Workers’ Comp Unit Gets Started on 1st Prosecutions

A district attorney’s unit launched last January to investigate suspicious workers’ compensation claims went an entire year without prosecuting anyone.

But this year has started off differently.

In the last two weeks alone, the workers’ compensation fraud prosecution unit has filed charges in two cases and at least four more are in the works, authorities said.

On Jan. 27, three counts of workers’ compensation fraud and one count of theft were filed against Alan Griffis, a sales manager at a Camarillo computer firm.

And this week, prosecutors charged an Oxnard truck driver, Ronald Lopez, with two counts of workers’ compensation fraud.

Authorities say such fraud is one of the biggest problems facing businesses in Ventura County and across the state.

In the past year, the new unit has reviewed 63 reports of suspicious workers’ compensation claims, said Deputy Dist. Atty. Rhonda Schmidt, who has been assigned to prosecute such cases.

“The cases just got to the point where they were provable,” she said. “It’s gone full cycle and we’re starting to get what we need (to prosecute) now.”

But authorities said charges against physicians and attorneys suspected of doctoring medical reports to help workers cheat the system may still be a long way off.

The reason is that cases against health care providers and lawyers involved in workers’ compensation cases are harder to prove and require more complex investigations, they say.

With workers, authorities said, investigators only need to catch them in one lie. But with doctors and lawyers, prosecutors generally have to prove a pattern of abuse, Schmidt said.

Still, she said she expects some Ventura County doctors and lawyers to be charged soon with workers’ compensation fraud.

“We’ve got those kinds of cases under investigation and, if the investigations go as I anticipate, charges will be filed,” said Assistant Deputy Dist. Atty. Colleen Toy White.

But the attorney representing Griffis, the first defendant charged by the D.A.’s unit, wonders why no doctors or lawyers have yet been charged.

“They set out to find what was trumpeted as the workers’ comp mills, where those dastardly lawyers were running around and getting people to claim they were injured and take them to Dr. Feelbad,” said David P. Callahan.

Prosecutors agreed that it would send a stronger message if so-called providers were charged in these crimes.

But they said that does not lessen the culpability of individual workers accused of bilking the system.

Griffis is director of sales and marketing at BGL Technology Inc., a family owned computer business.

Last March, he injured a shoulder carrying a filing cabinet down some stairs, according to court documents.

A short time later, the state workers’ compensation fund received a doctor’s report declaring Griffis temporarily disabled. Based on that report, Griffis was issued a weekly benefit check for $384 beginning March 26, court records show.

Griffis visited the doctor regularly until July 29, when the doctor suggested he undergo surgery to correct whatever problem he was having with his shoulder, the records show.

Griffis stopped seeing the doctor after that surgery recommendation, which prompted a state investigation of his claim.

Undercover surveillance by state investigators revealed that he was going to work every day and sometime even rode a motorcycle there, court records said.

After viewing a videotape of Griffis’ daily activities, the doctor told investigators that Griffis had lied about his condition because he could not possibly wear a heavy motorcycle helmet and turn his head from side to side if he was suffering neck and shoulder pain, the report said.

Attorney Callahan said he will prove in court that his client simply misunderstood the rules of the workers’ compensation system.

“This is a guy who suffered an injury where the doctors are telling him to have surgery,” Callahan said. “I think the doctors were right in the first place. I certainly think he never intended to defraud anybody, and that’s what they have to show.”

In the case against Lopez, prosecutors said the truck driver for an Oxnard welding supply company injured his right leg in 1992. A year later, he lied about having also injured his left leg in the same incident and received benefits for it, said prosecutor Schmidt.

Lopez, who pleaded not guilty during an arraignment Wednesday, could not be reached for comment.

Prosecutors, who say that workers’ compensation claims have dropped 40% locally since the unit was launched, said the recent filing of criminal charges should have even more of a deterrent effect on those who might be tempted to cheat the system.

And they warn that they will step up the number of prosecutions.

“We see the prosecution as just another part of that strong stance against workers’ comp fraud,” White said. “And we have just begun. . . .”