Overstaying Your Benefits

Sad disabled girl complaining looking at camera sitting on a couch in the living room at home

In most cases, injured workers legitimately qualify for and begin to collect deserved benefits. However, there are times when deceptive workers decide to forego returning to work even though they are physically and mentally able to do so. (This is called workers’ compensation fraud.) Sometimes they even start another job, but don’t report their new employment situation so they can keep collecting the workers’ compensation benefits from the old job. (That’s fraud too, which means big penalties if caught.)

That is the case with a truck driver in California. The 47-year-old Fillmore man was sentenced to six months in the county jail and three years of probation. And, he had to repay nearly $28,000 to American Claims Management, the company that processed his fraudulent claims.

Ventura County prosecutors say the man was employed as a truck driver when he injured his shoulder. He was placed off work on temporary total disability and had shoulder surgery.

The truck driver remained off work and continued to collect two-thirds of his salary, tax-free, for 17 months. (That sounds like a pretty good gig for him seeing that he could have been working.)

The trucking company received a tip that the man was working on cars and doing physical activities that contradicted his work limitation claims. (No one likes to see others wrongly collecting benefits, unless you’re a fraudster.) The Californian pleaded guilty to a felony charge of making a fraudulent statement to obtain workers’ compensation benefits.

Today’s Fraud of the Day comes from the article, “Workers’ comp fraud draws jail time, probation,” published in the Ventura County Star, July 19, 2019.

Sentencing has been handed down in a workers’ compensation fraud case involving a truck driver.

The Ventura County District Attorney’s Office announced Friday that Jaime Serna , 47, formerly of Fillmore, was placed on three years of probation after pleading guilty to a felony violation of making a fraudulent statement of a material fact for the purpose of obtaining workers’ compensation benefits.

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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.