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Tuesday, October 4, 2022

Injured Illinois Worker Charged with Workers’ Compensation Fraud

Defendant Lied Under Oath to IWCC Arbitrator in an Attempt to Obtain Benefits

CHICAGO–(ENEWSPF)–April 17, 2014.  Illinois Department of Insurance (DOI) Director Andrew Boron today announced a workers’ compensation fraud investigation has led to another indictment.  Jeffrey Fessler, of St. Charles, was arraigned today on felony charges for perjury and workers’ compensation fraud, in connection with false statements he made under oath during a hearing before an arbitrator from the Illinois Workers’ Compensation Commission (IWCC). 

Mr. Fessler made the statements in 2011 while testifying at a hearing to determine whether his condition was causally related to his injury, to determine whether he was entitled to vocational rehabilitation, to determine whether the medical services provided were reasonable and necessary, to determine whether his employer had paid for all reasonable and necessary medical services, and to determine the proper amount of temporary total disability benefits.  The hearing was conducted pursuant to Section 19(b) of the Illinois Workers’ Compensation Act.

Video surveillance obtained on behalf of Fessler’s employer showed him working at his residence and at two other homes during the period he claimed to be temporarily totally disabled.  At the hearing, Mr. Fessler made false statements concerning the ownership of the homes where he performed the work and about the compensation he received for the work performed.

“Our workers’ compensation fraud investigations have led to indictments and conviction of those scheming to take advantage of this system put in place to protect people injured on the job who need medical services.  We will continue to work with law enforcement, to make sure perpetrators are prosecuted,” said DOI Director Boron. 

“The Illinois Workers’ Compensation Commission will not tolerate fraud.  And this case, as well as other recent felony prosecutions involving workers’ compensation fraud, demonstrates that the Illinois Department of Insurance is determined to make sure that fraud is prosecuted,” said IWCC Chairman Michael Latz. 

The Department’s Workers’ Compensation Fraud Unit conducted the investigation and referred the case to the Kane County State’s Attorney’s Office for prosecution.  If convicted, Fessler faces probation or two to five years in prison, and a possible fine of up to $25,000.

The anti-fraud provisions were first enacted in 2005 and were later amended in 2011.  The 2011 amendments included stronger sentencing provisions which applied to this case based on the date Mr. Fessler committed fraud. 

For more information about Workers’ Compensation Fraud, including matters that may involve fraud perpetrated by a claimant, visit the DOI website at http://insurance.illinois.gov/WCFU/default.asp.  To report an employer, healthcare provider, attorney, insurance agent or company, contact the Workers’ Compensation Fraud Unit at 877-WCF-UNIT (877-923-8648).

Source: illinois.gov


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