As the result of a routine administrative investigation, a former federal employee faced legal consequences for making false claims related to workers’ compensation benefits. Here is the incident, investigation, resulting sentencing and the role administrative investigations played.
Incident Overview:
• In April 1998, the employee reported a workplace injury, alleging a fall in the ladies’ restroom.
• By July 1999, she was listed as completely disabled, receiving federal employee’s compensation benefits.
• However, recipients of such benefits are required to annually report employment or business activities.
Investigation and Findings:
• In 2014, an administrative investigation revealed discrepancies in the employee’s statements.
• Evidence, including surveillance footage, interviews, and business records, indicated her involvement in a magazine distribution business.
• She managed customer accounts, interacted with clients, and handled physical aspects of business operations – contradicting her reported disability status.
Evidence Presented:
The evidence gathered depicted the subject as the owner of the business. She managed customer accounts, interacted with customers, and was involved in the physical aspects of the business operations, such as handling magazine deliveries. These activities were in direct conflict with her reported disability status.
Enforcement and Prosecution:
Administrative investigators identified and documented behavior that was inconsistent with the reported medicals. Presented with the administrative investigation report, the Air Force Office of Special Investigations, along with an Assistant US Attorney leading the prosecution, saw the merits in pursuing the file criminally.
Sentencing and Restitution:
• On October 30, 2015, the employee received three years of probation, including a 60-day house arrest.
• Additionally, she was ordered to pay $83,465 in restitution to the federal government, which she fulfilled on November 10, 2015.
Key Takeaway:
This case underscores the importance of routinely confirming the integrity of workers’ compensation claims. A falsified disability status can have legal and financial repercussions across all stakeholders. Vigilance and cooperation by investigative bodies at all junctures of the process ensures the proper disbursements of government benefits.
Case No 8:15-CR-00190-T-36 AEP