Workers Compensation Fraud By The Godfather What's Next



                       Peyman Heidary is a chiropractor known to call himself “The Godfather.”

Law enforcement authorities say Heidary is a crime boss beyond his alias, accusing him of masterminding one of the largest insurance fraud cases the Riverside County District Attorney’s Office has ever prosecuted.

Heidary, 44, of Riverside is charged with heading a criminal organization that established medical clinics in Riverside, Orange and Los Angeles counties and a law firm that submitted thousands of workers’ compensation claims for nonexistent or exaggerated injuries that billed insurance companies for at least $50 million, court records say.

Investigators from the Riverside County District Attorney’s Office and the State Fund had also been able to document a loss of $5 million to the State Fund as of July 23, court documents say.

District attorney spokesman John Hall said the amount that insurance companies actually paid to Heidary was less than $50 million.

The criminal complaint filed July 25 in Superior Court in Riverside lists Heidary’s aliases as Brian Heidary, The Godfather and Number One.

The District Attorney’s Office wouldn’t say how it learned of Heidary’s aliases, but a search of public records showed that Heidary indeed is the No. 1 person in many companies. He is listed as president of California Health Care Management in Corona, Anaheim and La Habra; The Best of California Promotions and Management in Corona, Fullerton and Orange; Heidary Chiropractic in Corona, Fullerton and Anaheim; Doctor’s Reports Inc. in Fullerton and La Habra; California Injury Lawyers in Corona; and California Lawyers Network in Industry.

Other records show Heidary as past managing member of Riverside Health Clinic, Corona Health Clinic and Santa Ana Health Clinic.

In Riverside, the Corona/Riverside Health Clinic on Riverwalk Parkway is shuttered. A notice from the landlord, to Riverside Health Care Management, orders the business to vacate. Delivery notices from UPS are stuck to the door.

Heidary is scheduled to be arraigned today in Superior Court in Riverside. Heidary and three of his employees have been charged with 22 counts each of making fraudulent claims for payment of a health care benefit in excess of $950.

Heidary and Cary David Abramowitz, 57, of Los Angeles were also charged with practicing medicine without certification. Heidary and Erica Torres, 31, of Riverside were charged with practicing law without a license. Heidary, Abramowitz, Torres, and Michael Angel Tuosto Jr., 62, of Long Beach all were charged with conspiracy to commit a crime. All charges are felonies.

Heidary is being held in lieu of $1.3 million bond. Abramowitz and Torres, who are scheduled to be arraigned Sept. 23, posted $50,000 bond and were released. Tuosto was being held in lieu of $50,000 bond and isto be arraigned today.

“Defendant is neither a medical doctor nor an attorney,” district attorney Senior Investigator William Hanley wrote in a court document. The medical clinics’ “main purpose is to milk money out of Workers’ Compensation Insurance Companies,” Hanley added.

The District Attorney’s Office investigated Heidary along with the State Fund and other state agencies, including the Franchise Tax Board, after State Fund investigators alerted the D.A.’s office to a suspected fraud, Hall said.

Who Overseas Workplace Injury Reports?

That would be the Minnesota Department of Labor and Industry, your go-to place for labor and employment law enforcement.  The department aims to ensure healthy and safe workplaces for Minnesota workers. It also oversees the state workers’ compensation program, through the Workers’ Compensation Division.

…and what can it do for you?

If you’re at the very beginning of the workers’ compensation claim process, you can get an overview of how the process works in Minnesota (http://www.doli.state.mn.us/WC/ClaimProcess.asp).  The DOLI website has a form repository, including a claim petition to be used in cases involving a deceased employee:  http://www.doli.state.mn.us/WC/PDF/cp03.pdf.  Note:  we recommend that you talk to your lawyer before filling in this petition, not after. I recommend contacting www.vanderlindelaw.com immediately.

If your claim for benefits is disputed but you want an alternative to trial, the DOLI can provide mediation services.  These services are both free and voluntary, so they can be a good option if you think there’s a chance of reaching an agreement with your employer. Again I recommend you have a trusted, knowledgeable attorney like Jim Vander Linden on your side 612-339-6841.

Following a claim for benefits, you may want information on vocational rehabilitation services to allow you to return to work:  http://www.doli.state.mn.us/WC/FaqVocRehab.asp.  These services are offered at all locations of the department, which are St. Paul, Duluth, Bemidji, Fergus Falls, Hibbing, Mankato, St. Cloud, and Rochester.

