Social Media Helps Investigators Find Fraud in Work Comp
Long Beach, CA (WorkersCompensation.com) – In 2014, it was social media that helped the California worker’s compensation fraud division find Shawna Lynn Palmer and charge her with receiving more than $24,000 in workers’ compensation fraudulently.
Palmer, who worked at Stater Brothers, claimed in March 2014 that she had fractured a toe on her left foot and was unable to work. According to the statement issued by the California Department of Insurance, Palmer repeatedly told her doctors that she was not able to put any weight on her foot, to move her foot, or even to put a shoe on it.
Naturally, when investigators saw social media videos of Palmer participating in the Miss Toyota Long Beach Grand Prix beauty pageant in August 2014, where she walked across the stage in high heeled shoes, they were suspicious.
“This young lady certainly possessed a certain amount of beauty, and obviously she had a certain amount of bravado to pull off this scam,” said Bryon Tucker, Deputy Insurance Commissioner with the California Department of Insurance, in an interview with Nightline in 2014. “But when it came to brains, she was a bit lacking.”
Palmer was one of 5,729 suspected fraud cases in California during the 2013-2014 fiscal year. Of those, 255 cases resulted in arrest, and 248 cases were referred for prosecution. Losses for that year totaled more than $242 million.
And increasingly, investigators and prosecutors are using social media to track down fraudsters.
In 2014, social media helped California investigators determine that Leroy Barnes, one of the dancing hamsters in the Kia commercials, was also employed doing auto manufacturer’s commercials, performing with a rap group under an alias, and was working as a backup dancer for Madonna, Kelly Rowland and Chris Brown.
Barnes had told his doctor that he was not employed while receiving workers’ compensation benefits after an injury in 2013 where, he said, a piece of ceiling fell on his head. After a tip to the investigation bureau, Barnes was investigated and subsequently arrested. Barnes pleaded no contest to the fraud charges and was sentenced to pay $24,000 in restitution, 90 days of electronic monitoring and 400 hours of community service.
The use of social media as a tool helps investigators not only disprove ongoing injury, but can also help investigators identify information about a subject.
New York attorney Roy Mura, said a completed Facebook profile can contain up to 40 pieces of personal information, including name, workplace, age, injury, education and family members. Additionally, he said in a presentation to the International Association of Special Investigation Units, social media can help insurance investigators confirm policy application information, confirm facts of loss, confirm a claimant’s alibi, verify a claimant’s disability status, and help to locate witnesses.
State workers’ compensation investigators routinely use social media to check out suspected fraudulent claims.
Joseph Lopez, digital forensics manager with the Ohio Bureau of Workers’ Compensation, said social media is the tool they use to start investigations.
“We use social daily on almost every case that comes to us,” Lopez said in an interview with WorkersCompensation.com. “Our injured worker team uses it as one of the tools we have at our disposal. (Social media) doesn’t specifically make the case for us, but it is one of the tools we use to further the case and further the investigation.”
Lopez said it’s an important tool they use investigating employers as well.
“We may have employers who say they are out of business, but we’ll look on Angie’s List and see that they are soliciting business,” he said. “Or we may go on Thumbtack to see if their services are listed… and if we see a review of them online, we may call the person who posted the review and ask them about the employer.”
In Ohio, in 2014, Kayla Fortman was charged with one misdemeanor count of filing a false claim, after investigators found discrepancies in her claim and her social media posts. While Fortman claimed she fell at work in the company parking lot, she posted on social media that she had fallen at a gas station across the street while getting out of her car.
Fortman was sentenced to 180-day suspended jail time and two years’ probation. In addition, she was ordered to pay $200 in court costs and to make restitution to the state Bureau of Workers’ Comp in the amount of $1,908.76.
Investigating through social media, attorneys said, is cost-effective and relatively easy.
“There are two key factors that make social media research a must-do when handling claims,” said Amanda Podlucky, with the Orlando, FL office of Marshall Dennehey Warner Coleman and Goggin. “First, increasing numbers of users and social media applications have proven that social media is here to stay. Second, many individuals have a cyber-presence, whether or not they ever intended to. Internet and social media research can be done without leaving your desk and requires no cost; utilizing the tips above will help any claims professional know where to look and how to find the information to help leverage favorable results.”
But Nicholas Pothitakis, with Pothitakis Law Firm in Burlington, IA, said social media can be used to deny a legitimate claim as well.
“Social Media posts can be used as evidence against (a claimant),” Pothitakis wrote in his blog. “If you are a plaintiff in a Workers’ Compensation or personal injury case, you can assume that insurance adjustors and defense attorneys are keeping a close tab on your social-media feeds. They are looking for photographs and any interactions that could suggest that you are exaggerating an injury or got an injury doing something other than what you claim, or any posts that might discredit you or your case…. These can be taken out of context easily by a defense attorney.”
This article was updated as of 05/01/18.