When overzealous District Attorneys zero in on the Pot-Of-Gold!

It’s becoming very fashionable and profitable for District Attorneys around our state to zero in on a new cash cow; the prosecution of occupationally injured workers. What many Californians don't know is that the California Department of Insurance hands out millions of dollars each year to District Attorneys through their Fraud Assessment Commission, to those who demonstrate a track record of successful prosecutions.

This money comes from a fund that was created by the passage of Senate Bill 1218 in 1991, that also established the Fraud Assessment Commission to determine the level of assessments to fund investigations and prosecution of Workers Compensation insurance fraud. This funding comes from California employers who are legally required to be either insured or self-insured.

And many of these cases are of the flimsiest nature, taking honest hard-working Californians and turning them into convicted felons.

Since 2004, when Arnold Schwarzenegger shoved his so-called Workers Compensation reform down the throats of working Californians by intimidating an entire legislature, this practice is becoming more commonplace. The good names and reputations of hundreds of law abiding citizens are being trashed in the name of money grants from the FAC.

Litigation by insurance carriers has increased ten-fold with insurance companies challenging every minute little aspect of a case, totally clogging up the machinery of the Workers Compensation courts. As you might recall, the governor promised that if his reforms were passed, litigation would be reduced. This is just another broken promise from Arnold. The systematic judicial terrorism of injured workers simply goes unabated!

By the insurance industry’s own admission, injured worker fraud is less than 1% of the entire picture. So where is the other 99% and why don’t we hear about it on the radio, TV or in the news. Simply put, there’s no money for the DA's in prosecuting insurance companies for fraud and other equally heinous crimes and they are certainly not going to bite the hand that feeds them.

Sam Gold, producer of the Injured On The Job television program, the only regularly scheduled program in California that takes on the Workers Compensation system, has had a personal experience in that regard. As an injured worker, he brought 2 prima facie cases of fraud by an insurer and their attorneys to the attention of the Alameda County District Attorneys office.

At first he was appalled by the fact that the DA had no mechanism to take his complaint over the counter as they get most of their cases referred by insurance company fraud units. Later he was informed that the DA would not investigate the case. He later brought his complaints to the attention of the Department of Insurance Fraud Investigation Unit where it still languishes on somebody’s desk several months later.

Said Mr. Gold, "It figures that they would stonewall my complaint, there's just no money in it for them to go after the guys who are bringing this system to it’s knees."

Just last month an injured worker who worked as a dispatcher for a local Bay Area Police Department had her fraud conviction overturned by the appellate court on a basic premise of law; that fraud requires specific intent and that there needs to be a culpable mental state. Even a 1st year law student could have figured that one out. How come a San Mateo Superior Court judge couldn’t? BTW, he retired from the bench right after this case.

This grey-haired grandma who never got a traffic ticket in her life spent 60 days in solitary confinement in the San Mateo County jail for an offense that she did not commit although much of the evidence against her was tainted. This after the California State Supreme Court reinforced a decision that found the insurance carrier in her case guilty of defrauding her out of disability payments that were lawfully due her.

And there are many others all around the state who are being victimized as well. A police officer in Tracy; a County employee in San Mateo and a school custodian in San Luis Obispo. The list goes on and on.

William Zachry, a vice-president of risk management for Safeway Stores, Inc., chairman of the Fraud Assessment Commission and a Schwarzenegger appointee, was asked why an insurance carrier had never been prosecuted for fraud. His answer was simple and to the point. He said "We don't go after insurance carriers for fraud!"

Well Bill, if the DOI doesn't go after them, then who the hell does?