Written by Elizabeth Smith,
L&I's Assistant Director for
Fraud Prevention and
May. 17, 2013
Jose Ramon Amaya-Hernandez thought he found the perfect way to score narcotics – show up at a hospital claiming to be in pain due to a work related injury. However, investigators with the Department of Labor & Industries (L&I) uncovered his scam.
According to prosecutors, Amaya-Hernandez filed a total of 53 claims for injuries over a three year period. The claims were filed at a dozen different Seattle area hospitals.
L&I later denied these claims because there was no record that Amaya-Hernandez ever worked for any of the employers he reported. However, the hospitals had already provided him with narcotics for his phony injuries.
Although Amaya-Hernandez used several aliases, L&I investigators became suspicious. Using a cross-match through the Department of Licensing, they determined his actual identity and built their case.
On April 24, Amaya-Hernandez plead guilty to three counts of obtaining a controlled substance by fraud, receiving a sentence of 45 days in jail on each count, to run concurrently. He must also pay fines plus restitution to the hospitals he cheated.
May. 16, 2013
Read more in the News Tribune about L&I’s latest efforts to reign in abuse of our workers’ compensation system.
Apr. 4, 2013
Jaime Beroth, 63, and her husband Lawrence Beroth, 67, received sentences this week after pleading guilty to one count each of second degree theft in Pierce County Superior Court.
The Tacoma couple will both serve jail time and have to reimburse the state more than $200,000 after they both filed fraudulent workers’ compensation claims in 2009.
Both Beroths claimed injuries at work and filed claims with the Department of Labor & Industries, claiming they could no longer work. But a tip to L&I led investigators to the couple’s active drywall business, where they were secretly videotaped doing a variety of physical tasks.
Jaime Beroth was sentenced to 30 days in jail and Lawrence Beroth received a 20-day sentence. The bulk of both sentences were converted to community service. The couple was also ordered to pay over $224,000 in restitution, fines and other costs.
News Release: Tacoma couple must reimburse state $224,000 for workers’ comp fraud
Mar. 27, 2013
Betsaida “Betsy” Sosa received a 90-day jail term and must pay restitution after pleading guilty to first degree theft charges for fraudulently billing the Department of Labor & Industries for language interpretive services she never provided.
Sosa contracted with L&I to interpret for injured workers needing medical care, billing the agency for both her services and the mileage to her L&I appointments.
L&I auditor Tara Brink discovered that Sosa billed for amounts far in excess of the services and travel that actually occurred. Further investigation determined that she used false addresses and billed for appointments that never took place.
Under terms of her sentence in Thurston County Superior Court, the Tacoma resident may convert 60 days of her sentence to home detention or work release, if she is eligible for one of those programs. If not, she will serve the entire 90 days. She must also pay $34,208 in restitution.
News Release: Language interpreter gets jail time, must pay $34,000 for overcharging state
Mar. 7, 2013
A Pierce County couple must pay nearly $23,000 in restitution and fines after pleading guilty to charges that they continued to operate their Spanaway towing business after the state barred them from employing workers.
In a case I first shared with readers in October, L&I had revoked the certificate of industrial insurance for A1 Towing Service after owners Sandra and Billie Rouse failed to pay for workers’ compensation insurance for their employees.
The Rouses both appeared in Pierce County Superior Court last week and entered guilty pleas to a Class C felony for engaging in business after the certificate of coverage had been revoked.
In addition to the restitution and fines, Billie Rouse was sentenced to a 30-day jail term which was converted to 240 hours of community service.