Calif. Food Service Assistance Charged in Comp Fraud

Sandra Canas, 44, of Daly City, was arrested on Nov. 10, 2004 and charged with two felony counts of receiving income while receiving workers’ compensation benefits and one felony count of misrepresenting her level of disability to her doctor.

The case, being prosecuted by the San Mateo County District Attorney’s Workers’ Compensation Fraud Unit, was jointly investigated by the California Department of Insurance, Fraud Division (CDI), the District Attorney Inspectors and Keenan & Associates, an insurance broker and consulting firm in the state.

Investigators allege that Canas, who was an employee of South San
Francisco Unified School District at the time of the original work injury, was hired and paid as a housekeeper during the period she was receiving disability payments and did not notify her claims adjuster at the Redwood City branch of Keenan & Associates, third-party administrator for the San Mateo County Schools Insurance Group JPA.

Canas complained to her treating Physician James Kelly of her constant intolerable pain and that she was unable to perform simple housework. Dr. Kelly found her complaints of pain to be valid and
recommended further treatment but Canas refused and abruptly discontinued all treatment. Dr. Kelly, based on what he saw on an investigative videotape of Canas working as a housekeeper, stated during his deposition that Canas’ subjective complaints of disability were inconsistent with and out of proportion to his objective findings.

Canas appeared in court on Nov. 17, 2004 and plead not guilty to all
counts. The case is next scheduled on Jan. 5, 2005 for Superior Court review and to set the preliminary hearing.