Tensfeldt

Petitioner Gary Tensfeldt (Tensfeldt) was convicted of insurance fraud under Insurance Code section 1871.4, subdivision (a)(1), for lying about the circumstances of an alleged industrial knee injury to obtain workers’ compensation benefits. Tensfeldt entered a negotiated plea of nolo contendere to one misdemeanor count of insurance fraud, made restitution, and filed a second claim seeking compensation benefits for what he professed were the actual circumstances of the injury. The Workers’ Compensation Appeals Board (Board) denied the second claim. In affirming the Board’s decision, we will hold that when convicted of insurance fraud in violation of section 1871.4(a)(1), an applicant for workers’ compensation insurance benefits may be, and in this case is, wholly barred from receiving or retaining any such benefits directly emanating from or connected with the fraudulent misrepresentation.

I. Factual and Procedural Background

Tensfeldt was hired by respondent Water Department of the City and County of San Francisco (City) as an apprentice plumber on February 1, 1994. He was assigned to a cement cutting crew with two laborers under the supervision of Jim Lynch.

On…