Down to the Last Penny

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14180131 - young adult man suffering from severe shoulder pain

Workers’ compensation insurance was designed to help protect both employers and employees when an occupational injury occurs. It protects the employer from being sued by the employee and it protects the employee by providing support if a disabling injury occurs. A Buffalo, New York man took advantage of his employer and his state’s insurance fund when he committed workers’ compensation fraud by collecting benefits he did not deserve.

Workers’ compensation usually covers hospital and medical expenses, rehabilitation, and disability payments (about two-thirds of a worker’s salary). According to the Bureau of Labor Statistics, there were approximately 2.9 million nonfatal workplace injuries and illnesses reported by private industry employers in 2016. (That’s a lot of injuries that cost employers and insurance companies a lot of money, even more when fraud is involved.)

The New Yorker in today’s case legitimately sustained multiple injuries on-the-job after falling off a ladder while repairing a roof. (That hurts just thinking about it.) After taking a four-month break from working to heal from his injuries, the roofer told his employer that he had been cleared by his medical team to resume work. As a result, he returned to work with his home improvement employer. (Here’s the catch.) Even though he went back to work (hopefully, they let him do something that didn’t require a ladder), he kept filing paperwork with the state’s insurance fund as if he were not working at all.

Workers’ compensation fraud occurs when an employee makes a false claim to obtain benefits. The fraudster in today’s article didn’t make a mistake, he deliberately filed claim after claim with the New York State Insurance Fund (NYSIF), stating he was not working in any capacity. (Well, that was a blatant lie.) Consequently, the NYSIF paid the fraudster $9,436.24 in workers’ compensation benefits he did not deserve. (Did he really think he would never be caught?)

The 55-year-old Buffalo man pleaded guilty to workers’ compensation fraud for repeatedly submitting false claims about his work status. (He was not unemployed, but gainfully employed – by two employers to be exact.) He is awaiting sentencing.

Workers’ compensation fraud is a serious crime that usually requires the perpetrator to pay back the amount stolen, down to the last penny. He could also have to serve jail time. (Let’s hope that the sentence handed down in this case will prevent others from considering the same crime and repeating this man’s mistake, including taking more safety precautions when using ladders and making roof repairs.)

Today’s “Fraud of the Day” is based on an article entitled, “NY Man Pleads Guilty to Nearly $10,000 in Workers’ Comp Fraud,” posted on WorkCompWire.com on October 15, 2017.

Buffalo, NY – New York State Inspector General Catherine Leahy Scott recently announced the arrest and guilty plea of a City of Buffalo man on charges he defrauded the Workers’ Compensation system of nearly $10,000 in benefits to which he was not entitled because he had returned to work but continued collecting benefits as if he was not employed.

Arnold Fassbinder, 55, of Royal Avenue, Buffalo, was today charged with and pleaded guilty in Erie County Court to one count of Grand Larceny in the 4th Degree, a felony.

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Larry Benson, Senior Director of Strategic Alliances, LexisNexis Risk Solutions - Government

Larry Benson is responsible for developing strategic partnerships and solutions for the government vertical. His expertise focuses on how government programs are defrauded by criminal groups, and the approaches necessary to prevent them from succeeding.

Mr. Benson has 30 years of experience in sales and business development. Before joining LexisNexis® Risk Solutions, he spent 12 years founding and managing two software technology startups. During the 1990s he spent 10 years as a Regional Director helping to grow a New England-based technology company from 300 employees to 7,000. He started his career with Martin Marietta Aerospace working on laser guided weapons and day/night vision systems.

A sought-after speaker and accomplished writer, Mr. Benson is the principal author of “Fraud of the Day,” a website dedicated to educating government officials about how criminals are defrauding government programs. He has co-authored WTF? Where’s the Fraud? How to Unmask and Stop Identity Fraud’s Drain on Our Government, and Data Personified, How Fraud is Changing the Meaning of Identity.

Benson holds a Bachelor of Science in Physics from Albright College, and earned two graduate degrees – a Master of Business Administration from Florida Institute of Technology, and a Master of Science in Engineering from Lehigh University.