Due to its enforcement responsibilities, the department is the place to go if you have trouble with late payment checks for your workers’ compensation benefits.  Save documentation showing the late payments and send a request for review to the department at:
Minnesota Department of Labor and Industry
Workers’ Compensation Division
Compliance, Records and Training
443 Lafayette Road N.
St. Paul, MN  55155

If penalties are assessed by the department for late payments, those penalties are payable to you.
Finally, like any good website, the DOLI’s site provides a helpful FAQ:  http://www.doli.state.mn.us/WC/Faqs.asp.  The topics address what benefits you might be entitled to (wage-loss benefits, compensation for loss of use of a part of the body, medical benefits, vocational rehabilitation and retraining), whether you can be treated for a work-related injury by your own physician (yes, generally, with some exceptions), and whether you have to attend an independent medical examination (yes!).

Again, this entire process can be overwhelming and we want you to  be able to focus on getting better. In order receive the help you deserve please contact www.vanderlindenlaw.com to make sure you are collecting on all benefits that are due to you!

Injured At Work? Let Jim Vander Linden Help Call Today 612-339-6841!! How Common Is An Injury At Work?

Seven occupations had rates greater than 375 cases per 10,000 full-time workers: transit and intercity

bus drivers; police and sheriff’s patrol officers; correctional officers and jailers; firefighters; nursing assistants; laborers and freight, stock and material movers; and emergency medical technicians and paramedics. transit and intercity bus drivers; police and sheriff’s patrol officers; correctional officers and jailers; and firefighters. Laborers and freight, stock, and material movers had the highest number of days-away-from-work cases in 2012 with 63,690 cases (primarily in private industry). 

Private sector incidence rate for days-away-from-work cases decreased to 102 per 10,000 full-time

workers in 2012 from 105 in 2011. Despite the overall decrease, four occupational groups had increases in their incidence rates in 2012 including: computer and mathematical occupations; community and social service occupations; personal care and service occupations; and transportation and material moving occupations. The number of cases for these four broad occupation groups also increased. Transportation and material moving occupations had the highest incidence rate (258, up from 251 in 2011) of all occupation groups.

Transit and intercity bus drivers had an incidence rate of 852 cases per 10,000 full-time workers for

all ownerships. The majority of injuries and illnesses to bus drivers occurred in local government

with a rate of 1,026—statistically unchanged from the previous year. For private sector bus drivers, the incidence rate increased to 417 from 342 in 2011. Three other occupations with high rates and at least 0.1 percent of full-time equivalent employment occurred primarily in local government or state government: police and sheriff’s patrol officers; correctional officers; and fire fighters.

• Musculoskeletal disorder cases (388,060) accounted for 34 percent of all injury and illness

cases in 2012. Both the incidence rate and case count remained unchanged from the

previous year; however the median days away from work increased by 1 day to a median of 12 days.

Laborer and freight, stock, and material movers had the highest number of MSD cases and an

incidence rate of 164 per 10,000 full-time workers—up from 140 in 2011.

Occupation
 

Seven occupations had rates greater than 375 cases per 10,000 full-time workers: transit and intercity

bus drivers; police and sheriff’s patrol officers; correctional officers and jailers; firefighters; nursing

assistants; laborers and freight, stock and material movers; and emergency medical technicians and

paramedics. Injuries and illnesses to four of the seven occupations occurred primarily to state and local government workers: transit and intercity bus drivers; police and sheriff’s patrol officers; correctional officers and jailers; and firefighters. Laborers and freight, stock, and material movers had the highest number of days-away-from-work cases in 2012 with 63,690 cases (primarily in private industry) and an incidence rate of 391 (up from 367 in 2011).Only occupations that had at least 0.1 percent of full time employment are included in the list of high rate occupations.

For all occupations, the incidence rate for the public sector was over 71 percent higher than in the

private sector. The public sector rates were more than two times greater than private sector rates for

laborers, freight, and material movers, janitors and cleaners, and landscaping and grounds keeping. 

Laborers and freight, stock, and material movers, hand 63,690 10 Overexertion and bodily reaction (44%),

Contact with object or equipment (33%)
Nursing assistants 44,100 6 Overexertion and bodily reaction (55%),

Falls, slips, trips (18%)

Heavy and tractor-trailer truck drivers 41,840 18 Overexertion and bodily reaction (36%),

Falls, slips, trips (29%)

Janitors and cleaners, except maids and

housekeepers 38,610 11 Overexertion and bodily reaction (41%),

Falls, slips, trips (30%)

Police and sheriff's patrol officers 32,190

Violence and other injuries by persons or

animals (27%), Transportation incidents

(20%), Overexertion and bodily reaction

(20%), Falls, slips, trips (20%)

 

 

What Type of Injuries Qualify For Workmans Compensation??



