An interesting story made the national news recently, out of Westminster, California. Sure, I had never heard of it either, but it is about halfway between Anaheim and Huntington Beach in the massive stretch of humanity that is more generally referred to collectively, and incorrectly, as Los Angeles. The story begins with a "head injury in 2022 while attempting to handcuff a suspect" and culminates now in allegations of "15 felony charges and up to 22 years in prison." Yes, the article uses the "F" word - "Fraud."
The officer complained of heachaches and dizziness following the incident with the prisoner. The emergency medicine physician nonetheless "released her back to work without restrictions." Officer Nicole Brown began using sick days and was eventually "diagnosed with severe concussion syndrome" and excused from work.
Like many public servants who work pursuant to a collective bargaining agreement, she was reportedly not limited to workers' compensation benefits like other workers. She instead drew her "full salary" for the first year of absence. Overall, the city of Wesminster alleges it expended about $600,000 on medical care, salary, and workers' compensation.
The disability was founded on her complaints, that included:
“headaches, dizziness, sensitivity to light and noise, problems processing thoughts and words and an inability to work on the computer or do any screentime.”
While suffering these challenges, Officer Brown "was witnessed drinking and partying at the Stagecoach Music Festival ... (a) loud, crowded environment with temperatures over 100 degrees." She was also allegedly able to visit Disneyland and "three AYSO soccer conferences.
Officials also believe that while on disability, Officer Brown "went snowboarding or skiing in Big Bear and Mammoth, ran two 5k races, played golf, took online courses with a university and attended baseball games." The allegations are that these social and entertainment activities are contrary to the stated complaints, symptoms, and foundation for the $600,000 in taxpayer payments for workers' compensation.
To this point, the allegations are somewhat pedestrian. There are periodic allegations of misrepresentation in workers' compensation, some more salacious than others. While $600,000 seems a great deal of money, there have been larger sums discussed in relation to the "F" word.
But, This instance is somewhat more intriguing. Officer Brown was allegedly represented or assisted by California attorney, her "stepfather Peter Schuman." The attorney has "also been charged after being accused of aiding her in committing fraud." That has perhaps occurred previously, but is nonetheless at least quite rare.
The allegation is that Mr. Schuman "advocat(ed) on her behalf" negotiating "what police duties she could perform." That is reasonably normal. However, the city allegest that this occurred in a meeting "three days after the Stagecoach Music Festival." Having allegedly just returned from this outdoor, "best-attended and highest-grossing country music festival in the world."
During that negotiation of potential return to work, Officer Brown allegedly "claimed she was unable to look at the screen” and was “sitting in a dark room.” She allegedly claimed to be unable even to discuss her issues and complaints, leaving the attorney alone to "speak() on her behalf."
As of now, the news reports that the charges are:
Attorney - "one felony count of making a fraudulent insurance benefit claim and one felony count of assisting, abetting, conspiring with and soliciting a person in unlawful act."Officer Brown - "nine felony counts of making a fraudulent statement to obtain compensation, six felony counts of making a fraudulent insurance benefit claim and one felony enhancement of committing an aggravated white collar crime over $100,000."
The attorney faces a potential of "eight years in prison" while Office "Brown could face up to 22 years in prison." There have been instances in which an attorney faced repercussion. See Attorney Complicity and Disqualification (May 2017). However, those have been rare.
The topic is of interest periodically in Florida. Despite the lazy reference to the "F" word that recurs in many venues, including Florida, there is no necessity of proving Fraud, in workers' compensation. The prohibition in Florida law is inclusive of"Fraud," but less may result in committing a felony, defined in section 440.105(4)(f), Florida Statutes.
That responsibility may fall on "any employer," section 440.195(4)(a), Florida Statutes, or on "any person," section 440.195(4)(b). The "any employer" standard includes the constraint that actions or words must be "knowingly" engaged, and focus on compliance, payroll deductions, and coverage.
The "any person" provision in (b) focuses on "any false, fraudulent, or misleading oral or written statement for the purpose of obtaining or denying any benefit or payment under this chapter." This includes "any written or oral statement as part of, or in support of, a claim for payment ... knowing that such statement contains any false, incomplete, or misleading information concerning any fact or thing material to such claim."
The implications of that are broad:
"false, incomplete, or misleading"
And they are repeated regarding knowingly preparing any statement "intended to be presented ... in connection with, or in support of, any claim for payment or other benefit." even "concerning any fact or thing material to such claim."
In this, there is likely sufficient basis for an attorney to face repercussions in the wrong circumstances. Nonetheless, there is a specific provision in (b)4. that may seem more pertinent for attorneys and others who work with the injured. This applies the same potential for criminal prosecution to those who "knowingly assist, conspire with, or urge any person to engage in activity prohibited by this section."
The primary engagement of this statute is seemingly the termination of benefit entitlement in section 440.09(4)(a):
"An employee shall not be entitled to compensation or benefits under this chapter if any judge of compensation claims, administrative law judge, court, or jury convened in this state determines that the employee has knowingly or intentionally engaged in any of the acts described in s. 440.105"
Despite that focus on the employee, and the potential for cessation of benefits for misstatement, misleading, or "incomplete," there remains the potential for both prosecution and significant repercussions for "any person." Thus, whether the "any person" or the "knowingly assist," there are potential implications for more than the employee.
The Florida laws, of course, are of no import or influence in the Golden State, but are instructive. The implications of making or abetting knowingly made "false, incomplete, or misleading" statements can be significant and worthy of consideration for "any person."
It is imperative that both Officer Brown and Mr. Schuman have been charged with crime as reported. That allegation(s) does not mean that they are guilty. The accused are innocent until proven guilty. Their plight and these allegations are presented here for the purpose of illustration and education.
