Workers' Comp Fraud, Like Everything Else, Must Keep Up with The Times

No matter what the endeavor, it is important to keep up in our rapidly changing world. I suppose that it is no different in the world of workers’ compensation fraud. Especially in the era of Covid, when fake slip and falls are so “yesterday.”

Last month a New York man was arrested and accused of submitting multiple fake positive Covid-19 tests allowing him to remain home and collect workers' compensation. The apparent scam went on for several months.

He had been employed part-time in a nursing home kitchen, when in April 2020 he filed a workers’ compensation claim for exposure to Covid-19. To verify the claim, he provided documentation in the form of a physician's note and a positive Covid test.

One might note that he didn’t actually have to show he contracted the illness at work. But in the era of Covid, work-related causation is also so yesterday. But that is not our point, I suppose.

He started receiving $150 a week in workers' compensation. Over the course of the next 5 months, he continued to submit more positive Covid-19 tests, along with physician's notes showing he was still Covid positive and must remain out of work. In all, he submitted 7 tests, and two additional physician notes. He collected over that time $1,700 in benefits. 

Near the end of July, a sharp-eyed cookie at the insurance carrier noticed that the positive test results referenced the same specimen ID. That, my friends, is what people in law enforcement would call, “a clue.” Investigators ultimately determined that two of the positive tests submitted in April were real, and all that followed were fake. They also determined that one of the doctor's notes was a fake as well. 

The devil is always in the details, people. Thank goodness fraudsters don’t always pay attention to that little fact.

Even with an unpredictable virus such as Covid-19, 5 months of positivity seems very unlikely. I’m not sure how long our miscreant du jour intended to keep this little charade going, but it is obvious that he overplayed his hand. But you must give him an A for effort, as well as a bit of creativity. If employers are now responsible for commonly communicable diseases, they might as well have to be on guard for fraud based on commonly communicable diseases.

It is very important to stay current with the times, don’t you know.

Our errant fraudster has been charged with one count of grand larceny, one count of insurance fraud, and seven counts each of forgery, falsifying business records, and worker's compensation fraudulent practices. In retrospect, getting that $1,700 on false pretenses probably doesn’t feel as clever as it once did. Maybe he has probably learned a very good lesson from this teachable moment. Or maybe he hasn’t. 

At least some things always seem to remain the same.

Share This Article: