Texas Mutual Insurance Company announced that District Court Judge Lee H. Rosenthal Has sentenced Houston attorney Bernardo Eureste to three years probation for reported workers’ compensation fraud-related charges. Eureste, a former member of the San Antonio City Council, must also pay $108,486 in restitution to Texas Mutual and pay restitution to three former clients (injured workers), in amounts ranging from approximately $975 to $2,067.
The Texas State Bar had already found Eureste guilty of fee violations in
Dec. 2000. The Bar suspended his license to practice law for two years to be followed by a one-year probation. The three-year sentence will run concurrently with the three-year probation imposed by the district court.
Texas Mutual Insurance Co. (then called the Texas Workers’ Compensation
Insurance Fund), the Texas Workers’ Compensation Commission (TWCC), and the FBI conducted investigations that uncovered billing irregularities by Eureste. The investigations revealed that Eureste had devised a scheme to defraud his injured worker clients by submitting false claims, primarily for work that he did not personally perform.
The investigations also revealed that Eureste reportedly often billed identical hours on different clients without any variation. According to TWCC records, Eureste billed for an average of 90 hours per day, seven days per week, including weekends and holidays.
As part of the reported scheme, Eureste used a computer software program to generate claims on a monthly basis. Eureste regularly submitted charges for file reviews each month.
At the time in question, TWCC procedures automatically approved file reviews for 2.5 hours at $150 per hour per claimant per month. Eureste routinely submitted charges for the full amount despite the fact that his regional files were housed in their respective regional offices and were not sent to Houston, where Eureste conducted his work.
Eureste’s clients, workers suffering from on-the-job injuries, paid
Eureste’s fees.
According to TWCC rules, an injured employee’s attorney may receive up to 25 percent of the injured employee’s weekly income check (known as TIBs, for temporary income benefits). The workers’ compensation insurance carrier pays the benefits, but the injured employee pays the attorney fees.
Topics Texas Fraud Workers' Compensation
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