Motocross Racer Convicted of Workers’ Compensation Fraud

Motocross Racer Convicted of Workers’ Compensation Fraud

Montana Attorney General Tim Fox announced today a Three Forks man charged with fraudulently collecting workers’ compensation benefits from the Montana State Fund has pled guilty.

Antony H. Caruana, 42, pled guilty in District Court in Helena on October 16 to one count of theft related to fraudulently filing a workers’ compensation claim with Montana State Fund. On June 16, 2015, Caruana claimed he suffered a work-related injury to his right knee while working as an HVAC technician in Bozeman. Nine days earlier, Caruana had competed in a motocross race near Clancy. That same day, he submitted an injury form to State Fund and returned to work after seeing a medical provider. State Fund began paying Caruana’s medical bills. Subsequent investigations by the Montana Department of Justice’s Division of Criminal Investigation (DCI) uncovered that Caruana had competed in three other motocross races in the two months prior to his alleged workplace injury.

Less than two weeks after the alleged workplace injury, Caruana competed in a motocross race near Wolf Point. On July 20, 2015, Caruana was diagnosed with a meniscus tear in his right knee and underwent surgery followed by physical therapy. Caruana started receiving workers’ compensation temporary total disability (TTD) benefits based on a doctor’s conclusion Caruana could not return to work. On December 2, 2015, Caruana had a second surgery on the same knee for a new or recurrent meniscus tear.

In February of 2016, State Fund received a call from Caruana’s employer, Campbell’s Plumbing and Heating of Belgrade. Its owner reported seeing pictures on Facebook of Caruana riding dirt bikes after his claimed injury. Caruana’s employer spoke to family members who confirmed Caruana’s continued participation in dirt bike riding and motocross racing. A private investigator hired by State Fund observed Caruana participating in motocross races in June near Basin. In July, Caruana participated in another motocross race near Wolf Point. Four days later, a doctor concluded Caruana’s complaints of ongoing pain that prevented him from working did not correlate with her objective medical findings. After participating in three more motocross events, Caruana was interviewed by investigators from State Fund and DCI and was subsequently notified his TTD payments were being terminated. Less than two weeks later, Caruana went back to work for a different plumbing and heating company in Belgrade.

Between June 16, 2015 and October 10, 2016, Caruana received up to $91,770 worth of medical benefits and $40,937 in TTD wage loss benefits he was not entitled to — just from June 2016 (Caruana’s first post-surgery motocross race) to October 10, 2016, he received at least $12,295.14 in TTD benefits. On October 16, 2019, Caruana appeared in District Court in Helena and pled guilty to felony theft. At a sentencing hearing held immediately following his guilty plea, Caruana was given a three-year deferred probationary sentence and ordered to pay $12,295.14 in restitution plus a $500 fine.

“Montana takes work comp theft seriously, and I’m proud of the collaborative work of Assistant Attorney General Chris McConnell, Division of Criminal Investigation Agent John Komora, and the Montana State Fund Special Investigations Unit which led to this win,” Attorney General Tim Fox said.

Click here and here to view the charging documents.
Click here to view the judgment.
Photo credit: Photo provided by MT DOJ

X