Texas Man Pleads Guilty to Workers’ Comp Fraud

March 9, 2004

Texas Mutual Insurance Company reported that Roger Gilbreth pleaded guilty to workers’ compensation fraud-related charges.

The 390th District Court sentenced Gilbreth to two years deferred probation and 120 hours of community service. The court also ordered Gilbreth to pay a $200 fine and pay back the $8,974.68 in benefits he fraudulently obtained from Texas Mutual.

Gilbreth allegedly suffered an on-the-job injury while working for Fabstar Inc. Texas Mutual began paying him supplemental income benefits (SIBs) because he claimed the injury prevented him from returning to work.

The Texas Workers’ Compensation Commission requires injured workers applying for SIBs to complete and sign form TWCC-52 attesting that they are earning less than 80 percent of the wages they earned before their injuries. Gilbreth signed the form upon his initial application for SIBs, and then once a quarter thereafter, as the law requires. Each time, he claimed he was earning no wages.

Meanwhile, Texas Mutual received information that Gilbreth accepted a job in Arkansas. He did not notify Texas Mutual of the change in his employment status, as state law requires. He continued to sign the TWCC-52 and collect SIBs.

The Texas Mutual fraud division presented the signed TWCC-52 forms, along with other evidence, to the Travis County District Attorney office, which prosecuted the case. Texas Mutual estimates that Gilbreth could have fraudulently obtained around $68,000 in benefits had he gotten away with his scam.

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