One of our most widely read Investigative Case Highlights told the tale of a postal employee who milked an ankle injury for over 14 years, all to illegally profit from the workers’ compensation program. In this edition, we’ll examine three similar healthcare claimant fraud cases, including one so brazen, it’s hard to believe it’s true.

Now, if you’ve seen your mail carrier in action, you know it’s hard, physical work. Injuries on the job are not uncommon, but perhaps fewer are injuries that prevent postal employees from working. When that happens, the Postal Service takes care of its employees through workers’ compensation, but claimants are legally bound to disclose any other income or improvements to their health while receiving benefits. And on each workers’ comp form, the warnings are clear: failure to disclose profits or changes in health will lead to civil or criminal prosecution.

But some people think they can outsmart the system. Take one postal employee who filed dozens of fraudulent mileage reimbursement claims for travel she never made to “aquatic therapy” sessions at a local gym. She unlawfully received almost $27,000 in reimbursements and, when questioned by our special agents, she said she felt USPS owed her that money.

The employee pleaded guilty and was sentenced to one year of probation and ordered to pay restitution of $26,000 plus a $10,000 fine. She was also ordered to reimburse the court for costs associated with her defense, which totaled almost $4,500. More important, blowing the lid off this fraud saved the Postal Service $388,000 in potential fraudulent claim payments had she continued to receive benefits.

Another case involved a postal employee who took up a job with a ride share company for two years while failing to disclose the new income. He received over $46,000 in workers’ comp benefits, but his crimes went further when he fraudulently applied for two Paycheck Protection Program loans totaling more than $36,000. After pleading guilty, he was sentenced to 30 days in prison and three years’ supervised release. He also signed a sworn statement that he would pay back the ill-gotten gains to the Postal Service and the Small Business Administration.

The last case breaks the mold. It began in 2006 when a postal employee claimed a serious injury. How serious was it? It’s hard to tell, especially in light of events: She sought treatment with a doctor who had been a subject of a healthcare provider fraud investigation. The doctor’s diagnosis? Totally disabled from work and in extreme pain.

Over the years, she allegedly received compounded pain creams from said doctor, and supposedly suffered an ischemic stroke in 2008, which the Department of Labor (DOL) accepted as a work-related medical condition. Such a stroke cuts off the blood supply to the affected part of the brain, thereby killing brain cells quickly. They often lead to physical and cognitive impairments.

In her claims, the employee said she had difficulty performing everyday tasks, such as dressing, doing chores, driving, shopping, managing money, walking, standing, sitting, following directions, and completing tasks. But that didn’t seem to be the case.

The employee was the living, breathing image of physical activity: Our special agents observed her standing, walking, climbing stairs, driving, carrying items, and shopping at various stores with no apparent difficulty. She was a regular preacher at a local ministry. She traveled the country and internationally, proudly posting pictures online of her adventures.

And her side gigs were plentiful: she ran an event planning business, sold beauty products for one of the country’s largest direct-selling brands, and sold books online she had penned herself. And she was collecting Social Security disability insurance benefits. After financial institutions were subpoenaed, our special agents found she was grossing sometimes up to $11,000 a month from the side hustles on top of the more than $3,000 in workers’ comp benefits she was receiving each month.

The buck didn’t stop there. During four years, she submitted 775 claims for medical home visits totaling more than $116,000. Investigators found those visits never took place. In all, she submitted over 3,000 claims for medical payments and reimbursements that defrauded the Postal Service of over $667,000. That’s ignoring over 3,000 warnings!

In January 2024, the employee was sentenced to four years’ probation and ordered to pay $743,000 in restitution to the DOL. Because of the guilty plea, the DOL terminated her workers’ comp benefits, which saved USPS a whopping $1.3M in future fraudulent claim payments.

In the end, healthcare claimant fraud hurts people who genuinely need that vital support. If you suspect or know of such fraud involving Postal Service employees, please report it to our Hotline.

For further reading:

Department of Justice (via uspsoig.gov), Former U.S. Postal Service Employee Admits Filing False Documents to Receive Over $650,000 in Workers’ Compensation and Watervliet Woman Sentenced for Making False Statements