Workers' Comp Fraud Blotter (5/29/2014) – Mom and Daughter Interpreters Who Stretched Their Mileage Now Have To Stay Home

Workers' Comp Fraud Blotter (5/29/2014) – Mom and Daughter Interpreters Who Stretched Their Mileage Now Have To Stay Home


Workers' Comp Fraud Blotter – May 29, 2014

Mom and Daughter Interpreters Who Stretched Their Mileage Now Have To Stay Home (WA) – Gloria Mendoza Garcia and her daughter, Gloria Del Rocio Gonzalez, who were the Washington Department of Labor & Industries' top billers for mileage, have been sentenced to 30 days in jail, but they will be allowed to serve the time on electronic home monitoring, for overbilling the state by thousands of dollars. The women lived in separate homes and ran separate businesses, interpreting for Spanish-speaking injured workers at medical appointments. Mendoza Garcia claimed in her mileage bills that she started her trips from the address of a Seattle sports clinic because she had appointments there, but the clinic staff did not know her. She sometimes billed for 500 to 800 miles in one day. Del Rocio Gonzalez claimed to start her trips more than 30 miles away from her home. She told investigators that the address she used, where she had lived four years earlier, was on a billing template in her iPad, and she never changed it.   Read more

Employee Of Builder Gave Out Fake Insurance Certificates (FL) – Amy Eakes has been arrested for providing building contractors with forged liability insurance and workers’ compensation insurance certificates for C&A Builders, so the company could qualify for work even though it had no insurance policies.   Read more

Architect Without Workers’ Compensation Insurance Said He Would Take It Out Of His Employees’ Paychecks (CA) – Robert Gunn, a licensed architect, has pled guilty to failing to register as an employer and to failing to maintain workers’ compensation insurance. Gunn had told his employees that he did not have worker’s compensation insurance, but if he acquired it, he would deduct the cost of the premiums from their paychecks. Investigators found Gunn and his employees working on a remodeling project for a rental property, and an employee had been injured.   Read more

Disabled Prison Cook Operated Both Concession Stand At Town Park and a Catering Business (NY) – Jeffrey Holler has been charged with larceny, insurance fraud, and workers’ compensation fraud. Holler was receiving disability benefits because he said he could not work because of an injury that he sustained while working as a cook at a state correctional facility. But investigators found that he was operating his own catering business, and that he was also running the concession stand at the Barre Town Park, where he also was serving as the volunteer Barre recreation director.   Read more

Contractors At Construction Site For Grocery Store and Department Store Shut Down For Lack Of Insurance (CT) – The Connecticut Labor Department has issued stop work orders against three construction firms that were working at a retail center without workers’ compensation insurance. Alvin Quality Masonry LLC and Industrial Technical Services Inc. were working on a new Big Y supermarket building project at the center, and G&F Group LLC was doing carpentry work on the Kohl’s building being constructed at the center. G&F was also found to be misclassifying its employees as independent contractors.   Read more

Gutter Guy Arrested After Failing To Get Workers’ Compensation Insurance For Four Months (CA) – Jesus Carranza-Perez, the owner of Carranza’s Seamless Raingutters, has been arrested on charges of failing to procure his contractor's license and workers' compensation insurance. Carranza-Perez was given four months to comply with these requirements after he and his employee were found to be cleaning out raingutters and performing masonry work and landscape cleanup and a stop work order was issued to him.   Read more

Rock Chip Repair Technician Caught Double-Dipping (TX) – Robbie Moore has been indicted on workers’ compensation fraud-related charges for allegedly obtaining $5,503 in workers’ compensation benefits he was not entitled to. Moore reported a job-related injury while working as a rock chip repair technician for Mr. Chips, Inc. He claimed that he was unable to work as a result of the injury, and Texas Mutual Insurance Company began paying income benefits to him. But Moore later worked for another company as a laborer and materials handler while receiving those income benefits.   Read more

Claimant Altered Pay Stubs To Lower His Wages and Increase His Benefits (OH) – Gerald Whitacre has been ordered to repay $22,468.81 of unlawful workers’ compensation benefits after it was discovered that he submitted 41 altered pay stubs. After conducting an employer audit of the trucking company where Whitacre worked, investigators found that he altered his pay stubs to lower dollar amounts and submitted them to qualify for working wage loss disability benefits. If he had accurately reported his earnings, he would not have been entitled to the benefits he received.   Read more

School District Police Officer Exaggerated His Injuries From Tussle Between His Bicycle and Wayward Cantaloupe (CA) – A former Los Angeles Unified School District police officer, Pedro Plascencia, has been charged with workers' compensation fraud for attempting to defraud the insurance company by exaggerating the extent of his injuries. Plascencia allegedly sustained a work-related injury while patrolling the school campus on his patrol bicycle when he ran over a wayward cantaloupe and lost control of his bicycle. He originally claimed an injury to his right knee, right foot and right hand, but after obtaining legal counsel, he added injuries to his back, hips and both knees. Plascencia originally denied any prior medical injury, however subpoenaed medical records indicated that he did in fact sustain prior injuries to those body parts.   Read more

Landscaper Without Workers Compensation Insurance Avoids Jail If He Performs Community Service (WA) – Kenneth Winters, the owner of Executive Lawn Care, has been ordered to perform 240 hours of community service in lieu of one year in jail after pleading guilty to operating without workers' compensation insurance. The lack of coverage was discovered when one of his employees, who had worked for Winters for 10 years, was injured on the job. The employee stated that Winters threatened him and his family if he filed a workers’ compensation claim. The employee filed the claim anyway, which cost the state over $67,000 in medical and wage-replacement benefits.   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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