Helena, MT – Columbia Falls resident Salvador Maldonado-Medina recently pled guilty in Lewis & Clark County District Court to felony theft and employer misconduct for receiving Montana Workers’ Compensation benefits while working after claiming to be injured at one of his businesses, when in fact he was injured at another business he owned, where he elected to have no workers compensation coverage for himself or his employees.
In March 2015, Maldonado-Medina, 36, was accused of defrauding the Montana State Fund for $45,858.02 in wage loss and medical benefits he received from 2013 to 2015. Maldonado-Medina pleaded guilty to charges of employer misconduct and felony theft in District Court in Helena and on July 2 was given a six-year concurrent deferred sentence, and ordered to pay a $2,000 fine and restitution to Montana State Fund in the amount of $45,858.02.
Assistant Attorney General Mary Cochenour alleged that on February 18, 2013, Maldonado-Medina, who owns La Fiesta Mexicana Restaurant in Kalispell and SM Roofing in Columbia Falls, lied when he filed a work comp claim stating he had injured his knee after falling from a ladder at his restaurant, where he had a workers compensation insurance policy in effect. Montana State Fund accepted the claim and paid medical benefits and bi-weekly temporary total disability (TTD) benefits based on information that Maldonado-Medina could not return to word due to his injuries.
After State Fund received a physical therapy note that indicated Maldonado-Medina was on his feet for long periods of time due to his work, surveillance was conducted to determine if his roofing company was in operation, whether it had any employees, and whether Maldonado-Medina was earning wages while collecting TTD benefits under his restaurant’s policy. While Maldonado-Medina later told State Fund he had not conducted any roofing since his knee surgery and that he had no employees performing any roofing for the company during the policy period, investigators learned he had purchased more than $45,000 in roofing supplies which were delivered to 11 different residences in Flathead County during that time.
Subsequent interviews with the homeowners indicated that Maldonado-Medina had worked on several of the homes alongside two other men. State investigators were able to confirm that these men were Maldonado-Medina’s employees, and that their pay had not been reported under work comp insurance to SM Roofing. Investigators also learned that Maldonado-Medina in fact injured his knee while performing roofing work at a new home construction site in Whitefish, not at his restaurant in Kalispell.
“This case was highly unusual because it involved a defendant who defrauded Montana’s work comp system in two ways – both as an employer and as an employee,” said Attorney General Tim Fox. “Let this serve as a warning to anyone who tries to games the system, no matter how complex your scheme is. If you don’t report your employees for workers’ comp coverage while at the same time cover yourself at a lower premium rate and file fraudulent claims, we will find and prosecute you,” Attorney General Fox added. Premiums for coverage in the roofing industry are often many times higher than premiums in other businesses, such as those in an office setting, or restaurant work places.
Between February 2013 and March 2015, Montana State Fund paid $39,092 in medical costs and $6,765 in wage loss benefits to Maldonado-Medina. Curt Larsen, Special Assistant General Counsel at Montana State Fund, said that had his agency known that Maldonado-Medina was injured while roofing and not while working at his restaurant, Montana State Fund would not have accepted his claim. Larsen also praised the work of Assistant Attorney General Mary Cochenour, the Division of Criminal Investigation at the Montana Department of Justice, and his staff at Montana State Fund for their proactive and collaborative work on the complex and unusual case.
Source: MT DOJ