Bill Moves Ahead To Slow Down Workers' Comp Surveillance!


DENVER - State lawmakers voted 6-5 Thursday evening for a bill that would make it more difficult for insurance companies to do surveillance on workers they think are faking injuries or filing bogus workers' compensation claims.

Two Democrats on the House Judiciary Committee voted for the bill so the entire Colorado House could vote on it, even though they had serious concerns it would impact the criminal justice system.

Under the bill, insurance companies could start surveillance at any time, but the worker would have a right to ask for a hearing to learn why they were being watched. If the insurer can not justify their surveillance reasons to a judge, they could be fined $1,000 a day and would not be allowed to use the video in any claim or negotiations with the worker.

Currently, insurance companies can follow or watch any worker that they suspect of faking their injuries or working while receiving benefits, called double-dipping, without providing any official a reason.

More than 50 people packed the House Judiciary Committee hearing room to tell their stories about how surveillance either helped catch con artists or bothered them.

Most insurance companies and private investigators are against the legislation.

"This isn't just a Pinnacol [Assurance] issue. There are a lot of other self insurers in Colorado that will be negatively impacted by this bill," said Patty Lell of the Colorado Self Insurers Association. "It will definitely limit the use of our surveillance."

Lell says she is worried that small insurers could be fined $1,000 a day if they cannot prove to a judge probable cause or a reasonable basis to follow a worker who has filed a worker's compensation claim. She says that cost would be passed on to taxpayers.

Dozens of workers told lawmakers they were severely injured yet still followed for days, months and years after they filed claims with Pinnacol.

"They terrorized me for two years and they made me feel like a criminal," said Tammy Mathias, who suffered a brain injury after she was walking on a road and hit by a semi truck in September 2001. "You can't fake being hit by a truck. I want people to see that Pinnacol is wasting money, your time and tax dollars every day by being allowed to harass people."

Mathias claims her attorney had to file a cease and desist order against Pinnacol to stop investigators from following her.

Mark Simon, whose pelvis was crushed after a mobile home fell on top of him in 1985, says a year after he returned home from the hospital, he noticed a private investigator watching him with binoculars, peering into his living room.

"When I picked up my hunting rifle and started looking at him through the scope, he suddenly dropped his camera and quickly drove away," said Simon, who supports the bill.

The Colorado Attorney General's office believes the use of surveillance deters fraud and says the video evidence resolves many of their cases against people who have been charged with committing fraud.

In 2009, the Attorney General's office convicted 12 workers for theft or workers compensation fraud. In 2008, 24 people were convicted and in 2007, 22 workers were either found guilty or pled guilty to fraud-related charges. In three years, those workers have been ordered to repay the state $691,000, which includes some of the cost of the surveillance.

The Attorney General's office only has one dedicated prosecutor to handle all of the workers' compensation cases in the state.

"We believe if this bill is to pass, it will result in a lot more fraud occurring in our community with resulting losses to taxpayers and business owners," Assistant Attorney General David Cosson said. "A video doesn't lie. In the cases I've prosecuted, it provides indisputable evidence for the court and the jury that a crime has been committed. It is very often the key evidence in a criminal fraud case."

Cosson says in two-thirds of the cases where he has obtained convictions, video surveillance has been the key or deciding factor in obtaining a conviction.

Pinnacol had 54,751 claims of injuries on the job in 2008 and decided to put 2,600 of them under surveillance.

Insurance companies say there is no way to determine how much fraud is deterred or how much money is save by their anti-fraud efforts.

"It will have a chilling effect on investigations, allow fraud to go undetected and raise the cost for Colorado employers," said Shari Lee Leonard, special investigations unit director for Pinnacol. "Surveillance is a tool that is utilized to find facts about a case. It is not something we take lightly or assign out unnecessarily without reason and it is always in public places."

Rep. Sal Pace (D-Pueblo), who introduced the legislation, amended the bill to take out the need for an expedited hearing in order to remove the price tag for the bill.

The legislation now goes to the Appropriations Committee which will study the bill for fiscal purposes. If it is voted out of that committee, the bill goes before the full house for a vote, according to Pace.

 


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