Mass Big Dig Worker Pleads Guilty to Comp Fraud

September 15, 2005

A Tewksbury, Massachusetts man, who worked as a plumber on the CA/T Project, has pleaded guilty to charges he collected $95,405 in workers’ compensation while continuing to work at various jobs, Attorney General Tom Reilly announced.

Allen Sembler, 38, pleaded guilty to one count each of workers’ comp fraud and larceny over $250. Suffolk Superior Court Judge Margaret Hinkle sentenced him to 2 1/2 years in the House of Corrections, suspended for three years. Sembler was also ordered to pay restitution of $95,405 and perform 100 hours of community service.

Sembler was employed as a union plumber for a subcontractor of Modern Continental Construction Company Inc. on Feb. 11, 2003 when he reportedly injured his lower back while working on the Central Artery Tunnel Project in Boston. Shortly after his alleged injury, Sembler filed a workers’ comp claim for his injuries with Modern Continental’s workers’ comp carrier, National Union Fire Insurance Company, a subsidiary of the American International Group Inc. (AIG).

Initially, AIG denied Sembler’s claim based upon lack of medical documentation showing any injury or disability. On June 9, 2003, following a conference before the Department of Industrial Accidents Board, AIG was ordered to pay Sembler temporary total disability benefits in the amount of $882 per week, retroactive to Feb. 24, 2003. AIG issued a check to Sembler in the amount of $13,995 on June 16, 2003 for benefits covering the period Feb. 24, 2003 through June 15, 2003.

Thereafter, AIG issued regular weekly benefits checks to Sembler in the amount of $882. While receiving these benefits, Sembler worked several jobs for several different employers between February 2003 and July 2004.

An investigation by the AG’s Office, Insurance Fraud Bureau of Massachusetts, and AIG, revealed that Sembler had, in fact, been employed as a plumber on numerous contracting jobs while receiving workers’ comp.

In total, Sembler received $95,405 in benefits from AIG from February 2003 through September 2005 while working on the side.

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