Over the last week, the Department of Labor and Industries (L&I) issued two separate news bulletins about L&I claim fraud. Without question, people who defraud the workers’ compensation system in Washington State hurt other work injury claimants. It is a very serious matter. Again, anyone that commits any type of fraud relating to a workers’ compensation claim hurts injured workers.
Workers compensation fraud in L&I news
In one case, L&I received an anonymous tip that a Renton delivery truck driver was collecting workers compensation pension benefits while working. L&I says that this has resulted in one of the largest fraud cases in recent history. The accused man has been charged with theft of $325,000 in disability benefits that he wasn’t entitled to. Over the course of a 2-year investigation, L&I uncovered evidence including traffic infractions, payroll records, and trucking logs. The evidence shows that the man worked transporting apples between 2012 and 2017 while collecting disability pension benefit.
In addition to driving, the man was also reportedly lifting loads of 100-500 pounds. Clearly, it’s a very physical demanding work. Individuals are only entitled to pension benefits under their L&I claim or workers’ compensation claim if they are incapable of working as a result of their industrial injury or occupational disease. The man filled out declarations under oath stating that he wasn’t working, even though he was. Consequently, as is permitted under the Industrial Insurance Act, the Attorney General’s office is now prosecuting the man for felony fraud. At the same time L&I found that he willfully misrepresented himself and has demanded repayment of the benefits he wrongfully collected (with a 50% penalty on top).
Another case of workers compensation claim fraud
In another case this week, a 65 year old commercial real estate broker from Bothell pleaded guilty to attempted second-degree theft. As a result, he has been sentenced to 60 days jail time (with home monitoring) and 2 years probation. In addition, he must repay $86,484 to L&I in benefits that he shouldn’t be receiving. Upon investigation, L&I obtained damning surveillance footage, business records, and even exchanged undercover emails with the man regarding his services.
Workers compensation attorney and L&I attorney point of view
First and foremost, as an L&I attorney and workers’ compensation attorney representing workplace injury claimants in Washington State, our office condemns any and all claim fraud activity. At the same time, when I read stories like these, I am very conflicted.
On the one hand, fraud must not be tolerated. It is fraudulent activity that places all people that suffer a work injury under suspicion. On top, it drains the accident fund in Washington State: I believe L&I spends tremendous resources chasing cases of alleged fraud. Often, the injured workers that are investigated are innocent. They go through hell before that’s determined. Additionally, many work injury claimants spend their days fearful of doing something that will be perceived as fraud. That’s because work injury victims have been accused of fraud for engaging in simple activities like grocery shopping.
L&I claim videos showing work injury claimants
I regularly receive video footage from L&I or from opposing counsels showing “fraud” activity concerning my clients. The resources spent by L&I to obtain such videos are significant, and in my opinion, are also misused. I’ve received many videos showing the wrong person. Moreover, I regularly get videos of clients that show nothing more than usual daily activities.
Injured workers should know that it is not fraud to engage in the activities of daily living. However, it is important to modify activities and avoid doing things that exceed limitations imposed by medical providers. This is not only to prevent fraud accusations. It is for recovery and to avoid a reoccurrence of an injury. If you are an injured worker who is contacted by an L&I investigator, it is probably a good idea to speak with an L&I attorney first.