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Issues With Special Money For Prosecuting Workers Compensation Fraud

Possible Issues With Special Money For Prosecuting Workers Compensation Fraud

Issues With Special Money For Prosecuting Workers Compensation Fraud

Issues With Special Money For Prosecuting Workers Compensation Fraud

Possible Issues With Special Money For Prosecuting Workers Compensation Fraud – Since 2011, the investigative unit has been reviewing data submitted by prosecutors to the Department of Insurance. Since 2011, District Attorneys convicted 3424 people statewide, 2309 of which were employers, 751 workers and 41 medical providers. In the Bay Area alone, 644 people were convicted, 6 of which are medical providers. But this data does not reflect the full problem. While the prosecutors believe that these convictions were filed based on reasonable beliefs that these individuals were guilty beyond a reasonable doubt, doctors believe that they are being singled out and treated unfairly by the system through being targeted and accused of workers’ compensation fraud.

District attorney’s receive grants to investigate and prosecute fraud. Therefore, some academics and attorneys believe that money is a huge incentive for these attorneys; and may in fact lead to filing banal charges. Aviva Abramovsky, a law professor at Syracuse University also alleges that fraud grants may create a conflict of interest. In a paper she published in 2008, she argued that the insurance industry assessments create such potential for conflict.

However, prosecutors disagree with Abramovsky’s hypothesis and claim that they only file charges and convict providers where evidence of fault and wrongness exists. They allege that grant money is not an incentive that leads them into filing baseless charges and instead is necessary to weed out wrongdoers. The chief deputy district attorney in San Bernardino County, Gary Fagan agrees and argues that prosecutors are not overzealous. Fagan maintains that the only time prosecutors file charges is when there is evidence of guilt.

One Doctor Fighting Back Against Perceived Injustice For Comp Fraud Posecution

In 2014, a San Pablo pain specialist, Dr. Gary Martinovsky was arrested and accused of committing insurance fraud and unlawful dispensing medications. The case was later dismissed because it was filed in the wrong county (Alameda County). It was then refiled in the Contra County, where it was also dismissed this summer. The doctor never admitted guilt. Instead, the physician pleaded to complete a one-year diversion program instead.

Dr. Martinovsky maintained that the entire case was fabricated, possibly due to incentives/grants to prosecute fraud. He and his attorney believe that he was framed by prosecutors who are prosecute out of a vendetta on behalf of the insurance industry. In response, Dr. Martinovsky is suing the Alameda County District Attorney’s Office and a Department of Insurance’s investigator for civil rights violations.

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Alexander D. Napolin, Esq.