Buffalo, NY – New York State Inspector General Lucy Lang recently announced the arrest and arraignment of an Orleans County woman on charges that she defrauded the Workers’ Compensation system of more than $80,000 in insurance benefits to which she was not entitled.
The defendant, from Albion, NY, was arrested on June 8, 2022 by the New York State Police and appeared today before Judge Gary Moore to be arraigned on charges of Grand Larceny in the Second Degree, Insurance Fraud in the Second Degree, and five counts of Falsifying Business Records in the First Degree, all felonies. She has also been accused of violations of Workers’ Compensation Law §114(1), which carries with it a risk of civil penalties.
“In order to fulfill its vital purpose, the Workers’ Compensation system requires the honesty of all,” said Inspector General Lang. “We will continue to vigorously investigate and root out fraud to protect the system for injured workers and their families.”
An investigation by the Offices of Inspector General, which includes the New York State Workers’ Compensation Fraud Inspector General, found that the defendant began receiving workers’ compensation benefits in September 2018 when she was injured while working at Orchard Manor Rehabilitation and Nursing Center in Medina, NY. She subsequently reported to the insurance carrier, PMA Companies Inc. (PMA), through both representations to doctors and on various questionnaires, that she had not returned to work in any capacity, even on a volunteer basis. The defendant further indicated she had not collected earnings from any other source since her 2018 work injury. In fact, she was working as a bookkeeper and personal care aide for a local elderly woman, all the while collecting earnings. As a result of her intentional misrepresentations, the defendant obtained $80,867.75 in Workers’ Compensation insurance benefits between September 2018 and January 2022, to which she was not entitled.
Under State law, injured employees are required to provide truthful information regarding their work activity to insurance carriers and the Workers’ Compensation Board during the time they are receiving benefits.
Inspector General Lang thanked PMA for their assistance with the investigation, the New York State Police for their assistance with the arrest, and Orleans County District Attorney Joseph V. Cardone and his office for prosecuting this matter.
The defendant is presumed innocent until and unless proven guilty in a court of law.
Source: New York IG’s Office