Questionable injury claims spur investigations at LA County Probation Dept.

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This is the first of two reports. Read Part Two here.

The probation officer’s first workers’ compensation claim stated that he hurt his hand restraining a minor in one of the county’s juvenile camps.  From there, the claims piled up: stress-related asthma, a hurt wrist from tripping on a curb, a shoulder strain from putting up a bulletin board, and a "contusion" from hitting his knee on a desk. All in all, in 24 years with the probation department, the employee worked just five of them.

KPCC reviewed hundreds of Probation Department workers’ compensation files from 2010-2012 and found dozens of questionable cases, including workers spending months away from the job after getting spider bites or tripping in parking lots, or falling out of chairs.

Chief Probation Officer Jerry Powers stresses that the vast majority of workers’ compensation claims are legitimate, but he has taken several steps to crack down on questionable injuries since taking office in 2011. Since then, the number of probation staff on disability has dropped by one third, Powers says.

Questionable workers’ compensation and disability claims, he says, were one of the first things the L.A. County Board of Supervisors asked him to tackle when he came to probation.

When Powers started on the job, 15 percent of the workforce--about 750 people--were out on workers’ compensation or reassigned due to on-the-job injuries, he says.

"It makes my blood boil"

"That’s incredibly high," says Powers. "It makes me crazy. It makes my blood boil when I hear some of these things."

One man received 165 days of leave after getting agitated with his boss, sitting down quickly, and "hitting buttocks," according to his disability claim. A woman took 137 days off after fighting with her boss over her cubicle. Another woman went on leave for 89 days when she experienced pain after pressing a  button.

Powers maintains the problem of fraudulent claims is "epidemic" in the department--although officials there say they don’t have hard numbers on the percentage of claims believed to be illegitimate.

The numerous mishaps involving chairs have left department managers exasperated.

"Risk management took the wheels off of the chairs at a lot of locations," says Cynthia Maluto, who oversees return to work efforts at probation.

Workers on long-term leaves have also raised eyebrows.

"I’ve looked up cases where the employee will be off a whole year, come back for one day and then go off another year and come back, file another claim, [and] could be off for two years," says Maluto. "And in the 20 years of service they probably worked three months."

The crackdown

To tackle the problem, the supervisors ordered Powers to use an investigative model first developed by the L.A. County Sheriff’s Department.

First, he beefed up the unit that investigates claims. He told the team to "start scrutinizing doctors’ notes, questioning restrictions and limitations and frankly, if necessary, videotaping staff doing things they say they can't," Powers recalls. 

"Before I got here, when employees were injured they could take cruises, they could come and go as they pleased," he says. "We put in a requirement they have to be home between 8 a.m. and 5 p.m."

Probation now has a dedicated team checking up on employees who are out on workers’ compensation and disability claims. The team makes home visits to make sure employees are there when they should be. It follows up on claims it considers questionable, and can mount challenges based on its investigations.

Most claims are legitimate

When KPCC examined the department’s workers’ compensation rolls, we found a wealth of what appeared to be serious injuries employees sustained in the course of carrying out their duties: head and neck injuries from on-the-job car accidents, broken bones from intervening in fights between minors at juvenile camps, and emotional stress after witnessing deaths.

Sue Cline, a steward in the probation officers’ union, says the work of a probation officer can be stressful and highly physical - and it’s not surprising that the vast majority of workers’ compensation claims appear to be legitimate.

"I think you have to look at the big picture instead of these isolated cases," Cline says. "But do I think every single person is legitimate? No. Just like every person who works at Yahoo and says they got a paper cut isn’t legitimate."

Los Angeles County says it doesn’t know how much fraudulent claims cost taxpayers, yet a single claim - legitimate or not - can run into the tens of thousands of dollars, says Alex Rossi of the L.A. County CEO’s office.

"They can be incredibly expensive," he says. At times, "things like pushing a button or a spider bite" transform into a "major injury" because the employee claimed to be experiencing "continuous trauma" or "psychiatric injuries."

A drop in claims

And, says Rossi, the number of claims skyrocketed after 2000, when probation officers became eligible for 4850--a law designed to counterbalance the risk of working in public safety with up to one year of full, tax-free salary while on workers’ compensation leave.

