Read the Fine Print

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 The State of California’s Department of Industrial Relations has a comprehensive Guidebook for Injured Workers posted on its website. (Just about every question an injured worker may have about workers’ compensation is addressed here. And, there’s even a Spanish version too.) A man from Santa Paula, California, who reported an on-the-job injury while working for a landscaping company, evidently didn’t read the fine print and is now facing time behind bars and a substantial fine for committing workers’ compensation fraud.

Workers’ compensation is a wonderful benefit because your employer foots the bill if you get hurt while working. Additionally, you can receive workers’ compensation benefits regardless of who is at fault for your job injury. But, in most cases, you cannot sue your employer for a job injury and your employer cannot fire you for requesting workers’ compensation benefits. (It’s a pretty good deal if you incur an injury while on-the-job.)

The Santa Paula man reported an injury in July 2016, while working for a landscaping company in Ojai. After visiting a doctor for a diagnosis, he was placed on work leave due to a temporary total disability. During that time, his employer’s insurance company paid two-thirds of the injured employee’s salary while he was out of work and receiving medical treatment for his injury. (It’s important to note that his compensation was not taxed – another great benefit.)

Under California workers’ compensation requirements, an injured worker who is receiving temporary total disability payments, cannot work at all while recovering. (It says that on page 21 and the print isn’t even tiny, so not sure how today’s fraudster could have missed that.) The Santa Paula man, despite his injury, got a new job working full-time for a farm labor service in Oxnard a month later.

 The workers’ compensation benefits continued to roll in because the supposedly injured worker never told his previous employer that he had a new job. (The injury must not have been that bad if he was able to work on a farm, most likely doing manual labor.) He also failed to tell his new employer that he was receiving workers’ compensation benefits either. Despite receiving a warning that failure to properly disclose income could result in criminal prosecution each time he received a disability insurance check, he still neglected to fess up.

The 46-year-old Santa Paula man pleaded guilty to one count of felony workers’ compensation fraud. When sentenced he is facing a maximum sentence of five years behind bars and a $150,000 fine. (Words of wisdom for this fraudster? Read the fine print and know what you’re agreeing to, especially if you’re signing an agreement with the government.)

Today’s “Fraud of the Day” is based on an article entitled, Santa Paula man pleads guilty to workers’ comp fraud,” published by VC Star on May 22, 2018.

A Santa Paula man pleaded guilty Tuesday to defrauding his employer’s insurance in 2016, according to the Ventura County District Attorney’s Office.

Jose Alvizo-Rodriguez, 46, of Santa Paula, pleaded guilty to one count of felony workers’ compensation insurance fraud. The case was investigated by the District Attorney’s Bureau of Investigation.

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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.