Back on February 8, a Yolo County Jury convicted Linda Vela of 12 felony counts of insurance fraud, including three counts of Presenting a False Statement concerning payments from an insurance policy that she received from Liberty Mutual Insurance, through which Ms. Vela had a long-term disability policy.
According to the Yolo County District Attorney, Ms. Vela went out on disability and was diagnosed with bi-lateral carpal tunnel syndrome. She had surgery on her right wrist in June of 2004, which by all objective signs was successful.
Ms. Vela, however, complained that she was still in pain after the surgery and that she could not go back to work despite the surgeon’s recommendation that she could return to work. Her physician kept her off work as “totally disabled,” based on Vela’s stated complaints of pain, and her reported inability to use her hands.
As a result, the district attorney argued, Ms. Vela received Worker’s Compensation Benefits from McClatchy Newspapers, the parent company of the Sacramento Bee, as well as payments from Liberty Mutual Insurance Company, through which Ms. Vela had a long-term disability policy, and was able to receive 70% of her pre-disability salary, tax free.
In two articles in February (February 14 and February 19), we noted this was simply a case of the District Attorney’s office doing the bidding for Liberty Mutual Insurance to overcharge Ms. Vela who was clearly injured, impaired and unable to perform her duties.
As Public Defender Ron Johnson would argue in his closing statement, the victim in this case worked for the Sacramento Bee for 25 years, she worked hard, she was great employee, but when she went out on leave because the pressure to perform in this job became too great and she began to break down physically, the Sacramento Bee began pointing the fingers of fraud.
Despite charging her with 12 felony counts, even Deputy DA Steve Mount last Friday argued that this was not a case for jail.
Judge Mock agreed, granting probation, and asked the defense to return for a plan for 90 days of community service.
There was some concern by both Judge Mock and Deputy DA Mount that Ms. Vela might be unable to perform such service.
According to the pre-sentencing report from the Yolo County Probation Department, “While the defendant suffered a legitimate worker’s compensation injury, which ultimately resulted in surgery being performed on her right wrist, her embellishment after she became permanent and stationary caused her employer to pay out approximately $18,000 in worker’s compensation benefits, and Liberty Mutual approximately $28,000, which the defendant was not entitled to receive.”
Liberty Mutual is requesting roughly $35,500 which includes $31,000 in benefit payments and the rest for investigative costs.
The Probation report notes: “At the age of 58 the defendant is receiving Social Security and disability benefits. She suffers several physical and mental health conditions, for which she is being treated.”
They write: “Based on aforementioned, it appears she has the ability to comply with reasonable terms of probation but paying restitution may be problematic.”
The probation report adds: “Upon consideration of the aforementioned criteria, the defendant appears to be suitable for probation in that this matter represents her first felony conviction, she has expressed willingness to comply with probation, and appears to have the ability to do so.”
They suggest a jail term of 90 days, but based on medical limitations, they recommend either electronic monitoring or community.
Public Defender Ron Johnson argued that, given the fact that these conditions were not manufactured but rather embellished or exaggerated, the charges should be reduced to a misdemeanor. But Judge Mock declined that motion.
Our continued position on this case is that this has been a large waste of time and public resources, apparently done at the behest of a large insurance company with noted assets that they could have utilized to achieve largely the same outcome civilly through a repayment for an overpayment of benefits – which is essentially what this ruling amounts to.
The Vanguard continues to examine grant funding as a rationale for the prosecution of this case. Recently the District Attorney’s office provided the Vanguard with approximately 310 pages of records dealing with fraud enforcement grants through a public records act request.
Due to the continued delays of the Yolo County Counsel’s office who sat on the check from the Vanguard for nearly a month, the Vanguard only received these documents on Wednesday of this week and has yet to have the opportunity to analyze them.
As the Vanguard noted in February, Liberty Mutual is the 82nd company on the Fortune 500 list in 2011, with annual revenue of more than $33 billion in 2011.
From the standpoint of Liberty Mutual, there are some advantages to proceeding criminally if a prosecutor is willing to prosecute a case in which the defendant was clearly injured and hurting, even though they may have been overpaid.
Those we asked declined to go on the record but suggested it was more likely that one could be convicted of fraud rather than prevailing civilly, moreover, restitution payments are enforced, at least technically, under the threat of jail, where there would be no such consequence for failure to pay a civil judgment.
Nevertheless, the fact is that the Sacramento District Attorney’s Office who would have had immediate jurisdiction, declined to file criminal charges, and the question many should ask is whether the Yolo County DA should have.
