From office employees and medical professionals to landscapers and construction workers, it's not unusual to read stories about employee fraud/work comp fraud occurring here in California. What is far more unusual, however, is to read stories about one particular company or employer being plagued by repeat occurrences of work comp fraud over a relatively short amount of time.
Interestingly enough, however, this is exactly what seems to be occurring in the Hacienda La Puente Unified School District in Industry.
A few weeks back, 52-year-old Julio S. was arrested and charged with insurance fraud following a comprehensive investigation by the California Department of Insurance.
Specifically, authorities are alleging that Julio S., who worked as a campus security officer for the school district, claimed to have suffered a serious knee injury that prevented him from working. However, investigators purportedly uncovered evidence of him working as a private security guard for another business while collecting work comp benefits from the school district.
As it turns out, over the past year, the Hacienda La Puente Unified School District has seen at least four other cases of workers' compensation fraud.
According to reports, these include the following:
- Earlier this year, a high school teacher in the Hacienda La Puente who claimed to have suffered an elbow injury agreed to pay the school district $5,000 in restitution after he was discovered working at area race tracks while collecting work comp.
- In February 2011, a school official who claimed to have suffered knee, chest and back injuries after being struck by a student was arrested and charged with grand theft, perjury and insurance fraud after videotape showed her working for two weeks at a private medical clinic. She ultimately pleaded guilty to one count of insurance fraud, and was sentenced to serve five years probation and $8,800 in restitution.
- In February 2011, a school worker who claimed to have suffered a serious shoulder injury after trying to catch a fertilizer bag was arrested and charged after an investigator witnessed him hanging heavy holiday decorations and driving stakes into the ground. He ultimately pleaded guilty to one count of insurance fraud and was sentenced to pay $4,910 in restitution.
- In March 2011, a school official who claimed to have suffered rib, chest, leg, neck and back injuries while administering the Heimlich maneuver on a child, carrying the same child and being jumped on by another child, was charged with attempted perjury and insurance fraud. Here, investigators recorded her visiting Disneyland, carrying her children, camping and "moving without any apparent restrictions." She ultimately pleaded guilty to one count of insurance fraud, and was sentenced to two days in jail, two years probation, and $5,000 in restitution.
Workers compensation fraud/employee fraud is a very serious crime. If you suspect that such a crime has been perpetrated against your organization, you should strongly consider speaking with an experienced workers' comp defense attorney.
This post was provided for informational purposes only and is not to be construed as legal advice. Names have been withheld to protect the identity of the parties.
The San Gabriel Valley Tribune, "Hacienda La Puente Unified employee arrested for insurance fraud; sixth fraud case in district," J.D. Velasco, March 30, 2012