Courts Order Combined $10K in Restitution to Texas Mutual

March 20, 2014

Travis County district courts sentenced two men, in separate cases, on workers’ compensation fraud-related charges. The men collected a combined $9,928 in benefits they were not entitled to, according to an announcement by Texas Mutual Insurance Company.

Jose Rodrigo Ramirez-Valdez of Giddings was sentenced to two years’ deferred adjudication and ordered to pay $2,754 in restitution to Texas Mutual.

In a separate case, Joshua Abbott of Gainesville was sentenced to five years’ deferred adjudication and ordered to pay $7,174 in restitution to Texas Mutual.

Ramirez-Valdez reported a job-related injury while working as a crew chief for McCoy Tree Service Company of Norman, Okla. Similarly, Abbott reported a job-related injury while working as a welder for Orteq Energy Services LLC in Gainesville. Both men claimed they were unable to work as a result of the injuries, and Texas Mutual began paying income benefits to them.

Meanwhile, Texas Mutual uncovered evidence that both men were working for different employers while continuing to receive income benefits.

Investigators call this type of scam double-dipping because the claimant collects benefits for being too injured to work when he or she is, in fact, gainfully employed. Texas law requires claimants to contact their workers’ comp carrier when they return to work. Left unchecked, double-dipping and other workers’ comp fraud can lead to higher premiums for all Texas employers.

Source: Texas Mutual Insurance Company

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