Tuesday 18 May 2021

Roseville Workers' Comp

Ahmad Zaki Noori, 41, of Sacramento, Calif., was arraigned on two felony counts of workers’ compensation insurance fraud after allegedly misrepresenting symptoms following a work-related injury in order to receive $21,000 in undeserved benefits.

On July 16, 2019, Noori, while working as a welder, sustained a head injury and contusions on multiple parts of his body. Following his injury, a workers’ comp claim was filed with his employer’s insurance company and Noori began receiving payments. Following the injury, Noori reportedly presented himself as someone with severe amnesia and as someone who had difficulty performing daily functions of living, like speaking, walking or driving.

An investigation by the California Department of Insurance reportedly showed Noori misrepresented his symptoms to medical professionals and those handling his claim. Undercover surveillance showed Noori speaking, walking, and driving – all functions he claimed not to be able to do as a result of the injury. The surveillance also reportedly showed him performing duties at an automobile dismantling yard, like loading items onto a flatbed trailer and changing a spare tire.

Noori reportedly received $21,000 in workers’ comp payments and his employers’ insurance company lost an additional $80,679 in medical, legal and investigation costs.

Noori was arrested at his residence on April 13. He is scheduled to return to court on May 20. The case is being prosecuted by the Sacramento County District Attorney’s Office.

More Workers' Comp News

Jefferson County woman now battling for workers’ comp after surviving COVID-19

While the number of COVID-19 cases is down in Tennessee, those that contracted the virus are still fighting both the physical and financial effects.

At 45, Keniethea Tadlock had always been healthy. But last September she was admitted to Jefferson Memorial Hospital diagnosed with COVID-19, for three weeks she struggled to survive.

Many of these “COVID long-haulers” have a condition called post-COVID-19 syndrome. Tadlock is one of those still fighting the effects of the virus. The diagnosis was made by her doctor.

“From the COVID, I am still in organ failure, my heart, my lungs, and my kidneys,” Tadlock said. “I have been hit pretty hard.”

Tadlock has also been hit hard financially and received more than a thousand pages of medical bills.

“I owe the hospital $473,000 and some odd change now,” she said. “And that is just the hospital.”

Keneithea’s condition is what the American Medical Association calls a “COVID long-hauler.” She suffers from chronic pain, fatigue, shortness of breath, anxiety, depression, and insomnia.

“I have fear of sleeping because I’m afraid I’m going to die in my sleep,” Tadlock said.

“One day it’ll be good and the next day when she gets up and she’ll be down for two or three days,” her husband Steve Blankenship said.

Kenietha worked at this office in Halls for a regional propane gas supply company, Blossman Gas. She’s filed a claim with the state Bureau of Workers’ Compensation against her former employer alleging she got the virus at work.

“The burden is going to be on us to prove anything about it, that it was caused at work,” Blankenship said. “All that is going to be on us.”

Keniethea said the first worker’s comp hearing last week did not go well. She said the attorney representing Blossman’s insurance company wanted documentation of her illness.

“They said they had not gotten any form of paper saying that I was positive for COVID-19 whatsoever,” Keniethea said. “It says diagnosis on admission. COVID-19, pneumonia, acute respiratory failure.”

“With all the correspondence we have had with them between emails, me trying to get her short-term disability going, I don’t see how they couldn’t have known,” Blankenship said.

While the odds may be against her in receiving workers’ compensation benefits, Tadlock says she looks forward to the next hearing as her former employer has the next few months to examine her medical records.

“We are supposed to get together, and we’re supposed to all talk this out to see if they’re going to agree or not, whether or not they’re going to pay,” Keniethea said.

We reached out to the insurance company that represents Tadlock’s former employer. The legal team said it does not publicly comment on matters under litigation.

Tadlock’s next hearing before the workers’ compensation board is in early August. Her short-term disability ended in March. The couple is unsure how they will pay for their medical expenses.

Florida Man Accused of Failing to Pay $193K in Workers’ Comp Premium

A Florida man has been arrested for workers’ compensation premium fraud and additional charges for allegedly concealing payroll information to avoid paying more than $193,000 in workers’ compensation premiums, according to a statement from the Florida Department of Financial Services.

Julio Enrique Maldonado, owner of G.G.M. Construction LLC, faces charges of workers compensation fraud, under reporting payroll greater than $100,000, workers compensation fraud – false statements on application greater than $100,000, and Florida communication fraud aggregated value of $50,000 or more.

The charges follow an investigation by the DFS Division of Investigative & Forensic Services (DIFS), Bureau of Workers Compensation Fraud that found Maldonado claimed $120,000 in annual payroll to Builders Insurance Co. for the policy periods of February 2018 to November 2019. Due to the estimated annual payroll provided, the estimated premium calculated for the policy period was $15,780.

During the investigation, detectives discovered that Maldonado cashed several checks from January 2019 through December 2020, which totaled over $5.5 million. Maldonado did not respond to the request from Builders Insurance Company to conduct an audit. Based on Maldonado grossly underestimating/reporting his business payroll, Builders Insurance Company, was deprived of $193,284 in premiums, DFS said.

Maldonado was arrested on April 30, 2021 and booked into the Orange County Jail. If convicted, he faces up to 30 years in prison. Individuals charged with a crime are presumed innocent until proven guilty.

“This type of fraud has a major impact on our state as it raises insurance rates for Florida families. I appreciate the hard work of my fraud detectives for bringing this alleged fraudster to justice,” Patronis said.

Minnesota extends workers' comp for first responders hit by COVID-19

Ill front-line employees get presumption they got it on job until end of 2021.

A woman, having a suspected COVID-19 related medical emergency, was helped by emergency first responders in the north Twin Cities metro in December.

First responders and front-line health care workers who contract COVID-19 will be presumed eligible for workers' compensation for eight more months, under a bill signed into law this week by Gov. Tim Walz.

Normally, workers in Minnesota must establish that they were injured on the job to collect workers' compensation for missed time and/or medical expenses. But proving that they contracted a potentially lethal virus circulating in the general public while on the job can be difficult, if not impossible.

To prevent first responders and health care workers from facing financial disruption should they contract COVID, lawmakers passed a temporary law last year saying such workers are presumed to have been exposed to COVID at work for the purposes of obtaining workers' compensation. That shifted the responsibility to the employer to prove the infection happened elsewhere.

The presumption was set to end on May 1, but Walz on Monday signed an extension through Dec. 31. It covers doctors, nurses, firefighters, paramedics, police, long-term care workers, home health care workers, correctional officers and child care providers.

It doesn't extend to teachers or grocery store workers, who were not included under the temporary law passed last year.

Minnesota is one of about 15 states with a COVID-19 workers' compensation presumption for first responders and health care workers.

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