4-1-1 on Comp: CT Man Charged with Work Comp Fraud

Bruce Burk

Manchester, CT (WorkersCompensation.com) – Manchester, CT resident Ronald Gordillo was recently arrested on a warrant after it was determined there was probable cause that he had lied in connection with receiving approximately $17,000 in workers’ compensation benefits. For more WorkersCompensation.com coverage on the topic, click here.

Gordillo suffered an industrial accident in June of 2017 during some of his janitorial work. However, surveillance caught him in October of the same year doing almost identical work for another company. He also had stated in a deposition that he had not worked for anyone after the industrial accident.

In Connecticut, workers’ compensation fraud is a class B felony punishable with a possible sentence of 20 years in prison. Based on his deposition testimony, he could also be looking at a perjury charge.

The general definition of workers’ comp fraud is a misrepresentation that is done for the purpose of obtaining workers’ compensation benefits.

Misrepresentation typically requires the intent to be deceptive. It must be more than simple forgetfulness of prior medical history. Moreover, if an injured worker failed to disclose something in one instance but later remembered it and disclosed it, misrepresentation might not be present.

Another issue arises when the psychological element is at issue. Oftentimes, those experiencing psychological issues may have a different standard regarding their mental capacity.

There is no problem if an injured worker wants to continue to work after an industrial accident. However, issues arise when the injured worker is given work restrictions from a doctor… Especially if they collect benefits, but are secretly working on the side — essentially trying to double dip.

Raising a fraud defense carries with it a hefty penalty and can result in the injured worker being cut off from all benefits. Moreover, if the injured worker gets prosecuted, they could be ordered to pay restitution to the carrier for the benefits that they unlawfully obtained.

In this case, you have what appears to be a clear misrepresentation for the purpose of obtaining workers’ comp benefits. This person was collecting benefits while continuing to work for another company. The entire idea behind indemnity benefits is to be compensated for not being able to work, and clearly those benefits aren’t deserved if you are out working for another company.

Claimant depositions are crucial when trying to establish a fraud defense. That is the time to ask all the relevant questions about the claimant’s ability to work, their physical complaints, and whether or not they have any prior medical history that had not been previously disclosed.

We will have to wait and see how this case plays out. Most criminal cases result in plea deals. If that occurs here, it may result in the restitution of some of the benefits received by Gordillo.

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