N.Y. Arrests 14 in Upstate Workers’ Comp Sweep

New York Attorney General Eliot Spitzer, Inspector General Dineen Riviezzo, Insurance Superintendent Howard Mills, Insurance Fund Executive Director David Whener, and Workers’ Compensation Board Fraud Inspector General John Burgher, Jr., reported the arrests and arraignments of 14 individuals for insurance fraud and related charges following a joint investigation into workers’ comp fraud. The cases were brought in Albany, Broome, Dutchess, Erie and Herkimer counties.

The defendants were all charged with submitting fraudulent claims to obtain workers’ comp benefits. Typical misrepresentations involved failing to disclose present or past work status or the cause of injury. One defendant, Harold Higgins, allegedly collected more than $100,000 while concealing his employment in the elective post of Assessor for the Town of Copake in Columbia County. The total benefits paid to all 14 defendants by insurance carriers, including the New York State Insurance Fund (NYSIF), exceeded $250,000.

This sweep began in the fall of 2005, when Dale Fajen, of Schaghticoke, was charged with falsifying his company’s application for workers’ comp insurance. Fajen, who owned two construction companies, reportedly lied about the type of work his employees were engaged in so that he could pay lower premiums. On Oct. 17, 2005, he pleaded guilty to Insurance Fraud in the Second Degree, a class “C” felony, before the Hon. Jerry Scarano in Saratoga County Court. On Dec. 12, 2005, he was sentenced to six months in jail, plus probation. He was required to pay back $135,046 in premiums owed to the NYSIF.

The 14 defendants whose arrests were announced were charged with: Fraudulent Practices, a class E felony in violation of the Workers’ Compensation Law; Falsifying Business Records in the First Degree, a class E felony; and Insurance Fraud in the Fifth Degree, a class “A” misdemeanor. Eleven defendants who filed false documents with the NYSIF were also charged with Offering a False Instrument for Filing in the First Degree, a class “E”felony. One defendant was also charged with violating state tax law.

A list of the defendants follows. The charges described below are merely accusations and the defendants are presumed innocent until and unless proven guilty.

Harold Higgins, 56, Craryville, N.Y.
Higgins purportedly sustained workplace injuries on two separate occasions in November 1993 and October 1996 for which he filed notices of injury with his employer, the New York State Thruway Authority. In January 2000, he began working as the Assessor for the Town of Copake in Columbia County, and continued to do so through 2005. In documents filed with the NYSIF in 2000, 2001, 2003 and 2004, he falsely claimed to be unemployed . The defendant fraudulently received benefits in excess of $100,000. The case is pending in Colonie Town Court in Albany County.

Linda A. Autenrieth, 46, Queens, N.Y.
Autenrieth suffered an injury while working as a nurse’s aide for Northern Dutchess Hospital in October 1998, and began collecting workers’ compensation benefits from One Beacon Insurance. Subsequently, Autenrieth began providing private nursing services, a fact that she concealed from the insurance carrier, thus collecting over $40,000 in benefits. The case is pending in Town of Pine Plains Town Court in Dutchess County.

Donald W. Murphy, 70, Tivoli, N.Y.
Murphy suffered a work-related injury in August 1992. In November of 2003, he submitted a form to his insurance carrier falsely stating that he had not returned to work. He fraudulently collected benefits that exceeded $37,000. He also failed to file personal income tax returns for three years. The case is pending in Town of LaGrange Town Court in Dutchess County.

David J. Bajer, 48, Cheektowaga, N.Y.
Bajer submitted a claim for a knee injury allegedly suffered at work in January 2005 while he was employed by the New York State Office of General Services. He failed to disclose on the Injury and Treatment form that he had sprained his knee while skiing the day before. He received benefits amounting to $27,000. The case is pending in Buffalo City Court in Erie County.

Daniel Banyai, 32, Hyde Park, N.Y.
Banyai was injured in 1997 while working for Robin Apple Distributors, and began collecting benefits from the NYSIF. In documents submitted to the NYSIF, he failed to disclose the full extent of this employment. He fraudulently received benefits exceeding $17,000. The case is pending in Colonie Town Court.

Wayne Bradford, 56, Kerhonkson, N.Y.
Bradford directed an employee who had worked as a machine operator for his company, Blue Ridge Woodcrafters, to falsely state that the employee’s injury had occurred while employed at another of Bradford’s companies, Jes-Lyn Enterprises. Blue Ridge Woodcrafters had no workers’ compensation insurance. Additionally, in reporting the injury to the NYSIF, Bradford himself falsely indicated that the employee was working at Jes-Lyn. Based on this fraudulent claim, the NYSIF paid out over $10,000 in benefits.

Other individuals arrested and charged as part of the sweep include:

Cherie Griffen, 35, Beacon, N.Y.
Griffen is charged with fraudulently receiving $9,000 in benefits. The case is pending in Colonie Town Court.

Allen Paul, 39, Troy, N.Y.
Paul is charged with fraudulently receiving $8,900 in benefits. The case is pending in Colonie Town Court.

David Podeswik, 53, Ilion, N.Y.
Podeswik is charged with fraudulently receiving benefits in excess of $7,000. The case is pending in Village of Ilion Village Court in Herkimer County.

Nunzio Bonefede, 55, New York, N.Y.
Bonefede was charged with fraudulently receiving benefits in excess of $6,000. On January 10, 2006, in Buffalo City Court, this defendant pleaded guilty to Attempted Fraudulent Practices and Insurance Fraud in the Fifth Degree, both class A misdemeanors. He was sentenced to three years probation.

Jeffrey Kleingardner, 30, Livingston Manor, N.Y.
Kleingardner is charged with fraudulently receiving benefits in excess of $4,000. The case is pending in Union Town Court in Broome County.

Edmund Tietz, 53, Livingston Manor, N.Y.
Tietz is charged with fraudulently receiving benefits in excess of $3,800. The case is pending in Union Town Court.

Zahida Pervez, 46, Latham, N.Y.
Pervez is charged with fraudulently receiving benefits in excess of $3,000. The case is pending in Colonie Town Court.

Terry Rolling, 39, Niagara Falls, N.Y.
Rolling is charged with fraudulently receiving benefits in excess of $3,000. The case is pending in Buffalo City Court.