California Nursery Worker Arraigned for Alleged Workers’ Comp Fraud

Fernando Torres Garcia, 46, self-surrendered and was arraigned at the Kern County Superior Court in California this week on nearly a dozen felony counts of insurance fraud after allegedly misrepresenting an injury in order to receive undeserved workers’ compensation insurance benefits.

On July 16, 2018, Garcia allegedly reported to his employer that he injured his lower back and hip after he slipped while working in a trench to repair a water line.

Garcia was diagnosed with a lumbar strain and was placed on modified duty, to which his employer accommodated. Garcia continued to see his doctor as he claimed he was not improving and continued to suffer from pain. Garcia reportedly then amended his original workers’ comp claim to include his entire back, right hip, right thigh, right leg, right elbow, both knees and cumulative trauma.

An investigation by the California Department of Insurance revealed Garcia had numerous doctor visits between August 2018 and March 2019. During this time, surveillance was reportedly conducted on Garcia, and revealed he was able to lift heavy objects multiple times. However, since Garcia continuously claimed he was not improving he was referred for an orthopedic evaluation and given a rating of five percent impairment for his lumbar spine.

On June 21, 2019, Garcia underwent a Panel Qualified Medical Evaluation. After the evaluator reviewed Garcia’s medical reports, the surveillance footage, and Garcia’s physical examination and abilities, he determined Garcia did not meet the requirements for any permanent disability or ratable impairment. It was his opinion that Garcia misrepresented his complaints during his examination.

Garcia’s material misrepresentations caused deposition and surveillance expenses reportedly totaling $5,873.50.

The Kern County District Attorney’s Office is prosecuting the case. Garcia is scheduled to return to court on Nov. 20.

Topics California Fraud Workers' Compensation