Anonymous Tip, Employer Cooperation Solve Workers' Comp Fraud Cases

July 3, 2003
The state of Washington has ordered a 62-year-old woman from Okanogan to pay back $117,004 after an investigation showed that she had collected survivor benefits illegally. In addition, a 52-year-old Olympia man, Richard Sundblad, has been ordered to pay $20,300 in penalties and Department of Labor and Industries (L&I) benefits he collected while secretly working.

Carole Edwards, now Carole Herriman, was placed on the pension roles in January 1998 after her husband, Carlos E. Edwards, died while receiving an L&I pension. She remarried and did not notify L&I. Once she had remarried, she was not entitled to survivor benefits.

Each year, L&I sends a form to survivors to determine if they are still eligible to receive benefits. The form asked Mrs. Edwards if she had remarried. Her response, completed in April 1998, was "No way - ever."

In 2003, the department received a tip that Carole Edwards had remarried. An L&I investigation showed the information to be correct. Three months after assuring the department she'd never remarry, Carole Edwards did just that.

Each year since then, she has signed an affidavit stating she was still single. During that time, Mrs. Herriman collected more than $78,000 in survivor benefits. State law authorizes L&I to impose a 50 percent penalty on what is owed.

An investigation into Sundblad determined that he had collected workers' compensation time-loss benefits illegally. While collecting wage-replacement benefits from L&I, the claimant had arranged to have his paychecks deposited in the Sunblad Family Trust in an attempt to hide his work activities from the department.

Sundblad was injured Aug. 2, 2002, while working for Belmont Enterprises in Centralia. The claimant contended that his injury prevented him from working, and he began receiving time-loss benefits.

Belmont Enterprises notified the department that someone had seen the claimant's truck and felt he was working for a new employer. An L&I fraud investigator located the new employer and, with that employer's cooperation, videotaped the L&I claimant loading his truck with no sign of a disability.

The new employer also provided payroll information that showed the claimant's paycheck going to the Sunblad Family Trust. According to investigators, it appears the claimant intentionally dropped the "d" in the trust's name to avoid detection. The case was turned over to the Thurston County prosecutor, who has charged Sundblad with two counts of perjury, three counts of first-degree theft and one count of forgery.

About the Author

Sandy Smith

Sandy Smith is the former content director of EHS Today, and is currently the EHSQ content & community lead at Intelex Technologies Inc. She has written about occupational safety and health and environmental issues since 1990.

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