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CASE SUMMARYY
Montgomery’s mother, Mary Farris, sustained a workers’ compensation injury on
5/31/00 to her left knee due to a fall from some stairs that led to a parking
lot. Farris worked as a certified nursing assistant. She was placed on TTD and
treated conservatively. Her condition did not improve but surgery was never
performed. She was declared medically permanent and stationary on 3/20/01. TTD
payments were ended and PD advanced commenced as of 3/20/01.
She was evaluated by a QME on 7/19/01 who concluded that she was indeed P&S with
significant PD. The DEU rating her PD at 84%, which equated to payments payable
at $230/wk for an Award of $127,075.00. Since her PD rating was over 70%, she
was entitled to a life pension payment once her PD award was paid in full. Her
life pension weekly amount would have been $92.77/wk for the remainder of her
life.
On or around 6/22/06, the claims adjuster received a phone call from Montgomery
that she was moving her mother to Chandler, AZ.
On 4/24/07, the claims adjuster received another call from Montgomery indicating
a desire to settle her mother’s claim via lump sum as her mother (Farris) now
was suffering from Alzheimer’s. The adjuster explained the process for them to
pursue a settlement but Montgomery stated they did not have the time.
On 7/21/08, the claims assistant received a phone call from the son stating that
he was moving his mother back to CA and that he had legal guardianship. He
stated he would advise of a new address. He never did.
On 8/16/10, the supervisor at the time, Jonathan Beaton, conducted an SSN alive
check due to Farris’ age in order to determine if she was still alive and
receiving the checks. The database search revealed that Farris had passed away
on 2/8/08
On 8/17/10, claims adjuster contacted Montgomery and questioned her regarding
the status of her mother. Montgomery responded that her mother was still alive
although incapacitated. She also insisted to the claims adjuster that her mother
was still entitled to her checks. We obtained copies of the cashed checks and
note that Montgomery forged her mother’s signature.
The case was referred to SIU who verified the SSN database search showing that
Farris had passed away on 2/8/08. The case was referred to the Arizona
Department of Insurance who investigated the case and the above charges were
filed.
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