Workers’ Comp Scam Sends Former Postal Worker Up the River
A three-day kayaking trip helped sink the claims of a former U.S. Postal Service employee who had filed for total disability after an injury at work. The Montana woman was arrested and sentenced after fraudulently receiving more than $683,000 in wages and benefits from the U.S. Department of Labor over a span of 10 years.
An All-Expense Paid Trip to Prison
The USPS Office of Inspector General collected evidence that the woman was lifting hay bales, removing stumps, jogging, and engaging in other physical activities at her home. After sending her a survey and determining that one of her favorite outdoor activities was kayaking, agents posing as members of a marketing firm contacted her with an offer of a free kayaking trip. She accepted the offer and participated in a three-day, two-night kayaking tour in Washington’s San Juan Islands.
She received a follow-up survey from the agents and stated that the demands of the trip had not been strenuous. She was charged in May 2016 for fraudulently obtaining workers' compensation, engaging in wire fraud, making false claims relating to worker’s compensation benefits, and stealing government property. In December 2017, she was sentenced to 15 months in prison and ordered to pay more than $900,000 in restitution and criminal forfeiture.
Looking for Leaks in a Story
Fraud can occur in many forms, and is difficult to prove in Washington. However, our team of claims managers can spot red flags immediately and help you resolve these complex and expensive claims. Some common red flags may include:
- An employee who files a claim after a recent disciplinary action or termination
- An employee who exhibits exaggerated pain that is out of line with the alleged injury
- Someone who frequently files claims, or files on a Friday or Monday in order to extend their weekend
- An employee who is known to be involved in extra-curricular activities or hobbies that require physical activity beyond the medically assigned restrictions
Fraud Help for Vigilant Retro Members
If you recognize any of these signs with your injured employees or have other reasons to be suspicious about a claim, you don’t have to go it alone. Our team of claims managers, with over 65 years of combined experience, has seen it all. On behalf of Vigilant Retro members, we dig in and use tools such as social media surveillance, physical surveillance, or a medical records sweep to help spot leaks in a false claim. In especially complex cases, we can help you coordinate a legal review with an aggressive workers’ comp attorney.
Fraud not only causes higher costs and disrupts workplace culture, it’s downright illegal. The last thing you want is to help float the lifestyle of a criminal. Get Vigilant Retro today.
This website presents general information in nontechnical language. This information is not legal advice. Before applying this information to a specific management decision, consult legal counsel.