If you are seeking workers' compensation benefits, you will have to show that your injury or illness is work-related. Usually, if you were doing something for the benefit of your employer, and you were injured or became ill as a result, then your injury or illness is work-related and you can receive benefits as long as you meet the other eligibility requirements.

Although the "work-related" requirement seems simple, it can get tricky. Some common situations are covered below. If your injury or illness falls into a gray area, you may want to consult with an attorney to find out whether you will be eligible for benefits.

Lunch Breaks

Typically, injuries or illnesses that happen on an employee's lunch break are not covered under workers' compensation. For example, if you sprained your ankle while walking into a deli to pick up your lunch (or lunch for your coworkers), then you probably cannot claim workers' compensation for that injury. However, if you were also picking up lunch for your boss, then the injury might be covered. If you sprained your ankle in a cafeteria on the company's premises, then your injury might be covered by workers' comp.

Company Events

Many companies sponsor special events like parties, picnics, or baseball games -- and injuries sustained at these events are usually covered by workers' compensation. For example, let's say To drinks too much wine at the company anniversary party and decides to twirl his coworker Kari above his head while they are dancing. Unfortunately, he drops Kari, and they both fall. Kari breaks her arm, and Tom suffers a  strained neck. Both injuries are probably covered by workers' compensation.

Travel

If you are injured on your commute to or from work, your injury probably isn't covered by workers' compensation. However, there are sometimes when injuries during travel are covered. For example, if you are traveling for work, but not to your fixed work site (on a business trip, for example), then your injuries will probably be covered. If you are a traveling salesperson with no regular work site, then injuries you sustain while driving to meet with a customer will probably be covered. Or, if you are injured during your regular commute but are driving a company vehicle, then your injuries will probably be covered.

Misconduct

If you were injured while breaking a workplace safety rule or while doing something else that your employer has prohibited (even a criminal act), your injury may still be covered by workers' compensation, depending on the level of your misconduct. This is part of the workers' compensation bargain: Employees do not have the right to sue their employer for work-related injuries, but those injuries are usually covered by workers' compensation, regardless of fault.

As an example of how injuries that stem from misconduct are usually still covered under workers' compensation, let's say Ann and Lee work on the assembly line at Widget World. One day, they decide to play catch with a two-pound metal ball that is part of the machinery. This is a direct violation of a safety rule, which prohibits playing with the equipment. While Ann is attempting to catch the ball, it slips through her hands and hits her in the head, knocking her unconscious and causing a minor brain injury. Her injury could still be covered by workers' compensation, even though she was violating a work rule when she got hurt, especially if the employer knew this type of horseplay occurred and condoned it.
There are some exceptions to this general rule. For example, if your injuries were self-inflicted, then they might not be covered.

Preexisting Conditions

If you have a preexisting condition, and your job aggravates or exacerbates it in a way that results in an injury or illness, then the injury is probably covered by workers' compensation. For example, when Bill was 30, a disc in his back ruptured. The injury resolved itself within six months and has not bothered him since. He is now 45 and works in a department store. One day, he ruptures the same disc while lifting a heavy object off a shelf. Although his job did not cause his initial injury, it certainly caused it to reoccur. The injury is now covered by workers' compensation.

Hearing Loss

People who work in noisy environments -- such as construction sites or manufacturing plants -- often suffer hearing loss over time. Unless there is some other obvious reason for the impairment, this injury is usually covered by workers' compensation.

Mental Conditions

Mental conditions that are job-related are covered by workers' compensation. For example, if you are traumatized by witnessing another employee injured or killed on the job, your trauma is compensable by workers' comp. Conditions caused by a stressful workplace environment can also be compensable. In addition, if you become depressed because you have suffered from a workplace injury, that depression is covered by workers' compensation.
Be warned, however, that it can be hard to prove that the mental condition actually exists and that it was caused by workplace events. This is a situation in which a consultation with a lawyer can help you decide how to proceed.

Diseases and Illnesses

If you have a disease or illness resulting from your work, then you are entitled to workers' compensation. For example, workers suffering from asbestosis, which is a disease caused by exposure to asbestos, can receive workers' compensation benefits, as can workers suffering from black lung disease, which is caused by inhaling coal dust. Except in the case of recognized environmental illnesses like these, however, it can be difficult to prove that a disease is work-related and not something that would have happened anyway.