Work Comp Fraud: On-the-job “injury” provides paid time to work elsewhere

While lifting a heavy cabinet, the claimant heard his knee pop. An orthopedic doctor placed him in off-work status. Surveillance found him playing beach volleyball, with good range of motion and gait. He was also filmed purchasing construction supplies and offloading them at a home where he was building a deck. When interviewed by our investigator, he stated that he spent all his time reading, doing household chores and light exercise as recommended by his doctor.

Meanwhile, a subpoena was issued for his banking records. In a WCAB hearing, he claimed he was paid to supervise the building of a deck, paying out the entire amount he received to day laborers, but had no records of this. In a second deposition he admitted to previously providing false information. We presented the case to the DA’s office; the claimant pled guilty to a felony of insurance fraud and was ordered to pay restitution. Actual Savings: $15,000.