Home > Fraud Awareness, SID Information > Dishonored Memories: Deceased Claimants with Dishonest Relatives

Dishonored Memories: Deceased Claimants with Dishonest Relatives

September 23, 2011 Leave a comment Go to comments

Most of us seek to honor the memories of our deceased loved ones. Sadly, however, dishonest relatives may express their grief quite differently than law-abiding citizens. These criminals choose to dishonor the memory of deceased relatives by committing workers’ compensation fraud in the personal, confidential records of a deceased claimant.

Forgery and Uttering: Our workers’ compensation laws demonstrate compassion by granting death benefits to spouses and dependents of claimants whose injuries result in death. We expect that a responsible, surviving relative will report the claimant’s death to us and other pertinent agencies in order to stop lost time benefits. Yet, this does not always occur. Therefore, we proactively compare our claim data with obituary records to identify deceased claimants and cease lost time benefits payments. However, criminals falsely report to us that their deceased relatives continue to live. These criminals pretend to be the claimants themselves, even adopting the voice of an opposite gender’s voice and/or an elderly person in an attempt to deceive us. These charlatans would seek to intercept any check addressed to a deceased claimant, forge their signature, and pretend to be the claimant (aka “uttering”) in order to cash the check to which they know they are not entitled. In situations where lost time benefits are paid electronically, family members inappropriately access and use monies to which they are not entitled, by concealing the claimant’s death. We prosecute these deceptive acts to the fullest extent of the law.

Falsifying Eligibility for Death Benefits: Our workers’ compensation laws ensure the surviving spouses of deceased claimants receive widow benefits – that is until they re-marry. Unfortunately, dishonest surviving spouses falsely report to us that they are single, even after they have re-married. In attempting to deceive us, they may even submit falsified or altered documents.

Lastly, our workers’ compensation laws permit the surviving dependents of deceased claimants to receive benefits for a work-related death when they are dependent children under 18 years of age, or are attending an accredited educational institution full-time and between 18 and 25 years of age. Unfortunately, dishonest surviving dependents falsely report to us that they are attending an accredited educational institution full-time even after they drop classes and attend only part-time or have discontinued their studies and dropped completely out of such programs. Further, some of these criminals submit enrollment applications to accredited programs only to apparently secure the required, preliminary documentation. They may not, in fact, intend to attend a single class. In attempting to deceive us, they too may submit falsified or altered documents.

A Case In Point

We received an allegation that a subject had submitted falsified college enrollment documentation and was not, in fact, eligible to receive benefits from his father’s death claim. Our investigation identified the subject had forged multiple enrollment verification forms to three institutions from 2003 to 2009 as part of a fraud scheme in order to continue receiving death benefits past the age of 18. We found that at the final institution for which he submitted enrollment documentation, the subject had not attended even one class.

The subject pled guilty to one count of workers’ compensation fraud and one count of forgery, both fifth-degree felonies. The court sentenced the subject to serve 12 months of incarceration concurrently on each count (suspended) and five years of community control, and to perform 40 hours of community service. The court ordered the subject to pay BWC $60,500 in restitution and $2,000 investigative costs.

Be on the Lookout

Red flags that may indicate a person forged and cashed checks of a deceased claimant or falsified eligibility for death benefits:

  • A relative of a deceased claimant brags about receiving benefits;
  • The spouse of a deceased claimant attempts to conceal his/her re-marriage;
  • The college-age dependent of a deceased claimant attempts to conceal his/her part-time enrollment, or non-enrolled, status at an accredited institution;
  • A person accesses and uses funds from a deceased claimant’s bank account (into which BWC makes deposits); and
  • A relative of a deceased claimant asks others to participate in a fraudulent scheme against the workers’ compensation system.

If you suspect anyone is fraudulently receiving the benefits of a deceased claimant, let us know. You may report it online at http://bit.ly/reportfraud or you may speak with a fraud hotline agent by calling 1-800-OHIOBWC.

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