As the probation department notes, there is “no victim vulnerability from the McClatchy Company and Liberty Mutual,” no prior felony criminal record, she is not “an immediate danger to others if not imprisoned” and there is virtually no chance that she would commit a repeated offense.
So Liberty Mutual gets repaid on the public dime, and little else.
—David M. Greenwald reporting
[quote]In two articles in February (February 14 and February 19), we noted this was simply a case of the District Attorney’s office doing the bidding for Liberty Mutual Insurance to overcharge Ms. Vela who was clearly injured, impaired and unable to perform her duties.[/quote]
That is merely the Vanguard’s OPINION. In fact, the judge did not agree…
[quote]Our continued position on this case is that this has been a large waste of time and public resources, apparently done at the behest of a large insurance company with noted assets that they could have utilized to achieve largely the same outcome civilly through a repayment for an overpayment of benefits – which is essentially what this ruling amounts to.[/quote]
Again, that is the Vanguard’s opinion, and not one shared by the judge. Often cases are tried and sentences handed down as a DETERRENT…
That’s why it says “our continued position” rather than “Judge Mock’s” opinion.
The notion of deterrence here is ludicrous. It assumes that she consciously knew she was breaking the law and that this case will be sufficiently publicized to reach a future would-be “law breaker” and the sentence is significantly severe to deter their behavior – I don’t see how you can sustain a deterrence claim in a case like this.
[quote]The notion of deterrence here is ludicrous. It assumes that she consciously knew she was breaking the law and that this case will be sufficiently publicized to reach a future would-be “law breaker” and the sentence is significantly severe to deter their behavior – I don’t see how you can sustain a deterrence claim in a case like this.[/quote]
You are assuming the defendant did not consciously know she was breaking the law; again the judge disagrees with your assessment of this defendant…
“You are assuming the defendant did not consciously know she was breaking the law”
I am based on attendance in the court trial and my conversations
“again the judge disagrees with your assessment of this defendant…”
I’m not sure that the judge ruled on that point
This is a sad case of a person who broke the law. So many people cheat in the same ways that the state has come up with a program that leads to more investigating and prosecuting this kind of felony fraud.
The objective of emphasizing enforcement is to deter others from crimes that cost all of us incredible amounts of money.
For too long, medical insurance and workers comp fraud has been viewed as an easy way to take advantage of the system. Many individuals and doctors involved in this kind of fraud get away it because of the difficulty of proving intent and because of the subjective nature of individual evaluations.
Regardless of the reasons Ms. Vela chose to break the law–and whether she “embellished or exaggerated” her problems rather than completely made them up–she’s guilty of 12 felony counts of insurance fraud, including three counts of Presenting a False Statement.
As in all cases, the prosecutor is representing “the people,” not any particular, “rich” company.[quote]“Her physician kept her off work as “totally disabled,” based on Vela’s stated complaints of pain, and her reported inability to use her hands.”[/quote] This is not accurate. One’s own doctor (or even a physician who “specializes” in cranking out disability claim documents) has no power to “keep her off work as ‘totally disabled’.” Basing recommendations on a patient’s “stated complaints” is problematic rather than definitive, of course, with other physicians in disagreement working with the same patient and complaints.
All of the issues which give you such heartburn were thoroughly hashed out in February the [i]Vanguard[/i] articles. One new item is the leniency supported by all parties, including the prosecutor. The fact that the judge refused to reduce the charges suggests there’s no doubt about the significance of the crime and the appropriateness and legitimacy of the prosecution.
Now, you’re pissed that the “county counsel…sat on the check” for nearly a month. We already know of your “cash for convictions” obsession, however, what do you expect to find from this records request package of 310 pages?
I guess since you already “know” the DA’s motive for prosecuting, it isn’t a big leap for you to conclude that those charged are innocent and that he’s wasting our tax money by pursuing them.
Your charges of “cash for convictions” have been based on the fact that the state has special emphasis programs (gang, insurance fraud, etc.) and that the Yolo County DA coincidently gets convictions of people who have committed these kinds of crimes. What does your null hypothesis training tell you about this approach to looking at something? [quote]“Those we asked declined to go on the record but suggested it was more likely that one could be convicted of fraud rather than prevailing civilly….”[/quote]Why would “those” decline to go on the record? How many gave you this opinion? Were they law school professors, deputy DAs, Ms. Vela’s defense attorneys, someone in line at Murder Burger, just made up for convenience? Please give us [u]something[/u] with which to judge the value of such evaluations when you toss them into the discussion.
What’s your recommendation for future fraud cases after following this one so closely?
