New York Inspector General Reports on 2 Workers’ Compensation Fraud Cases *Centurion Insurance AFS*

New York State Inspector General Lucy announced a sentencing and a guilty plea in two separate workers’ compensation fraud cases.

Lang announced the sentencing of Brian Simpson, 55, of Monroe County, who defrauded the workers’ compensation system of more than $16,000. Simpson, who had previously pled guilty in December was sentenced yesterday in Webster Town Court to a term of three years’ probation and ordered to pay full restitution.

The state’s investigation established that between April 11, 2022, and March 3, 2023, Simpson made multiple misrepresentations to examining physicians and submitted inaccurate paperwork to the New York State Insurance Fund (NYSIF) regarding his inability to work during the covered period. More specifically, despite asserting that he was not working since sustaining an alleged workplace injury, the investigation established that Simpson was in fact actively working as a bus driver for First Transit, Inc. while collecting workers’ compensation benefits.

As a result of his misrepresentations, Simpson fraudulently obtained benefits in the amount of $16,764.78.

Lang also announced the guilty plea of Charles Epps, a former New York State Correction Officer who collected over $35,000 in workers’ compensation indemnity benefits to which he was not entitled.

Epps, 56, of Buffalo, pleaded guilty yesterday in Erie County Court to insurancfefraud and grand larceny.

Prompted by a referral from the Department of Corrections and Community Supervision, the Inspector General’s investigation established that on May 8, 2020, Epps claimed to have been injured while working at the Wende Correctional Facility in Alden He subsequently made a claim for workers’ compensation benefits and in July 2020 went out of work claiming a disability from the May injury. Epps received lost wage payments from DOCCS and the New York State Insurance Fund (NYSIF) from July 2020 to November 2022.

While he collected indemnity benefits, Epps completed NYSIF work activity reports and independent medical examination questionnaires which falsely represented a lack of work activity. The investigation revealed, however, that Epps began working as a motor coach operator for New York Trailways during this time period and was regularly assigned to operate a roundtrip bus route between Buffalo and New York City.

As a result of his misrepresentations to NYSIF, Epps fraudulently obtained $35,544.67 in workers’ compensation benefits. Additionally, a related investigation by the Social Security Administration uncovered that Epps also fraudulently collected $16,907.40 in Social Security disability benefits through concealment of his employment as a bus driver.

Epps was terminated from DOCCS during the investigation.

Topics
New York
Fraud
Workers’ Compensation
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