Tip Helps Texas Mutual Bust Workers’ Comp Fraud Scam

October 20, 2005

Texas Mutual Insurance Company reported that Thomas Whited of Bastrop pleaded guilty to workers’ compensation fraud-related charges.

The Travis County 167th District Court sentenced Whited to a one-year suspended jail term with the following conditions: serve thirty days in jail, repay $2,441.25 in benefits to Texas Mutual, perform 160 hours of community service, attend treatment and counseling as recommended by probation, and pay a $250 fine, plus court costs.

Whited reported a job-related injury while working for C.W. Oates Masonry Inc. His doctor placed him in off-work status, and Texas Mutual began paying him temporary income benefits (TIBs).

A C.W. Oates employee contacted the Texas Mutual fraud department after observing Whited working as a mason on another construction project. The investigation uncovered evidence that Whited started his new job three days after he reported his alleged injury, and he continued to collect TIBs while working.

Investigators call this sort of scam “double-dipping” because the perpetrator, in effect, gets paid twice: once by his new employer for working, and again by his previous employer’s insurance company for being too injured to work. If allowed to continue, double-dipping scams can lead to a higher workers’ compensation insurance premium for the first employer when the company renews its coverage.

State law allows injured workers to receive TIBs only while they are unable to work. The law also requires injured workers to notify their workers’ compensation insurance company when they begin working again.

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