Should the DA stop investigating and prosecuting worker comp/medical insurance fraud allegations for all the reasons you’ve listed–because rich corporations are the “victims,” because the state encourages action and provides funds to county offices, because some perpetrators are sympathetic and ill?
FYI, vulnerability is a [Rule of Court 4.421 – If I recall correctly] consideration i.e., circumstance(s) in aggravation.
The insurance company is a victim regardless of the presense of such an aggravating factor. Hence, under Art. 1 Sec 28, of the CA Constitution and PC 1202.4, the victim has very specific rights.
If the business sought civil litigation it would require attorneys to be retained/paid. Whereas; a criminal case does not.
The person who declared the following, convoluted ‘Suggestion’ does NOT seem to grasp the issues at hand:
[quote]Those we asked declined to go on the record but suggested it was more likely that one could be convicted of fraud rather than prevailing civilly, moreover, restitution payments are enforced, at least technically, under the threat of jail, where there would be no such consequence for failure to pay a civil judgment.[/quote]
For starters:
Er, different standards of proof.
Uh, threat of jail? Serious stretch…
See Peo. v. Covington [If my memory serves me]
BTW a defendant’s ability to pay restituition is not a consideration for judges when sentencing. In general, restitution is meant to make victims whole.
Perhaps Ms Vela didn’t know she was breaking the law – this enforcement action, and lots of press about it will help spread the word. And the victims of this type of crime are not the insurance companies, it is the rate payers. The insurance company simply raises its rates against the honest, truthful group so that it can make up for losses on the dishonest group. Enforcement actions like this actually contribute to lower, more affordable insurance rates for everyone, something that everyone can be very happy about. I appreciate the Yolo DA for following up on a thankless case.
Elaine, Why is it that you have such a nasty tone with the Vanguard because he disagrees with Judge Mock or anyone for that matter? I often wonder why people can’t simply express their views without getting so bent out of shape. Why comment if it gets you that irate?
David, I hate to see the YOLO DA waste county dollars on non-Yolo issues. Community service could have been decided some time ago without adding to her stress level. Thank you for reporting on this.
Anne, don’t worry. David and Elaine have an interesting and special relationship that plays out every time he writes something like this. They both sound nasty, but they really aren’t doing anything but chatting about the law.
First, he writes up something that stretches things beyond reasonableness. Then, she explains why his reasoning is faulty or how he’s misapplying the law. Then, he calls her comments “ludicrous” and explains why her view doesn’t make a lick of sense. It’s kind of sweet, nothing nasty.
They go back and forth for awhile, then one of the rest of us has to step in and provide a rational accounting in a effort to satisfy both of them. You’ll get used to it.
P.S.–Eventually David will correct your misunderstanding about this case being a “non-Yolo” issue. The Yolo DA has this case because Ms. Vela resides in Yolo County and was committing crimes in this jurisdiction.
You’re right that it’s too bad that the prosecution and defense couldn’t have come to agreement without a trial–but, of course, it takes two,
[quote]“You are assuming the defendant did not consciously know she was breaking the law”
I am based on attendance in the court trial and my conversations
“again the judge disagrees with your assessment of this defendant…”
I’m not sure that the judge ruled on that point[/quote]
The judge ruled she was guilty on several counts, no?
[quote]Elaine, Why is it that you have such a nasty tone with the Vanguard because he disagrees with Judge Mock or anyone for that matter? I often wonder why people can’t simply express their views without getting so bent out of shape. Why comment if it gets you that irate? [/quote]
1) Disagreeing with dmg is “nasty”? Please explain what words I have used that indicate I am being “nasty”. I have reread my comments several times, and cannot find anything that remotely approaches “nasty”.
2) When dmg misapplies the law, as a lawyer I feel obliged to correct him. I don’t want the public to misunderstand the law. The law can be extremely complicated and nuanced, and it is easy to misunderstand by the layperson, even one sitting in the courtroom. I know, bc I came into the practice of law late in life, after I had my own unpleasant experiences with the justice system.
3) It is clear dmg has a heavy bias in favor of defendants and against law enforcement, including the DA’s office. That bias frequently shows in the tortured logic he uses to come to some of the absurd conclusions he does.
Elaine: The jury ruled that she was guilty.
[quote]“It is clear dmg has a heavy bias in favor of defendants and against law enforcement, including the DA’s office. That bias frequently shows in the tortured logic he uses to come to some of the absurd conclusions he does.”[/quote]I’m not sure you’re accurate here, Elaine. We’ll see how he deals with the “defendants” in the pepper-spray case. If he reveals any bias in favor of the alleged sprayers here, someone should be jumping all over him.
