Albany, NY – New York State Inspector General Lucy Lang recently announced the arrest and indictment of a Staten Island man who allegedly falsified multiple COVID-19 test results over five consecutive months in 2020 to obtain workers’ compensation benefits.
Ajani Shaw of Staten Island was arraigned in Richmond County Supreme Court before Hon. Alexander B. Jeong on one count of Grand Larceny in the 4th Degree (Felony), one count of Insurance Fraud in the 4th Degree (Felony), seven counts of Forgery in the 3rd Degree (A Misdemeanor), seven counts of Falsifying Business Records in the 1st Degree (Felony) and seven counts of Workers’ Compensation Fraudulent Practices (Felony).
“Workers’ Compensation insurance is essential to the success of our state’s workforce and businesses, and all the more so during times of crisis,” said Inspector General Lang. “Thanks to our partners at the Staten Island District Attorney’s Office for helping ensure the integrity of this vital safety net.”
In March 2020, Shaw was working as a part-time kitchen service employee at Staten Island’s Seaview Nursing Home. He filed a workers’ compensation claim for exposure to COVID-19, including an April 3, 2020 “out-of-work” note signed by a physician from Staten Island’s Advantage Care Physicians and an April 8, 2020-dated positive COVID-19 test to the insurance carrier. The insurer then began paying Shaw $150/week in workers’ compensation benefits.
Shaw later emailed additional documents to the carrier purporting to be in support of extending his claim and benefit. Specifically, Shaw submitted a COVID-19 positive test result dated April 19, 2020 and an “out-of-work” note dated April 22, 2020. Further, he submitted six additional COVID-19 positive test results spanning May 8 through August 8, 2020 and an “out-of-work” note prescribing four more weeks of quarantine. The carrier continued to pay benefits to Shaw through July 24, 2020, when the carrier noticed that many of the positive test results used the same specimen ID.
The investigation determined that Shaw submitted two legitimate COVID-19 positive test results in April 2020. Shaw had two appointments with a physician at Advantage Care in April 2020 but was not seen again until August 2020. While the April 2020 notes were legitimate submissions, a June 2020 note prescribing four additional weeks of quarantine was fraudulent. In total, the investigation found that Shaw submitted six fabricated positive test reports to the insurance carrier in addition to the June 2020 false medical note.
Because of these submissions, Shaw continued to receive $150/week in benefits, totaling $1,761 in indemnity payments.
Inspector General Lang thanked Richmond County District Attorney Michael McMahon and his office’s Economic Crimes Bureau for prosecuting the case and conducting the arrest. The investigation was handled by Attorney-in-Charge for Workers’ Compensation Fraud Bryan Richmond and Investigator Jaclyn Desautels.
The defendant is presumed innocent until and unless proven guilty in a court of law.
Source: NY Inspector General’s Office