TEXAN MUST PAY FOR FRAUD

Jake V. Silva was found guilty of fraudulently obtaining workers’ compensation benefits by the 132nd District Court in Scurry County, Texas. He was sentenced to two years imprisonment (probated to five years on probation) and 160 hours of community service. According to Texas Mutual Insurance Company, the court also ordered him to pay: $1,000 in fines; $283 in court cost; $4,855 in restitution (payable at $110 per month); and $40 per month in probation fees. The court determined Silva committed fraud by continuing to collect temporary income benefits (TIBs) checks after he returned to work at a different company. During the course of his claim, Silva received regular notices with each TIBs check reminding him that Texas Workers’ Compensation Commission Rule 129.3 requires injured workers to tell their insurance carrier if they return to work, earn wages, or receive an offer of employment. The prosecution presented the notices as evidence. To prove fraud, however, the prosecution had to show that Silva knowingly lied in order to receive benefits. Its strongest evidence was a recorded conversation in which investigators informed Silva of his obligation to notify Texas Mutual if he began working while collecting TIBs.

Topics Texas Fraud Workers' Compensation