I think Anne meant to refer to more than just this particular story, since David obviously took the more nasty approach this time. I tried to reassure her that the strong language you two use is just an expression of your love and respect for each other and the views you hold.
Speaking of “tortured,” did you notice these odd comments (odd when juxtaposed, anyway):[quote]“As the probation department notes…there is virtually no chance that she would commit a repeated offense,” and “The notion of deterrence here is ludicrous….assumes that she consciously knew she was breaking the law….”[/quote]Guaranteed that at least two people will be deterred by this prosecution (Ms. Vela and me, and, one would think, lots of people who hear that this kind of fraud won’t be ignored in Yolo County any more).
I understand the need for “tortured logic” when supporting someone guilty of a dozen felony counts over an extended period when the person is such a sympathetic figure.
Ms. Vela’s physical and mental health issues make this a terribly sad situation compared to, say, Madoff’s role as a criminal. And I think it’s very appropriate to for David to care about her plight. I also think his interview was an interesting story that provided valuable insight about how she fell into the illegal acts.
What bothers me about David’s view of this world is that he won’t consider the alternative. For example: [quote]“Should the DA stop investigating and prosecuting worker comp/medical insurance fraud allegations for all the reasons you’ve listed–because rich corporations are the “victims,” because the state encourages action and provides funds to county offices, because some perpetrators are sympathetic and ill?”[/quote]
[quote]Elaine: The jury ruled that she was guilty.[/quote]
And the judge sentenced her, no?
[quote] I tried to reassure her that the strong language you two use is just an expression of your love and respect for each other and the views you hold. [/quote]
LOL Right you are!
[quote]What bothers me about David’s view of this world is that he won’t consider the alternative. [/quote]
What bothers me about David’s view of this world is that he seems to believe anything a defendant tells him. This woman does not strike me as a particularly sympathetic character. As I said many times before, she failed to make any efforts to work things out with her employer. It appears she made decisions unilaterally on her own, and d_mn the consequences. But when collecting pay for not working, one doesn’t get to make those types of decisions on one’s own…
[quote]Just Saying: Speaking of “tortured,” did you notice these odd comments (odd when juxtaposed, anyway):
dmg: “As the probation department notes…there is virtually no chance that she would commit a repeated offense,” and “The notion of deterrence here is ludicrous….assumes that she consciously knew she was breaking the law….”[/quote]
Yes, I did notice. This is just the sort of tortured logic I am talking about. It makes no sense…
It appears that 12 individuals unanimously found, beyond a reasonable doubt, that Vela committed insurance fraud. If the Judge believed the jury found incorrectly, then he could have rejected the verdict, and granted a new trial. Vela was represented by counsel.
Under the circumstances, it seems like the Vanguard is continuing to repeat an argument that Vela’s attorney already made, an argument that obviously was rejected by the jury.
Restitution is a commonly ordered remedy in criminal courts. Why should anyone be dismayed that Vela has been ordered to repay the money she stole?
Elaine: The judge sentenced her based on the jury’s verdict and the law with regards to such sentences.
“What bothers me about David’s view of this world is that he seems to believe anything a defendant tells him”
You seem to forget I watched the entire trial. I don’t always believe defendants, there are many times I don’t. In this case, it is more than simply do I believe the defendant, it’s also a matter that essentially the punishment was that she has to repay what the probation department determines she owes, well if that’s the case, what was the point of this exercise? Probably could have had that result four or five years ago.
“If the Judge believed the jury found incorrectly, then he could have rejected the verdict, and granted a new trial.”
I think the jury based on the law and the evidence they had before them did what they had to do, my problem was the decision to try this as a criminal matter.
To dmg: Yes, we know, you never saw a defendant you didn’t sympathize with. But not all of us believe such behavior should be allowed to flourish. Ultimately, when employees are permitted to get away with this sort of thing, not taking any effort to work things out w their employer, unilaterally taking the matter into their own hands, who do you think pays for that? Not the insurance company, not the employer – but the ratepayers/other employees. Why should fellow employees have to pay for this woman’s disability, when she refused to work something out with her employer? It is possible she could have typed on her computer through speech recognition software, not using her hands at all. Did she suggest that as a possible solution? The responsibility is ON HER to come to the employer with a request for a reasonable accommodation…
[quote]“I think the jury based on the law and the evidence they had before them did what they had to do, my problem was the decision to try this as a criminal matter.”[/quote]I know that’s your problem (since it’s almost impossible for a jury to do something else with a guilty person). But, please give this just a little thought (third request):[quote]“Should the DA stop investigating and prosecuting worker comp/medical insurance fraud allegations for all the reasons you’ve listed–because rich corporations are the “victims,” because the state encourages action and provides funds to county offices, because some perpetrators are sympathetic and ill?”[/quote]Deciding not to treat a criminal as a criminal suggests you have some alternatives. What are they and why should the criminal justice system take that step with sympathetic people who commit felony crimes?
