Sep 22, 2024

California Man Earns $450K while Collecting over $50k in Workers’ Compensation

by Nadia El-Yaouti | Oct 07, 2021
injured worker with cast filing workers comp Photo Source: Adobe Stock Image

A California man has been arraigned for alleged insurance fraud and perjury after he claimed to have received cumulative trauma received on the job.

Frank Simplicio, 45, of Porter Ranch is accused of collecting workers’ compensation disability benefits after he claimed he was unable to continue his work as a landscaper. The investigation revealed that while claiming the disability, Simplicio was actively working as a landscaper.

The Department of Insurance conducted the investigation. During the investigation, officials found that Simplicio had filed a claim with his employer’s insurance company which stipulated he could not work because of cumulative trauma to his back and neck. Additionally, Simplicio claimed that during this time with his employer, his job duties led him to have diabetes, inability to sleep, and internal injuries. Simplicio notes that his cumulative trauma occurred between July 19, 1996, and May 2015. However, he waited until two years after he received his alleged injuries to file his claim to the insurance company.

During the course of the investigation, it was revealed that Simplicio received over $50,000 from his employer’s workers’ comp insurance. Between February 20, 2018, and September 19, 2018, Simplicio received $32,051 in Temporary Total Disability. Between September 20, 2018, and December 13, 2019, Simplicio received $18,610 in Permanent Disability payments.

In addition to the multiple fraud felony counts Simplicio faces, he was also indicted on perjury charges for lying about his dealings with the insurance company. In his deposition, Simplicio stated that he was a landscaper but had not worked ever since he filed his injury claim on May 2, 2017. However, footage obtained in October 2018 shows Simplicio actively working as a landscaper.

A search warrant on Simplicio’s bank accounts shows that he was collecting checks between June 2015 and December 2019. The payments totaled over $450,000. Investigators add that the check payments do not include any income made to his account through direct deposits.

The Qualified Medical Examiner who handled Simplicio’s insurance claim shared with investigators that Simplicio knowingly lied about his injuries. The examiner adds that if the insurance company had known about his ability to work, he would not have been put on Temporary Total Disability.

In addition to the over $50,000 paid out to Simplicio in benefits, the insurance company handling his case lost out on over $100,000 in investigative, medical, and legal costs. Following the indictment, Simplicio surrendered himself to the Los Angeles Superior Courthouse on July 29, 2021.

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Nadia El-Yaouti
Nadia El-Yaouti
Nadia El-Yaouti is a postgraduate from James Madison University, where she studied English and Education. Residing in Central Virginia with her husband and two young daughters, she balances her workaholic tendencies with a passion for travel, exploring the world with her family.