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Category: Case Results

Three Felony Convictions Following Workers’ Compensation Fraud

Rissman partner David Beach, obtained a favorable verdict.

The claimant sustained a compensable back injury in the course and scope of his employment in 2017. Extensive benefits were provided, including three spinal surgeries and the implantation of a spinal cord stimulator. The employer/carrier obtained surveillance evidence of the claimant doing repairs and maintenance work at multiple residences and using several power tools. The claimant very clearly and adamantly denied all of these activities during his deposition. In fact, he testified that the activities were “impossible.”

The employer/carrier then asserted a misrepresentation defense and denied all additional benefits. The claimant’s attorney withdrew and the claimant ultimately found new representation and pursued additional benefits. A Final Merits Hearing was held in Tampa, at which time the claimant committed another misrepresentation when he admitted doing activity on the surveillance video he had seen, but denied actually going up onto the roof of a house or using a ladder. The investigator, after his deposition wherein he was aggressively accused of lying about the claimant’s rooftop activity, discovered an additional photo of the “scene” on his cell phone wherein the claimant was visible standing on top of the roof of the house that was being remodeled. As a result, the Judge of Compensation Claims accepted the employer/carrier’s misrepresentation defense and denied all additional benefits while noting that it was “troubling” because the claimant definitely had a very significant injury.

In accordance with the State Reporting Requirements, the Employer/Carrier provided evidence to the State Attorney, including deposition transcripts and the Final Order. The claimant was charged with three felonies: grand theft, workers’ compensation fraud, and perjury. The claimant pled “open to the Court” rather than facing a criminal trial.

On May 31, 2024, the claimant was found guilty of all three felonies and sentenced to five years of probation rather than incarceration, specifically because of a medical disability which the criminal court judge found warranted a downward departure from the sentencing guidelines. The probation will be supervised with random drug testing and the claimant has been ordered to perform 100 hours of community service. Moreover, the prosecutor and the claimant’s criminal defense attorney agreed on a $20,000.00 restitution to be paid back to the carrier based on all medical, indemnity and legal expenses incurred from the date of the deposition forward.

 


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