In spite of Elaine’s hard line on this one, I think anyone who pleads that mental illness contributed to her criminal decision (if the act is not violent), should get shipped over to the county health dept. lock-up. But, I think you must have some other options in mind for these folks you suggest shouldn’t find themselves in “criminal matters.”
To JustSaying: What I have suggested, that this defendant should have taken the trouble to ask for a reasonable accommodation, is not a “hard line” as you suggest. It is the LAW!
You’re right, Elaine. I’d overlooked her responsibility and the company’s to deal with reasonable accommodation. While Ms. Vela might not have been up on all the requirements, I’d think her employer would have make it clear throughout the period under dispute.
I’m also astounded that her doctor wouldn’t have advised her correctly. I wonder how he possibly have done what he testified to: [quote]“Her physician kept her off work as “totally disabled,” based on Vela’s stated complaints of pain, and her reported inability to use her hands.”[/quote] I guess this convenient memory was helped along by her defense attorney, but at the risk of admitting to malpractice?
Are there any Black or Latino judges in Yolo County? And by Black or Latino, I do not mean an [i]Uncle Tom[/i] or a [i]Tío Taco[/i].
1: Uncle Tom: a black who is overeager to win the approval of whites by obsequious behavior or uncritical acceptance of white values and goals.
1: Tío Taco: Mexican-American equivalent of an Uncle Tom; a sellout to the Gabachos (whites).
There are not any judges of color in Yolo County.
For a county that reported a 30.3% Latino population in the 2010 Census, the absence of a single judge of color should raise questions in the minds of its residents and legal practitioners. Similarly, I would be concerned if the Yolo County DA’s and the PD’s offices lacked a lawyer of color.
This gross underrepresentation is more troubling if one considers that Yolo’s immigrant and mixed Mexican (or Mexican American) with white populations, likely bring the reported 30.3% Latino population closer to 40% or more.
Imagine if this underrepresentation were reversed. Would this prosecution and conviction be about a Ms. Vela or a Ms. Smith?
David, here I’d guessed that you and Don had long ago left this story behind. Now, we’ve got your response to GorillaPatriot three minutes after he posted. And, Don didn’t decide to censor his offensive post.
I hope you’ll find time to consider my question:[quote]“Should the DA stop investigating and prosecuting worker comp/medical insurance fraud allegations for all the reasons you’ve listed–because rich corporations are the “victims,” because the state encourages action and provides funds to county offices, because some perpetrators are sympathetic and ill?”[/quote]
You do understand I get email notices for every comment posted. I don’t believe that Don does however.
In terms of your question, I’m not blanketly opposed to the DA investigating and prosecuting insurance fraud allegations. I find it interesting that you say for “all the reasons” I’ve listed but then fail to list some of the critical reasons why I think it was inappropriate in this case. In this case, I really believe it was a gray area – a subjective determination as to whether she was really embellishing, whether there was miscommunication, whether she got more than she really deserved.
What we know is that she was actually hurt, even now the judge in weighing appropriate alternative sentencing suggested that she could not use her hands for community service, so that it is an acknowledgment that she was indeed hurt, the question how hurt is largely subjective. To me repayment would have been more appropriate and its essentially what is happening in this case anyway.
Which of my statements do you find offensive, Just Saying? Political correctness is not my strong suit.
But while we are on the topic of[i] offensiveness[/i], some might find it offensive or even disingenuous to discuss a criminal case while ignoring the elephant in the room. Here, the big elephant is a local criminal justice system that is flawed. It is flawed because it deems itself fair when nearly half its population is underrepresented by those with the awesome power of administrating justice.
Now, with the “race card” (as bigots like to call our white privileged reality) out of the bag, there could be sound reasons why one DA’s office decides to go forward on a (bogus) charge and another does not. But one need not make a logical leap to infer that when the interests of a billion dollar corporation are being represented on taxpayer dollars, that corporation’s grants to the local DA’s office might have something to do with it.
Or maybe, the Yolo DA’s office just enjoys launching a missile to kill a mouse.
GorillaPatriot, 1 just thought we were past using such derogatory, racial terms about people. Guess not in the [i]Vanguard[/i].