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SANTA ANA – Fernando Franco Garcia denied any prior injuries when examined for a recent work-related back problem. Investigators learned he had two past claims and two past settlements (Republic Indemnity and Nationwide) Garcia has been arrested and charged with three felony counts of workers’ compensation fraud and two felony counts of making false statements. He faces up to five years in prison and/or a $50,000 fine.
LONG BEACH – Ronald Lee Neff may receive a four year prison sentence and/or a $50,000 fine if the DOI proves their WC fraud case. Investigators claim that Neff supplied forged AME medical reports in support of a 1990 claim against self-insured Salvation Army. The doctor who allegedly conducted the examination and signed the reports denied ever seeing Neff. * More from Long Beach. Lisa Potter complained of right shoulder pain because of repetitive use of a hand held inventory computer. Potter continued to tell her doctors that the pain was not resolving and she was unable to enjoy full use of her arm. While she was collecting benefits, she was seen assisting her husband with his delivery route and lifting items with her right arm with no apparent pain. She’s been arrested and charged with two felony counts of workers’ compensation fraud and will be prosecuted by the LA-DA.
MODESTO – Juan Manual Santana got caught by videotape. Santana sought treatment for a work-related back injury, seeing a chiropractor more than 100 times and continually claiming he was unable to do a variety of tasks. Pictures are worth a thousand words, and when the video was shown to the Doctor, he concurred that Santana was exaggerating his claim. As a result of the fraud, ESIS, a division of Cigna Property and Casualty, paid out $35,789. Santana has been arrested and charged, and the Stanislaus County District Attorney’s Office is prosecuting the case.
GLENDALE – Evelyn Leyva and her husband operated the “Hispanic American Family of the Year” Foundation. When the foundation experienced extreme financial difficulties, Leyva filed a workers’ compensation claim with State Comp Insurance Fund claiming psychological distress and back and shoulder pain. She represented her position as that of an employee of the company. SCIF paid out $52,369.10 on that basis, but later found out that Levya was the Secretary of the Corporation. Since officers are not eligible for benefits, and her attestation that she was solely an employee was erroneous, she’s been charged with five felony counts of workers’ compensation fraud and two felony counts of false impersonation. If convicted, she faces up to five years in prison and/or a maximum fine of $50,000.
WESTLAKE VILLAGE – Kelly Robert Moore has been accused of making false or fraudulent statements in order to obtain workers’ compensation benefits. After being fired from his job, Moore claimed a work-related injury had occurred prior to his firing. He filed for EDD benefits and continually stated to doctors that he was unable to work and had no source of income except his benefits. Department of Insurance fraud investigators learned Moore was working as an independent contractor and earned more than $14 thousand while he was collecting more than $40,000 in benefits. The Los Angeles DA’s Office is prosecuting the case.
DELANO – Baldev Singh was employed as a heavy laborer with Grimmway Farms of Bakersfield when a 50-pound bag of carrots fell on him and injured his knee. Singh collected more than $28,000 in benefits – supplementing total disability payments with income earned as an ice cream vendor. Gimme a chocolate-covered vanilla fraud bar with nuts, please.
REDDING – Linda Ann Coyle and her son, Michael Wade, are in deep doo-doo. Both have been charged with workers’ compensation premium fraud in conjunction with janitorial businesses Sani-Clean and West Coast Janitorial. Department of Insurance fraud investigators believe the second business was started to hide a lengthy claims history and decrease work comp premiums. As a result of the scam, State Comp Insurance Fund lost $18,746 in premiums. Both Coyle and Wade face up to five years in prison and/or a maximum fine of $50,000.
PALMDALE – When Renoir Vincent Valenti told his medical doctors that he could walk only with the aid of a cane and could play with his children for just a few minutes at a time due to difficulties with his injured right knee, they believed him. After they saw a videotape of Valenti playing soccer, basketball, hockey and roller-skating with his children for several hours, the doctors changed their opinions. The City of Los Angeles paid $13,211 in benefits to Valenti and the DA is prosecuting.
HUNTINGTON BEACH – Jose M. Torres injured his hip while working as a custodian for the Huntington Beach Union High School District. Apparently not content with the medical reports, Torres added a few touches of his own and forged his doctor’s signature on disability slips. The district, a self-insured entity, paid out $1,162.98 as a result of Torres’ fraudulent activity.
RANCHO CUCAMONGA – Five days prior to a workplace accident, Tiffany Johnson of Moreno Valley injured her knee in a soccer game and was wearing a knee brace. She reportedly told co-workers that she didn’t have medical insurance and was going to fake an accident. Then came a puddle of milk on the floor and a slip, miraculously landing on the injured knee. When the San Bernadino DA prosecutes the case, it’s not going to help Johnson that she also supposedly told those co-workers that she was mad at her employer and was going to “get back at him.” California Compensation paid $1,201 as a result of Johnson’s fall. It could cost Johnson $50,000 and five years in prison.
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