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California

Today’s lesson: Teachers should not fib on disability claims

L.A. school district headquarters
L.A. school system officials, who work at district headquarters near downtown, deploy a team of investigators to root out employee fraud.
(Al Seib / Los Angeles Times)

A local teacher learned a hard lesson this month when a judge sent her to jail and ordered her to pay $92,000 in restitution for disability insurance fraud.

Sheila Marie Green, who lives in Lake Elsinore, pleaded guilty to two counts of insurance fraud after prosecutors accused her of submitting claims on several policies that pay benefits for being injured and unable to work. At the time, Green was also collecting a paycheck for working as a teacher in the Los Angeles Unified School District.

In this situation, Green was stealing from three insurance companies, but her actions are part of a suite of fraudulent behavior related to false disability claims. L.A. Unified makes a concerted effort to go after employees who might be cheating the system, often through falsified or exaggerated workers’ compensation claims.

Since 2003, internal district investigations have led to 27 arrests, which resulted in 23 convictions and 1 acquittal. Three cases are pending. The district has won restitution claims for a quarter of a million dollars during that time, but it’s not clear that this investment covers the cost of investigations.

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The major benefit of enforcement may be as a deterrent, said district general counsel Dave Holmquist.

“We publicize these arrests and convictions,” Holmquist said.

All told, the nation’s second-largest school system pays $100 million a year in claims through the state-supervised workers’ compensation system. Injured employees are sent to district-approved doctors, who are supposed to set strict limits on how long an injury would keep a person off the job. A private company reviews claims, and the district deploys investigators through its risk-management office and inspector general.

Green, 48, worked variously as a substitute or full-time teacher in the adult division of L.A. Unified from 2001 through mid-2017, according to district records. She worked the longest at Carson High School and Friedman Occupational Center, on the south edge of downtown. She resigned under pressure in the wake of the charges against her, Holmquist said.

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Taking part in the case were the Riverside County district attorney’s office and investigators from both the private insurance companies and L.A. Unified.

From 2013 through 2016, Green forged the signature of an L.A. Unified payroll employee, falsely documenting that she was too injured to work. During a search of Green’s vehicle, investigators found documents with the forged payroll employee’s signature as well as papers with numerous “practice” signatures of the payroll employee.

In addition to the restitution, Riverside County Superior Court Judge Helios Hernandez sentenced Green to two years in county jail and six years of mandatory supervision.

howard.blume@latimes.com

@howardblume


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