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LAPD Sergeant arrested for Workers’ Compensation Fraud

January 15, 2012 - WorkCompWire

Los Angeles – On January 12, 2012, a veteran Los Angeles police sergeant was arrested by investigators from the Department’s Workers’ Compensation Fraud Unit (WCFU) on one felony count of Workers’ Compensation Insurance Fraud, and one felony count of Insurance Fraud, as well as a misdemeanor count. Sergeant Juan Fernandez, who has 24 years of service with the Los Angeles Police Department, was assigned to Mission Division at the time of his workers’ compensation claim. He surrendered to authorities after a warrant for his arrest was issued.

The WCFU of Special Operations Division began investigating Fernandez after he submitted inconsistent doctors’ notes. The WCFU was expanded by the Department in late 2008 to investigate employees possibly involved in workers’ compensation fraud and abuse of benefits. The goal of the Department is to aggressively investigate fraud and abuse of benefits within the workers’ compensation system. The Department wants to ensure that those injured employees who legitimately need those benefits are not placed under a cloud of suspicion by those few who lie to receive benefits and time off work that they are not entitled to. Last year the WCFU was responsible for the conviction of a detective involved in fraud, who ultimately pled guilty and paid restitution in the amount of $105,000.00.

Fernandez was placed off from work from the police department on a workers’ compensation claim on May 13, 2010, and did not return to work until March 27, 2011. WCFU’s investigation revealed that Fernandez had submitted an altered doctors’ note that allowed him to stay off work beyond the prescribed period and continued to receive compensation he was not entitled too. Fernandez was booked at Los Angeles County Men’s Central Jail in lieu of $30,000.00 bail. If convicted, Fernandez could face up to 7 years in State Prison, and, or a fine of up to $150,000.00.

The investigation was conducted in partnership with the Los Angeles County District Attorney’s Healthcare Fraud Division and Tristar Risk Management.

Source: LAPD

Filed Under: Claims, Legal, & Compliance News, Industry News, Risk Management News, Top Stories, Workers' Compensation

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