Employee Insists Pain Persists After Work Related Injury, but Surveillance and Examinations Support Otherwise
46-year old Fernando Torres Garcia reportedly slipped and injured his lower back and hip while working for Lamont Nursery in a trench repairing a water line on July 16, 2018. After his diagnosis of lumber strain, Garcia was placed on modified duty, an accommodation met by his employer.
Garcia saw his doctor numerous times between August 2018 and March 2019. During these follow-ups, Garcia reported his injury was not improving and the pain persisted. Eventually, Garcia amended his original workers’ compensation claim to include his entire back, right hip, right thigh, right leg, right elbow, both knees, and cumulative trauma.
Due to his reported persistent pain, Garcia was referred for an orthopedic evaluation in which he was given a rating of 5% impairment for his lumbar spine.
Around this time, the California Department of Insurance began an investigation into Garcia’s claim. As part of the investigation, Garcia was surveilled. The surveillance revealed he was able to lift heavy objects on multiple occasions.
Garcia underwent a Panel Qualified Medical Evaluation on June 21, 2019 in which his medical reports, surveillance footage, physical examinations and abilities were reviewed. The panel’s determination was that Garcia did not meet the requirements for any permanent disability or ratable impairment. It was the opinion of the panel that Garcia had misrepresented his injuries and pain as reported on his claim.
These misrepresentations cost a monetary value of $5,873.50 in deposition and surveillance expenses.
Garcia turned himself in and was arraigned at the Kern County Superior Court in regards to nearly a dozen felony counts of insurance fraud for allegedly misrepresenting his injuries to benefit from undeserved workers’ compensation insurance payments.
His case will be prosecuted by the Kern County District Attorney’s Office
