Attleboro Man Nabbed For WC Fraud

“This defendant collected workers’ compensation benefits while continuing to work in violation of the law,” AG Coakley said. “The investigation and prosecution of these crimes are important to preventing the increase of premiums as the result of fraud.”In 2005, Gabriel was injured on site during his employment with a construction site. After filing a claim, the Department of Industrial Accidents (DIA) ruled that his employer’s insurance company pay Gabriel temporary total disability benefits for his injuries beginning in June 2007 through February 2009.[pullquote]State and federal law requires claimants of injury related benefits to periodically make certain disclosures that may include but are not limited to the certification of their employment status, condition of health, and report any earnings while receiving compensation.[/pullquote]

In June of 2008, the insurance company received an anonymous tip that Gabriel was not in fact injured, but rather, was working as a subcontractor in Rhode Island while collecting workers’ compensation benefits. Upon further investigation, the insurer determined that in July 2008, Gabriel has signed an Employee Earnings Report (EER) in which he affirmed that he did not receive any income while working as a subcontractor. In reality, however, Gabriel had earned more than $62,000 from April 2007 through November 2008 working as a subcontractor in addition to the $53,000 in workers’ compensation benefits that he was collecting at the same time.

Gabriel, who pled guilty to the charges of Workers’ Compensation Fraud and Larceny Over $250, was sentenced to two years probation in addition to being required to pay full restitution. According to the AG’s office he must also serve 100 hours of community service for each probationary year, 20 hours of which will be in participating in the program “Changing Lives Through Literature.”

 “This type of insurance fraud, working while collecting Workers Comp, is unfortunately not an isolated case. The Insurance Fraud Bureau vigorously investigates these types of cases, because they represent double-dipping, and can have a devastating effect on honest employers who pay the premiums to protect their employees,” said Daniel Johnston, Executive Director of the Insurance Fraud Bureau. “Today there are over 80 similar cases under investigation by the Insurance Fraud Bureau in the state, and we work closely with the Attorney General on all of them.”