EPS attorneys regularly take steps necessary to protect our clients from fraudulent claims. EPS activities in a recent matter helped result in a fraud conviction. As reported in the Department of Insurance press release (http://www.insurance.ca.gov/0400-news/0100-press-releases/0070-2008/nr057-2008.cfm):

News: 2008 Press Release
For Release: June 13, 2008

San Diego Man Sentenced To Jail, Ordered to Pay More than $25,000 in Restitution for Workers Comp Fraud Scheme
SACRAMENTO Insurance Commissioner Steve Poizner today announced the sentencing of a San Diego man for insurance fraud. On May 21 Ramon Romo was sentenced to 180 days in San Diego Superior Court and ordered to pay more than $25,000 in restitution in addition to $680 in fines.

“Scamming your insurance company doesn’t pay,” said Commissioner Poizner. “My Department of Insurance investigators work closely with district attorneys throughout the state to make sure that insurance fraud does not go unpunished.”

On June 6, 2005, Romo fractured his thumb while on the job, and filed a workers’ compensation claim with his employer, NASSCO. Several months later, he added claims for back, neck and right shoulder injuries, claiming the injuries occurred at the same time as his thumb injury. In December 2005, Romo testified under oath that his additional injuries were not preexisting. He repeated this claim during a qualified medical exam.

On two separate occasions in June 2006, Romo was videotaped lifting and carrying heavy materials including sheetrock and insulation. He was also seen carrying a young child. In October 2006, Romo told his medical examiner that he was unable to lift his two year-old child, and any objects exceeding 20 pounds.

California Department of Insurance (CDI) Fraud Division investigators additionally discovered that Romo had filed a workers’ compensation claim for neck and back injuries in 1998 with his previous employer, Airline Interiors. Because of his injuries at that time, he reached a settlement in March 2003 and received $26,000 for his injuries.

As a result of this investigation by CDI, NASSCO, and the San Diego District Attorney’s Office, Romo pled guilty to one count of insurance fraud, and ordered to pay $25,830.67 in restitution to NASSCO, his employer.