I once represented a client who worked as a motor officer in Riverside County. Years of riding a motorcycle had caused significant and permanent injury to his hands and arms. Finally, after grinning and bearing it for far too long, the client filed a workers’ compensation claim and got much-needed medical attention. Thereafter, the client endured years of surgical procedures and physical therapy sessions to recover from his work-related injuries, which ultimately ended his law enforcement career. All of his treating physicians agreed that the client’s injuries were job-related, so there would be no issues with his claim, and he had no reason to be represented by a lawyer, right? Wrong — flat wrong. What happened to this client should be recorded in an instruction manual for all law enforcement officers: A potential threat to your career is triggered when you file a workers’ compensation claim. Today, many cities and counties are in financial straits and seek ways to deny such claims. It is becoming all too common for workers’ compensation insurers to investigate workers’ comp claims for possible fraud. Police departments, cities and counties are often active participants in these insurer-initiated investigations. This is what happened here.
It all began with an unexpected knock on our client’s door and what the client, who was off on injured status, believed was just a friendly conversation. The truth was that the friendly conversation was part of an investigation ordered by the client’s workers’ comp plan administrator, with the full knowledge of his Department. This conversation was the catalyst for what followed, which nearly ruined the client.
The unexpected visitor stated he was employed by the administrator of the Department’s workers’ compensation plan and was there to ask a few questions about the level of customer service our client was receiving regarding his claim. The client invited the man in and answered questions for more than an hour. Well after the fact, the client learned that this man was actually an investigator who, in addition to asking scores of questions about the client’s injuries, restrictions, how he was doing, etc., was watching every move the client made during their interview to see if the client acted inconsistently with the work restrictions imposed as part of the client’s off-duty, injured status. Eventually, the man left. But that was not the end of the investigation.
Next, the insurance company, with the knowledge and approval of the Department, initiated a sub-rosa surveillance of the client. That involved an investigator who followed and videotaped the client and his family for months. Again, the purpose of the video was to try to catch the client engaged in something inconsistent with restrictions imposed because of work-related injuries. The video we reviewed showed that the investigator followed the client and his family around while they did mundane things like shop for groceries, visit Costco, purchase gas, work in and around their home, and even travel to San Diego while the client and his family celebrated his son’s birthday. In other words, they went to great lengths to ensure the client did not get the workers’ compensation or medical retirement benefits he was entitled to and to ensure that his career would end in ruin by pursuing a workers’ compensation fraud case against him.
Here, the investigator worked with the client’s Department, specifically Internal Affairs, to determine whether the client actually was unable to work or was just another fraud artist they needed to shame, charge and banish from their ranks.
Most thankfully, after our client went through hell, we extricated him from this mess. The client is happily retired but he endured far too much anxiety and uncertainty along the way. The moral of the story is if you are injured and file a claim, get a lawyer immediately.
Here, for example, had the client told the visitor that he would be happy to speak to him after his lawyer arrived, the interrogator would have had no choice but to discontinue his efforts to talk to the client because doing this with a represented party is not permitted under these circumstances. No experienced lawyer would permit such a conversation because, as it did here, it leads to more robust investigative activities and consequences. A trained lawyer would also have warned the client regarding the strong possibility that there likely was already a sub-rosa investigation, so it would be important to watch how he acted, moved and behaved when he was outside of his home. This client, who had suffered a series of objectively verified job-related injuries, didn’t even entertain the idea that his employer would permit an investigation to occur, let alone assist in the investigation to discredit his claims.
Today, retirements based on medical or psychological conditions are increasingly difficult to get, even under the most righteous circumstances. Do not travel this road alone at any point — retain counsel to assist you from the minute you file a workers’ compensation claim. Further, seeking and successfully obtaining an industrial disability retirement (IDR) also requires the help of a skilled specialist. Protect your career and financial future. Don’t let a work-related injury turn into a legal nightmare that, in turn, can become the fatal blow to a long career.
About the Author
Susan R. Jerich is a member of the Rains Lucia Stern St. Phalle & Silver Legal Defense of Peace Officers Practice Group. She represents officers in administrative investigations, disciplinary appeals, criminal investigations and prosecutions and Brady list appeals.