WOMAN RECEIVES DISABILITY BENEFITS FROM AFLAC WHILE WORKING AT SEPTA

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Philadelphia – Detectives from the Philadelphia District Attorney’s Office Insurance Fraud Unit investigated Crystal Johnson-Fowlkes after receiving a referral from SEPTA. The referral alleged that Fowlkes had been collecting temporary total disability benefits from AFLAC while she was working as a cashier at SEPTA. AFLAC policies are offered as optional secondary insurance for SEPTA employees in order to provide them with short-term coverage for disabilities non-work related. Fowlkes abused this AFLAC policy by filing claims for injuries that were in fact work-related and by receiving disability payments while working full-time with SEPTA.

Fowlkes fraudulently received AFLAC disability benefits on three separate occasions. On July 21, 2011, Fowlkes went out on disability for problems related to her asthma condition and allegedly remained on disability until July 2012. Fowlkes submitted a claim to AFLAC and received six separate checks which amounted to over eighteen thousand dollars before taxes. The investigation revealed that Fowlkes was simultaneously working as a SEPTA cashier during this time period and earned over forty-five thousand dollars in gross wages in addition to the disability benefits.

Soon after Fowlkes finished collecting disability benefits for her asthma, she alleged that she aggravated a pre-existing injury to her left ankle by walking up the SEPTA staircases. Fowlkes underwent surgery for these injuries in November 2012, and later submitted a claim for disability benefits with AFLAC. Fowlkes continued to receive these benefits through March 2013 even though her policy was not supposed to cover work-related injuries. Fowlkes unlawfully collected both worker compensation benefits from SEPTA and over six thousand dollars in AFLAC disability benefits during this four month period.

Following her ankle injury claim, Fowlkes submitted a third disability claim related again to her asthma. Fowlkes was admitted to Lankenau Hospital for treatment on April 17, 2013 and soon after began to again receive AFLAC disability benefits. Fowlkes continued to receive these benefits until November 2013. In support of this claim, Fowlkes also submitted three continuing disability forms in which she indicated that she had not returned to work at any position. However, human resource documentation indicates that Fowlkes had returned to her full-time position at SEPTA as of April 29, 2013. In late October of 2013, human resources personnel discovered that Fowlkes had been receiving disability benefits from AFLAC while working at SEPTA and she was consequently terminated from her position as a cashier.

Fowlkes received over thirty-four thousand dollars from AFLAC in benefits which she had not been entitled to receive. Fowlkes was arrested for three counts of Insurance Fraud and three counts of Theft by Deception on September 1, 2015. She is next scheduled to appear in Philadelphia Municipal Court for a status listing on September 11, 2015.

Charges:

Insurance Fraud 18 Pa C.S. § 4117 – F3 (3 counts)

Theft by Deception 18 Pa C.S. § 3922 – F3 (3 counts)


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