Our result oriented Administrative Investigations caught a former Powered Support Systems Mechanic fraudulently claiming disability benefits. An effective administrative investigation led to this conclusion. The subject had reported an injury sustained in 2006 and was receiving FECA benefits.
His active role in a business that needed a lot of physical work raised suspicions. This led to a detailed investigation.
Investigation Process:
o In December 2006, a Powered Support Systems Mechanic claimed he could not work because of a sustained injury. In September 2015, an administrative investigation took place. A social media audit and background check showed that the employee owned a barbeque business in San Antonio. The Facebook page for the business displayed photos of the employee and reviews of the menu offerings.
o Over several weeks, we watched the employee at different times and days. We saw him doing various jobs at his restaurant. Covert video showed him inside the restaurant cutting up barbequed meat. He also told customers that he owned the business.
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:
The team provided the client with a complete report and the video evidence. Then, someone presented it 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 claim.
In July 2021, he pleaded guilty to fraud, was sentenced to five years of probation, and the court also ordered him to pay restitution of $100,00.
The successful outcome of this case underscores the importance of routine administrative investigations for uncovering fraudulent activities. A careful method for collecting evidence and recording possible fraud is crucial. It helps federal investigators evaluate the case for criminal prosecution. The efforts maintain the integrity of federal workers’ compensation benefits.
Case No: 5:18-CR-00528-FB-1