Ms. Barillas claimed she is the Human Resources Manager as she was willing to cooperate in providing any information about the Claimant’s alleged CT claim. During her interview with the Investigator, the witnesses appeared forthcoming with her answers. Ms. Barillas claimed she had been the HR Manager since December 2011. She said a portion of her duties is to determine the appropriateness and amount of worker’s compensation claims; investigates individual claims for eligibility for workers’ compensation benefits; ensures that all legal and procedural requirements are met for the processing of claims.
She also assists her employees with the completion of the workers’ compensation documentation when needed. The personal information she had about the claimant is that he resided at 348th East 90th Street, Los Angeles, CA 90003 and per his W2 forms the claimant is married and has dependents which he has not listed accurately. On 12/3/2015, Ms. Barillas stated the claimant’s position as the Shipping Supervisor with the company had been permanently removed which had been agreed upon by Benjamin Gauregui, Director of Production and Jay Kuo, Senior Vice President.
She stated that they decided to eliminate the Shipping Supervisor role due to a restructuring or reclassification, after the claimant had been an employee as of 12/24/11. Per the Notice of Change of Status and the Separation Notice the position was considered as a layoff which had an effective separation date of 12/3/2015. She said the claimant accrued his hour’s vacation hours, and his accumulated hours of back pay after he had been laid off. (See Documents 004, 005)
She claimed after the claimant’s departure from the company; she received notice of a post-termination workers’ compensation claim had been filed against the insured by the Law Offices of Lionel E. Giron who were legally representing the claimant for a CT claim of injuries from 12/3/2014 through 12/3/2015. She said as soon as she received notice of the intentions of the legal firm she was in complete shock as the claimant never complained or reported any pre-existing pain or discomfort from a previous old workers’ compensation claim which the claimant had filed on 10/14/2014.
She said this was the only claim which may be what the claimant and his attorneys had referred to, but stated from her observations of the claimant he appeared to be OK. She said reported from what Mr. Cantillo told her, the claimant was healthy while he performed his physical duties out in the warehouse, where he was observed squatting, twisting, turning, walking, reaching, standing, bending at the waist and his neck without any difficulty.
She said she found the legal documentation that suggested the claimant had listed a CT claim as being absurd and suggested that he retained an attorney to reap the benefits by looking for and applying for a truck driving job while receiving unemployment insurance. She bases her theory not only on skepticism but on facts alone as the claimant filed for unemployment insurance with the Employment Development Department State of California (See Attachment #006) and a DOT Employment Verification Request requesting to verify the employment history of Miguel Ramirez Castro.
The verification and requests were from a temp agency under the name of HireRight Inc. , 1000 Counterview Drive 300 Nashville, TN 37214. (See Attachment #007) As she continued to go through the Claimant’s personnel file, she discovered the claimant did not locate any definitive answers as to the injuries which he is claiming within his CT claim. She claims that the Claimant’s Personnel file did not contain any witness information or a Supervisors Report outlining the facts related to how the claimant sustained his lower back injury on 9/24/14.
She said the company did everything they could for the claimant even though he did not specify that this injury was work-related, and went as far to accommodate the claimant to be medically examined even though he did not specify the back injury as work-related. She said the company referred the claimant to be medically examined at U. S. Health Works Medical Group, at 3430 South Garfield Avenue, Commerce CA 90040, Ph: 323-722-8481, on the day he informed her of his alleged injury.
In conjunction, Ms. Barillas stated the work status reports from their pre-designated medical provider diagnosed the claimant’s injury as a Sprain/Strain Lumbar due to the pain in his back and placed him under modified work duties. She said per the documentation which she had provided for this investigation, the doctors notes restricted the claimant with no stooping and bending. No kneeling or squatting, with limited lift, limited pull and limited push up to ten pounds while wearing a back support.
She said the claimant was on modified work restrictions from 9/16/14 through 10/10/14 and continued with physical therapy treatments from 10/1/14 through 10/10/14 per the U. S. ; Heath Works Physical Therapy status sheet. (See Attachment 012) On 10/10/14, she said Frank Chow examined the claimant, D. O. at U. S. , Health Works Medial Group who released the claimant from total care and medications effective 10/10/14, with no additional limitations or restrictions or ratable disability needed for future medical care. See Attachment 014)
She stated she had some information as to the Claimant’s medical history when the Claimant submitted two doctor’s notes from a non-designated medical facility which the insured does not utilize. She said on 11/3/14, the claimant was under the medical care under the care of Reynaldo B. Castillo, M. D. , at All Care Medical Group, Inc. She said the doctor’s note did not specify the reasons for the Claimant to be entirely placed off from work for three days until he would return to work on 11/6/14.
She said the Claimant did not specify his medical diagnosis as to why he had to be off from work for this medical reason. She said the Claimant in 1/29/15, had also provided her with a second doctor’s slip from the All Care Medical Group, Inc. where the claimant was placed under the medical care of Pierre Espenan, P. A. , from 1/29/15 through 2/23/16. During the time of his three weeks away from work, she did not question the doctor’s office to provide their reasons to place their employee off from work for a considerable amount of time without pay. See Attachments 015, 016)
She stated the Claimant’s position as the Shipping and Receiving Warehouse Supervisor included the essential duties and responsibilities to oversee all the receiving procedures from the time a load comes in until their quality control department inspects all the products. His additional responsibilities included seeing that the warehouse employees put away the products while he accounted for the inventory in the warehouse.
She said the job description of the claimant’s position was provided which did not contain any physical activities required by the Claimant. (See Attachment 002) She claimed that the Claimant had a good reputation as was well liked by his peers and by management. She stated the Claimant did not have any issues with anyone at the company and would go beyond with what was needed to be done.
However, as time went on and neared the end of his employment with the business, his work performance was not satisfactorily. She said she started to receive reports from the Claimant’s Supervisor, Mr. Cantillo, who had submitted documentation dated 9/1/15 and on 11/10/15 referencing the Claimant’s disregard for safety practices and a plethora of other issues stemming from leadership and communication skills that needed improvement.
Ms. Barillas claimed she did not have any personal information about the claimant. But stated that his wife, Vilma Ramirez still works for the company. She does not know how many children that the Claimant and Mrs. Ramirez has together. She said she is not privy as to the type of physical activities which he does after work. She does not believe the Claimant either smokes or drinks alcohol or has a substance abuse problem.
