Elmira woman sentenced for defrauding NYS workers' comp system

ELMIRA — The Offices of the New York State Inspector General announced the guilty plea and sentencing of an Elmira-based home health aide who was paid more than $6,000 to care for an elderly workers' compensation recipient – but never showed up for hundreds of hours she was supposed to work.

Denise Lewis, 45, of Elmira, pled guilty on May 17, to Insurance Fraud in the Third Degree, a D Felony. At that time, Lewis paid $6,600 in restitution. Today, the presiding judge, the Hon. Richard W. Rich, Jr., sentenced her to a three-year conditional discharge.

Lewis worked for a now-deceased elderly and disabled workers' compensation recipient at her Chemung County residence. Lewis claimed to have provided health care services to the individual during certain hours – but eyewitnesses and surveillance conducted by members of the Inspector General's office confirmed she was never present at the individual's home during these times. Between October 2017 and July 2019, Lewis submitted more than 20 fraudulent timesheets to a third-party claims administrator for payment and was paid over $6,000 for more than 400 hours not worked.

"In order to fulfill its vital purpose, the Workers' Compensation system requires the honesty of all," said Inspector General Lang. "We will continue to vigorously investigate and root out fraud to protect the system for vulnerable New Yorkers who rely on all its benefits."

The Workers' Compensation Fraud Inspector General investigates fraud, abuse and/or illegal acts against the New York State workers' compensation system, including fraud by medical service providers, employers seeking to evade appropriate workers' compensation charges, and employees who fabricate injuries to fraudulently receive system benefits. Complaints and referrals are confidential. The Office of the Workers' Compensation Fraud Inspector General can be reached at 1-800-367-4448, www.ig.ny.gov, or via email to: [email protected].

The Inspector General's Office thanked Sedgwick Claims Management, the third-party claims administrator for Continental Casualty Company CNA, for its help with the investigation, the New York State Police for its assistance with effectuating Ms. Lewis' arrest, and the Chemung County District Attorney, Weeden Wetmore, and his office for prosecuting this case.

The matter was handled by Investigative Counsel Philip Druss and Investigator Steven Brucker under the supervision of Deputy Inspector General Jeffrey Hagen, Chief of Investigations for the Western Regional Office Charles Tirone, and Attorney-In-Charge of Workers' Compensation Fraud Bryan Richmond.