Debra Rodriguez, 48, was arrested on four felony counts of insurance fraud while attending a pre-trial hearing at the Workers’ Compensation Appeals Board in Sacramento. Rodriguez was transported and booked into the Sacramento County Jail. Bail was set at $5,000. The Sacramento County District Attorney’s Office is prosecuting the case.
In August 1999, Rodriguez reported to her carrier that she had injured her right shoulder, wrist and neck, and had aggravated her left shoulder. According to CDI investigators, she claimed the alleged injuries occurred after sitting at a desk that was not properly modified for her. Investigators stated one treating physician, based on his testing and examination, believed Rodriguez was exaggerating her pain, and a Qualified Medical Examiner (QME) who later examined Rodriguez also believed her symptoms were not credible. As a result of this allegedly fraudulent claim, Travelers Property Casualty Insurance paid out $34,710.
In separate cases, CDI investigators arrested two other Sacramento County residents, Kathleen Anstead, 43, and Alecia Smith, 34, on charges of workers’ comp fraud. Anstead was booked into the Sutter County Jail, and bail was set at $10,000. Smith was booked into the Yolo County Jail. The Sacramento County District Attorney’s Office is prosecuting each case.
According to investigators, in April 1997, Anstead filed a workers’ comp claim with Golden Eagle Insurance indicating she had injured her shoulder, neck and back while working as an instructor for Community Resource Services. During the claims process, Anstead allegedly made misrepresentations to her doctors when she failed to disclose prior workers’ comp claims for a prior neck injury. Anstead is further alleged to have committed perjury during a sworn deposition before a Workers’ Compensation Appeals Board Hearing when she denied any previous injury or prior treatment to her neck. Based on Anstead’s misrepresentations, Golden Eagle’s total loss on this claim was $18,000.
In April 1988, Smith filed a workers’ comp claim while working for the State Franchise Tax Board. Smith claimed she suffered from carpal tunnel and was unable to open and close her hands and fingers. A CDI investigation revealed Smith had made material misrepresentations to the State Compensation Insurance Fund (SCIF) and treating doctors. Based on surveillance video, Smith was seen performing physical activities that were inconsistent with the representations she made throughout her claim.
As a result of these alleged misrepresentations, SCIF’s overall losses totaled $33,500.
Topics Claims Workers' Compensation
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