Martin Lobatos must be a really good driver, because he passed his driver’s test with an above-average score when he was supposedly on the verge of catatonia.
Lobatos and his wife, Belen Luna Lobatos, have both entered guilty pleas, after being indicted by a grand jury, in what appears to have been over a year long workers’ compensation scam. The couple live in Aurora, Denver. They are accused of stealing $120,000 worth of workers’ compensation funds from Pinnacol Assurance. Eventually, a private investigator was hired and Lobatos was placed under surveillance. However, before this happened, Martin Lobatos led doctors and the insurance company down a road of twists and turns.
Martin was working as a roofer. On September 29, 2008, he fell six to ten feet from a ladder, face first, causing him to briefly lose consciousness — although that’s in dispute. He was taken to Vail Valley Medical Center, where he was diagnosed with a wrist fracture, two broken ribs and a closed head injury that caused a small abrasion and some swelling. A CT scan on his head and neck came back negative, and he was discharged from the medical center the same day he was admitted.
Lobatos filed a workers’ comp claim on September 30. After returning to work full-time on October 21, he began complaining of headaches, dizziness, vertigo, and blurred vision. An MRI on October 28 didn’t show any reason for these symptoms, but he claimed that they persisted. A doctor who examined him in April 2009 couldn’t find any medical reason for his continuing issues. This doctor determined that Lobatos had reached maximum medical improvement (MMI) and assigning him what the indictment describes as a “zero-percent impairment rating.”
Lobatos was terminated from his job that same month (April) and subsequent to him declining to accept a $20,000 settlement from Pinnacol Assurance in September 2009, Lobatos started to complain of new symptoms, including dizziness, memory loss, difficulty recognizing his own children, inability to use stairs without help, pain caused by eating, chewing, bright lights, and the weather. Lobatos was quite convincing and a second physician rejected his predecessor’s findings, determining that the MMI ruling was premature.
In October, Martin, accompanied by his wife, began seeing a medical professional of their choice, Dr. Edwin Healey, and the list of maladies expanded again to include personality changes, inability to drive and suicidal thoughts. Healey determined that his patient was “totally and permanently disabled,” and Martin did his best to prove it. By March 2010, he presented himself as being catatonic. He was immobile and unresponsive behind a pair of dark glasses, only occasionally rousing himself to offer guttural sounds and random body movements.
Pinnacol Insurance agreed to pay the Lobatos $4,000 per month for in-home care, supplemented by thousands more in total temporary disability payments. However, in December 2009, before and after doctor appointments where he outlined disabling issues, he took and passed a driver’s test – both the written exam and eye test.
In February 2011, he was placed under surveillance. He was seen visiting a transmission repair shop, a ranch supply store, a Wal-Mart, a western wear store, a food store, a restaurant, and a church. He was also spotted in his backyard overseeing the construction of a shed.
The surveillance videos of these activities were shown to Belen following two more appointments in which she continued to insist that Martin remained in a nearly vegetative state. According to the indictment, she claimed that he had good days and bad days — and admitted skipping over the good ones.
Martin has now pleaded guilty to theft and making a false statement on a workers’ comp claim — violations that could earn him up to a $750,000 fine and as many as twelve years in prison for the theft charge alone. Belen entered a guilty plea regarding theft and a false workers’ comp statement and could face a maximum $500,000 fine and six years behind bars.
As part of the plea agreement, the Lobatos have agreed to pay Pinnacol Assurance $160,000 in restitution.
