The case of a former Powered Support Systems Mechanic fraudulently claiming disability benefits was brought to a conclusive end thanks to a results-oriented administrative investigation. The subject had reported an injury sustained in 2006 and was receiving FECA benefits. However, his active involvement in a business that required significant physical activity raised suspicions and led to a thorough investigation.
Investigation Process:
o In December 2006, a Powered Support Systems Mechanic claimed he could not work due to a sustained injury. As part of an administrative investigation, in September 2015, a social media audit and background search results indicated that the employee-owned and operated a barbeque business in San Antonio. The Facebook page for the business displayed photos of the employee and reviews of the menu offerings.
o Subsequent surveillance over several weeks at varying times and days of the week documented the employee performing different roles at his restaurant that included covert video of the employee inside the restaurant cutting up barbequed meat as he claimed ownership of the business to customers.
o This activity was in direct contradiction to the false statement the employee made to the Department of Labor, Office of Workers’ Compensation Programs. He completed and submitted a form CA-i 032 to the Office of Workers’ Compensation Programs claiming that he had not been employed or self-employed or involved in any business enterprise in the 15 months prior to the filing of the form EN-I 032 when he knew the claim to be false.
Legal Outcome:
A comprehensive report, along with the collected video evidence, was submitted to the client and subsequently presented to the Air Force Office of Special Investigations (OSI). The investigation’s findings led to a criminal case where the subject admitted to her fraudulent activities.
In July 2021, he pleaded guilty to fraud, was sentenced to five years of probation, and ordered to pay restitution of $100,00.
The successful outcome of this case underscores the importance of routine administrative investigations for uncovering fraudulent activities. A meticulous approach to gathering evidence and documenting potentially fraudulent behavior plays a crucial role in aiding federal investigators assess the merits of the file for criminal prosecution. The efforts maintain the integrity of federal workers’ compensation benefits.
Case No: 5:18-CR-00528-FB-1