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Law Educator, Esq.
Law Educator, Esq., Attorney
Category: Employment Law
Satisfied Customers: 118632
Experience:  20+ Years of Employment Law Experience
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I worked state of va in Human Resources and I was in and out s

Customer Question

I worked for the state of va in Human Resources and I was in and out sick and on kight duty multiple times from 2011 - 2014 and my supervisor pulled all my claims and saw that I had filed the light duty claims which she said should not have been paid but I checked "no the employee is not earning at leadt 80% of their pre-disability salary" on the Employees statement of the Alfac claim. I did fill them outmyself 99% of the time and would have my coworker sign it for me. I am guilty of signing my coworkers name a couple of times when I ws s there alone and in a hurry which I should not have done I realize however I used to do that with my supervisor at a different office abd I knew Bette than too in this facility. If they sre saying I should mot have received compensation for the light dut then all the employees in the facility would have bere paid in error because that is how I was trained.
Submitted: 2 years ago.
Category: Employment Law
Customer: replied 2 years ago.
I was so so nauseated after the Nissen Fundoplication surgery in 2011 and I stayed sick 24/7 until they re -did the surgery in 2013 that I could barely . function. I lost 50 pounds and was becoming depressed from feeling bad all the time. Even though I explained this to the surgeon he released me to full duty. I am guilty of filing light duty claims past the date I was released. I know it was wrong. I think I just got used to the extra money and felt if it continued, that would be one less thing for me to worry about. During that time, my mother fell and cracked her skull and couldn't be alone so I was going back and forth to Greensboro at least every other weekend. I had the stress fractures in 2010-2011 and the Nissen in Late 2011. I probably wss released to full duty in early 2012, hence the offense dated of 03/15/12. Im thinking thats when I filed the false light duty claims. It c ould have never been there as nowhere near $26000.00 because one month of light duty or ome month of total disability paid me around $800 I believe? And you can only file for 12 months for each disability before returning to work ill time g or so long. Im thinking I may have filed about six months worth that I should not have maybe? I f int have the records. I am going to try to log into Aflac if still can. Six month xxx st even $1000 would be $6000. Not $26,000.00
I think they are back charging me for every lighy duty claim. I had two other HR reps say they always filled the form out the same wsy and had alwsys signed off on light duty by checking the same block I did. Yes I filed some by sending the sane doctors note w different dates that I should not have but quite a few that I filed for light duty were signed off by one of the HR Supervisors and they saw the box checked on my form. I wasnt trying to get away with snything on mosy of them. I just filled those forms out for Staff, so i would fill mine iut also but get someone else in hr to sign/approve it before sending it to Aflac for payment. I was taken out of work completely again somewhere around July 2013 because I was still so ill and having health problems from not being able to eat. They repeated the surgery in September 2013 so I was out for a few months and went back light duty again. My son started his episode in February 2014 and my mother was barely hanging on the whole time I was sick thrn she died in July and when I returned to work I wss confronted with this. I resigned 8/24/14, then totaled my care 09/30/14. Let me promise you, I truly believe God has already punished me for what part I really do wrong! I will never ever think about such again. I feel so stupid. I w as x just scratching to make it from one day yo the next all that time between me being so sick, my mother and my son actually started these symptoms in 2013. It took from then until December 2014 to get his correct diagnosis and correct meds. In the meantime I lost my job, my Mother, totalled my car ) mandate almost ended up divorced. Im dorry to say all that but I swear I dont no what made me file the false claims except I was crazy from my world spinning out of control!
The forgery part I assume is from my signing my coworkers name on the Employer page of the Aflac form on some of the claims. She even said it was ok on the legit ones but the HERO is pushing this.
I just dont no what to do. Do I need a lawyer before June 2nd? Im am scared to death and dont even have money to pay a lawyer to help me because I was out of work do long. And of xxx purse er everyone says tou better hire one.dont dare use the court appointed obe or you will land straight in jail! Now that we got my son finally on the road to recovery, his father has been given 6-12 months to live. My son already feels like I am all he has because his Father abd their family didnt believe he was really sick when he went thru all of his nightmares! I have none of my family members in this area except my husband and his family and my son and my husband do not have a good relationship. If I have to ho to jail, im afraid what my son will do.
Expert:  Law Educator, Esq. replied 2 years ago.
Thank you for your question. I look forward to working with you to provide you the information you are seeking for educational purposes only.
Yes, you need an attorney before the June 2 date, because there is an implication of criminal charges and insurance fraud is a felony. Now, the better news, if this is your first offense and given the circumstances, it is more likely than not that even if the CA pursues the insurance fraud charges, the result will not usually be more than probation and paying restitution and no jail time would be served.
I would not suggest using a public defender if at all possible, as while they are good attorneys generally, they are also very overworked and do not spend the time fighting for the best deal possible for their clients that a private attorney will.
However, even if you cannot afford a private attorney, get the public defender and you just need to stay on them to make them work for the best deal for you. As I said, they are good attorneys, just overworked, and if you stay on them and they like you, they will spend a bit more time fighting for a better deal for you.