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Fraudster Nabbed Frolicking in the Garden

January 25th, 2013

When a worker claims to be injured and unable to work, what can we expect about his capabilities?  In theory, at least, when a worker is able to return to his usual and customary duties, he should not be entitled to temporary disability benefits.  What’s more, his permanent disability should be relatively low, and my beloved readers have even seen Almaraz-Guzman applied to lower the permanent disability indemnity in cases where an applicant could fulfill all her job duties.

And then there’s the following story.  Jose Cortez of San Bernardino County sustained an injury while working as a gardener after a branch fell and landed on him.

While Mr. Cortez was collecting disability payments, private insurance investigators observed him on six occasions performing his usually gardening duties, and referred the case to the District Attorney’s office, who then took the case the rest of the way and filed criminal charges.  (Although the D.A.’s office deserves credit for its investigation and impending prosecution in this case, the insurer’s investigators are to be commended for providing the Department of Insurance with a packaged case ready for the slam-dunking.)

Your humble blogger has been known to rant and rave about what such fraud does to California, which can be boiled down to criminal waste – someone is getting free money without providing society with any sort of labor or product in return.  Law enforcement dollars are wasted on investigation and prosecution, and private companies waste dollars on investigators while their policy holders must chip in extra to root such frauds out.

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