The seventh time was not the charm for the claimant. Between February 2014 and June 2018, she had been successful in obtaining three settlements of six workers’ compensation claims (five CTs and one specific) that she filed against the employer after being terminated upon the discovery that multiple Social Security numbers she was using were invalid. The settlements totaled $24,700.00. Either before or after each settlement, she applied for work at a different employer location, using a variation of her name and a different SSN.
She succeeded in being hired at a fourth employer location in October 2017, but in May 2018, after about six months, she was terminated for cause. Then in May 2019, she filed a post-termination CT claim, alleging injury to her right knee. The claim was promptly denied on the grounds of being a post-termination claim and lacking supporting medical evidence.
In September 2019, the claims administrator asked Erin Ward-Dugan to substitute in and take over defending the claim. After quickly completing discovery, she recommended taking the case to trial. There did not appear to be substantial medical evidence to support a finding that the applicant had sustained an injury, and there was ample evidence for attacking the applicant’s credibility.
Trial took place on December 17, 2019. The applicant’s attorney declined to call the applicant as a witness and proceed with direct examination, so Erin called her to the stand for cross-examination. Erin proceeded with detailed questioning about her prior claims, including all of her various aliases and false Social Security numbers used to obtain employment, her numerous post-termination claims of injury to many of the same body parts, and the settlements obtained. When questioned about the current CT injury claim, the applicant tried to change the injury to a specific. She admitted that she did not seek medical treatment for over a year after her termination and did not tell her doctor about her injury history. When asked questions about her work for a subsequent employer (essentially the same type of work she did for the defendant), the claimant invoked the Fifth Amendment.
Just five weeks later, the WCJ issued a Findings and Order that claimant take nothing. There was no substantial evidence to support a finding of injury. The limited medical reports that claimant relied on were deficient since the claimant had not disclosed her multiple prior alleged injuries, claim history, or subsequent job with a different employer to the doctor. Although the WCJ did not directly comment on the claimant’s credibility, there is little doubt that the documentary evidence that Erin introduced and the damaging testimony that she elicited on cross-examination rendered the claimant a poor witness on her own behalf.
The applicant did not appeal the Findings and Order. The case has been referred to the SIU for additional fraud investigation.
You can read redacted versions of the Minutes of Hearing and Summary of Evidence and Findings of Fact and Findings And Order below.
Company Name: Dietz, Gilmor & Chazen, APC
Industry: California workers’ compensation defense
Full Name: David Jankosky, DGC Client Services (818-654-9911, Ex. 1231)
Email Address: firstname.lastname@example.org