The Gate Has Closed

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Some of the most common types of workers’ compensation fraud include: workers submitting false claims for injuries that never happened or were misrepresented as a work-related injury; double dipping or working while collecting benefits; exaggerated claims where workers sustain a legitimate injury but inflate the severity to collect more money; and, employer fraud where payrolls are underreported and/or employees are misclassified for the purposes of paying a lower insurance premium. Today’s fraudster from Simi Valley, California chose the double dipping method to collect nearly $50,000 in workers’ compensation benefits he did not deserve.

The man at the center of today’s case worked for an electric gate business with this company motto: “Where Honesty & Integrity Mean Something.” (As you read on, you will realize the irony of those words seeing that today’s fraudster possessed neither characteristic, taking advantage of his employer and the state’s workers’ compensation insurance fund.) After suffering an on-the-job injury, the Simi Valley man qualified for disability and began receiving workers’ compensation benefits. The former employee collected $34,981 in disability payments over six months, but he neglected to report that he made $48,686 as a self-employed contractor during the same time. (I’d say that $83,667 over six months is a pretty darn good salary.)

The 67-year-old two-timing contractor from Simi Valley, California pleaded guilty to felony charges related to workers’ compensation fraud. While the formerly injured worker faced five years in jail, he got lucky when his felony was decreased to a misdemeanor. Lucky for him, he’ll only need to serve three years of probation and pay back full restitution of $41,326 to the State Compensation Insurance Fund. (He’s already paid $3,811 to his former employer. That’s a good start to being honest and showing that he’s working on having integrity.)

According to today’s article, workers’ compensation fraud costs U.S. employers around $2 billion each year. When workers’ compensation fraud occurs, it not only raises the rates for other businesses, but also creates an unfair advantage over honest competitors who value their employees and provide insurance coverage in the event of an on-the-job injury. (Congratulations to the California State Compensation Insurance Fund for closing the gate on this deceptive worker’s illegal scheme.)

Today’s “Fraud of the Day” is based on an article,CA Business Owner Pleads Guilty To Workers’ Compensation Fraud,” posted on WorkersCompensation.com on January 15, 2019.  

Ventura, CA (WorkersCompensation.com) – District Attorney Gregory D. Totten announced today that Charles Ruben (DOB 9/13/1951), formerly of Simi Valley, pled guilty to a felony violation of Insurance Code section 1871.4(a)(l}-making a fraudulent statement of a material fact for the purpose of obtaining workers’ compensation benefits.

Some of the most common types of workers’ compensation fraud include: workers submitting false claims for injuries that never happened or were misrepresented as a work-related injury; double dipping or working while collecting benefits; exaggerated claims where workers sustain a legitimate injury but inflate the severity to collect more money; and, employer fraud where payrolls are underreported and/or employees are misclassified for the purposes of paying a lower insurance premium. Today’s fraudster from Simi Valley, California chose the double dipping method to collect nearly $50,000 in workers’ compensation benefits he did not deserve.

The man at the center of today’s case worked for an electric gate business with this company motto: “Where Honesty & Integrity Mean Something.” (As you read on, you will realize the irony of those words seeing that today’s fraudster possessed neither characteristic, taking advantage of his employer and the state’s workers’ compensation insurance fund.) After suffering an on-the-job injury, the Simi Valley man qualified for disability and began receiving workers’ compensation benefits. The former employee collected $34,981 in disability payments over six months, but he neglected to report that he made $48,686 as a self-employed contractor during the same time. (I’d say that $83,667 over six months is a pretty darn good salary.)

The 67-year-old two-timing contractor from Simi Valley, California pleaded guilty to felony charges related to workers’ compensation fraud. While the formerly injured worker faced five years in jail, he got lucky when his felony was decreased to a misdemeanor. Lucky for him, he’ll only need to serve three years of probation and pay back full restitution of $41,326 to the State Compensation Insurance Fund. (He’s already paid $3,811 to his former employer. That’s a good start to being honest and showing that he’s working on having integrity.)

According to today’s article, workers’ compensation fraud costs U.S. employers around $2 billion each year. When workers’ compensation fraud occurs, it not only raises the rates for other businesses, but also creates an unfair advantage over honest competitors who value their employees and provide insurance coverage in the event of an on-the-job injury. (Congratulations to the California State Compensation Insurance Fund for closing the gate on this deceptive worker’s illegal scheme.)

Today’s “Fraud of the Day” is based on an article, “CA Business Owner Pleads Guilty To Workers’ Compensation Fraud,” posted on WorkersCompensation.com on January 15, 2019.  

Ventura, CA (WorkersCompensation.com) – District Attorney Gregory D. Totten announced today that Charles Ruben (DOB 9/13/1951), formerly of Simi Valley, pled guilty to a felony violation of Insurance Code section 1871.4(a)(l}-making a fraudulent statement of a material fact for the purpose of obtaining workers’ compensation benefits.

Between May 11, 2016, and November 23, 2016, Ruben was placed off work for an injury sustained while employed at an electric gate company in Simi Valley. During that time, he collected disability payments that totaled $34,981.33 and systematically failed to report that he earned $48,686.20 while working as a self-employed contractor.

Between May 11, 2016, and November 23, 2016, Ruben was placed off work for an injury sustained while employed at an electric gate company in Simi Valley. During that time, he collected disability payments that totaled $34,981.33 and systematically failed to report that he earned $48,686.20 while working as a self-employed contractor.

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.