workers’ compensation fraud. Thompson used multiple physicians to obtain multiple narcotics prescriptions for a work injury and used multiple pharmacies to conceal his actions.   Read more

Disabled Truck Driver Was Able To Secretly Trim Trees and Drive Trucks (TX) – Anthony Garza reported a job-related injury while working as a driver for B. Catalani Inc., and he claimed that he was unable to work as a result of the injury. While he was receiving workers’ compensation income benefits, though, he was self-employed operating a tree-trimming business and working for another company as a truck driver. Garza has been placed on probation and ordered to pay $7,497 in restitution.   Read more

Salesman Double-Dipped While On Temporary Disability (OH) – Jeffery Hall has pled guilty to workers’ compensation fraud for working while receiving benefits. Hall was found to be working as an independent sales consultant between August 2011 and May 2012 while receiving temporary total disability benefits. He can avoid jail time by paying restitution of $31,544.24 and having no new convictions in the next five years.   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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