It Takes One to Know One

Tina Marie Gains of Elk Grove was arrested and charged with five felony counts of insurance fraud and one felony count of unemployment benefits fraud. The 42-year-old woman allegedly made false statements in order to obtain workers’ comp and unemployment benefits. At the time of her arrest, Gains was working as a workers’ comp claims examiner for ATI Claims Services of Oakland.

According to CDI fraud investigators, on Aug. 7, 1996, Gains was terminated from her job with Professional Search of Oakland. Roughly two weeks later, she submitted a workers’ comp claim to her former employer’s insurer, State Compensation Insurance Fund (SCIF). In her claim, Gains alleged she suffered an industrial injury to her wrists, hands, the left side of her neck, her left shoulder and her upper left back while working for Professional Search. SCIF awarded Gains temporary disability payments.

Investigators learned that Gains submitted forms to the Employment Development Department for disability benefits, claiming that she was not employed. Yet employment records revealed that Gains continued to work as a workers’ comp claims examiner and/or a data processor during the times she claimed she was not working.

As a result of Gains’ fraudulent activity, SCIF paid out $28,840 on this claim.

Topics Fraud Workers' Compensation