According to a report from My News LA, a Riverside County, California man has agreed to plead guilty in a workers’ compensation fraud claim. Angel Luis Maces, 24 of San Jacinto, was charged after allegedly faking a work-related injury in order to collect thousands in undue workers’ compensation benefits. In this article, our Fresno workers’ compensation defense attorneys provide a more detailed explanation of the charges in this case and discuss workers’ compensation fraud in general.

Guilty Plea: Tens of Thousands in Fraudulent Workers’ Compensation Benefits

My News LA reports that Mr. Maces has agreed to enter a guilty plea to one count of workers’ compensation insurance fraud. In doing so, the Riverside County District Attorney’s Office will drop a second fraud-related charge that was still pending against this individual. The workers’ compensation fraud charge in question is a felony offense. As part of the guilty plea, the Riverside County man is facing:

  • 24 months on probation;
  • 270 days of work release; and
  • Payment of more than $75,000.00 in financial restitution.

Investigation: False Claims of Physical Limitations

Mr. Maces was arrested after a multi-month investigation by California insurance regulators. The agency was reviewing a workers’ compensation claim regarding a September 2018 incident. At that time, Mr. Maces was employed at a Temecula, CA based landscaping business. He filed a workers’ compensation claim for a knee injury that was allegedly sustained in a fall accident. Mr. Maces claimed to both his employer and his doctors that he was severely “hobbled” as a consequence of the accident.

By early 2020, the insurance company suspected fraud. It launched an investigation into Mr. Maces. Eventually, the matter was referred to California state regulators for additional scrutiny. As part of the investigation, extensive surveillance video was taken. On several occasions, the defendant was observed moving freely—without any serious limitations. Further, he did not use crutches despite representing to the insurance that he needed them all of the time.

Workers’ Compensation Fraud: False Statements or Intentional Misrepresentations

Under California state law (Insurance Code Section 1871.4), it is strictly unlawful to make a false statement, fraudulent material statement, or a material misrepresentation in an effort to secure undue workers’ compensation benefits. Fraud may be charged as either a felony or misdemeanor.

Fraud does a significant amount of damage to employers, insurers, and the California workers’ compensation system as a whole. Companies have the right to take action to defend themselves against fraudulent workers’ compensation claims.

Get Help From a Fresno, California Workers’ Compensation Defense Lawyer

At Yrulegui & Roberts, our California workers’ compensation defense team has the professional skills and established reputation that clients can rely on. If you are facing a fraudulent workers’ compensation claim, our lawyers are here to help. Call us now or contact us today for a confidential review and evaluation of your case. We serve Workers’ Compensation Appeals Board (WCAB) locations throughout the whole region, including in Fresno County, Kern County, and Kings County.