Union steward Cline says Powers’ move to crack down on workers who are faking injuries is more about politics than tackling a major departmental problem. Many workers stay out for long stretches simply waiting to get care within the slow-moving workers’ compensation system, Cline says.

"I see those cases more than I see the others," she adds.

But the probation department’s management sees qualified success in the crackdown-- Powers says since he took office, the number of employees out on workers' compensation has gone down by roughly one third, from about 750 to about 500. And he says the number of 4850 cases has dropped by 25 percent.

When it comes to gaming the system, probation chief Powers says one of his biggest problems is staff taking out separate private disability policies.

"Several times we’ve found employees who will falsify medical notes and send them to these insurance companies and tell them they are injured and off duty for months at a time," he says.

The problem, says Powers, is that "they are not off duty. They are drawing a paycheck at the same time they are collecting a check from these insurance companies. And some of these employees will have two, three, four separate policies."

This can be lucrative, with workers doubling or tripling their salaries, according to Powers.

"We know everyone who has those policies and we are working with the insurance companies to cross check those policies," he says.

That cooperation has resulted in the arrests of two probation workers for allegedly collecting disability checks while they were still on the job, Powers says.

"This isn’t just a probation problem," he asserts. "I would bet my house that if you were to go look at other city or county agencies…you will find others that are doing that."

Probation officials say they haven’t formally disciplined or tried to prosecute any employees for faking injuries. They say it’s extremely difficult to prove malingering, especially because some doctors back up workers’ stories.

Claims review

KPCC reviewed 1,179 cases of injuries and worker's compensation claims involving L.A. County Probation Department employees filed between 2010-2012. Here is a sampling that highlights some questionable compensation claims, as well as how tough working in probation can be. 

​57 cases of "stress" stemming from office spats to, in one case, the suicide of a juvenile in a probation camp:

  • ​​An employee was "upset with supervisor" because "cubicle taken away," resulting in 137 days off work. 
  • An employee said she "heard two men talk about her, [which] caused stress," so she took 7 days off work.
  • An employee was supervised by a lower ranking employee, causing "mental stress" that resulted in 180 days off work.
  • An employee suffered "mental stress after performing CPR on dying minor," resulting in 44 days off work. 
  • An employee took 6 days off after stress from "witnessing death of a minor."

271 slips, trips, and falls (excluding trips, slips, and falls that occurred while restraining a minor in a juvenile detention camp):

  • ​An employee "slipped on sand on asphalt, caused inflamed knee," resulting in 180 days off work.
  • An employee said "while lifting chair, it slipped and fell, hit employee," resulting in 161 days off work.
  • An employee took 20 days off work because air ducts had blown cold air on the employee’s shoulder.
  • An employee "slipped on computer cables and fell on floor," leading to 134 days off work. 

The majority of claims, 454 cases, involved handling minors:

  • An employee "bruised elbow and hips breaking up fight between minors," resulting in 3 days off work.
  • An employee was "kicked during physical fight" between 2 minors, ending in 180 days off work.
  • An employee took 3 days off after being "assaulted by minor and choked."
  • An employee took 26 days off after a "minor struck her in face, [and] she fell down."​

An overview: Top 10 Probation Department workers' comp complaints vs. Sheriff's Dept. complaints, 2009-2010*

Injury Description Probation Dept Sheriff's Dept
FALL ON FLOOR/PARKING LOT 13.70% 0.40%
PULL OR PUSH OBJECT(S) 13.34% 1.16%
ASSAULTED NEC 9.68% 1.11%
CAUGHT BETWEEN 2+ MOVING OBJ. 8.85% 0.05%
CONTACT/EXPOS. WORKSITE-INSIDE 6.61% 0.72%
LIFT/LOWER/CARRY OBJECT(S) 5.08% 5.77%
STRUCK BY FALL/SLIDE/MOVE OBJ. 4.84% 3.15%
INSUFFICIENT DATA TO CLASSIFY 4.72% 0.47%
STRUCK AGAINST STATIONARY OBJ. 3.19% 3.89%
RECOVERING FROM SLlP, LOSS BAL. 2.95% 2.75%

*As a percentage of all complaints in each department.  Data source: Los Angeles County Chief Executive Office

 

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