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California employee fraud: Woman accused of false comp claim

Business owners have a wide range of responsibilities, including ensuring that their workers are safe while on the job. The vast majority of California employers take those duties seriously, and care deeply about the health and safety of those within their employ. It is important, however, that employers understand that there are individuals who strive to take advantage of workplace safety laws to make a fraudulent workers' compensation claim against their employers. One such case of apparent employee fraud was recently reported.

An example lies in the recent sentencing of a woman accused of making false claims to gain workers' compensation funds. She was employed as a field worker at Scheid Vineyards when she claimed an injury in early 2007. A few months later, she told an investigator that she suffered serious physical limitations due to her injury, and that she experienced difficulty completing basic tasks using the arm, wrist and hand that were injured.

However, video surveillance showed the woman engaging in various physical activities that contradicted those statements. The insurance company associated with her claim compiled a list of these misrepresentations and presented the case to the Worker's Compensation Unit of the District Attorney's office. As a result, she was prosecuted for insurance fraud.

At a recent sentencing hearing, the woman was given 90 days in jail, as well as three years on informal probation. She paid over $16,000 restitution to the insurance company who processed her claim before sentencing, which may have helped her convince the court to reduce the felony charge to a misdemeanor. This employee fraud case serves as a warning to all California employers of the risk of falling victim to false injury claims. While most workers are honest and interested in earning an honest living, there are some who seek to file false claims, up to and including long-term disability assertions. Being able to defend against these types of misstatements is an important part of any Wisconsin business plan.

Source: Central Coast News, "Greenfield Woman Sentenced for Workers Comp Fraud," Chloe Beardsley, June 28, 2013

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