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Prepared by
Thomas J. McBirnie
August 2001
On November 28, 2000, the Commission on Health and Safety and Workers Compensation (Commission) issued a "call for information" regarding the states ongoing program against workers compensation fraud. The call asked that the workers compensation community and interested members of the public respond concerning the six issues discussed below. Subsequently, written responses were received from several sources, ranging across a wide spectrum of opinion. In addition, Commission staff was able to speak informally with many of the principal participants in the anti-fraud program and also attended meetings of the Fraud Assessment Commission. At one of those meetings, district attorneys from around the state discussed many of the issues surrounding the program including priorities, funding, resource needs, problems and proposed solutions.
Following receipt of this input, roundtable discussions were held in San Francisco on April 10, 2001, and June 26, 2001. Public interest in the topic exceeded expectations, as 38 people attended the first roundtable and 40 attended the second. Despite the large number of people participating in these roundtables, the discussions were thoughtful, detailed and informative. Many recommendations in this report are an outgrowth of those discussions. While there were opposing opinions and continuing disagreements on some of the core issues, there was general support for many of the ideas expressed.
The following is a discussion of some of the information and comments received on the six issues raised.
Is workers compensation fraud a major problem?
There is no generally accepted method or standard for measuring the extent of workers compensation fraud in California. As a consequence, there are widely divergent opinions about the size of the problem and the relative importance of the issue. In part, the problem is one of how broadly or narrowly "fraud" is defined. For example, should employers who are illegally uninsured for workers compensation be considered part of the fraud problem? Should physicians who show a pattern of excessive treatment of work injuries be considered part of the fraud problem? Should insurers and self-insured employers who are repeatedly found to have failed to pay the full amount of benefits owed be considered fraudulent? Most importantly, should the estimated amount of "undiscovered" fraud be included in the calculation? It is difficult to find agreed answers to these questions.
Those who describe fraud broadly and believe that a sizable amount of fraud goes unreported claim that workers compensation fraud is a major problem. For example, the Los Angeles District Attorney (LA DA) cites a 1993 "Little Hoover Commission" report that reportedly concluded that (1) 30% of system costs, or $3 billion a year, are wasted in fraud, (2) 20% to 30% of employee claims are fraudulent, and (3) businesses are twice as likely to commit fraud than are injured workers. On the other hand, those who doubt that fraud is that prevalent or substantial point to the relatively small number of cases in which it is prosecuted. In that regard, California Applicants Attorneys Association (CAAA) refers to statistics indicating that in 1998, there were 358 fraud arrests, three-quarters of which were injured workers, and that amounted to "less than one-tenth of 1% of claims."
In addition, CAAA has submitted a 1998 article prepared by the Labor Research Association that refers to a 1997 study by the Wisconsin Division of Workers Compensation which concluded that, "There is no evidence that criminally prosecutable fraud is more than one percent of all reported claims in Wisconsin, a far cry from the 20-30% estimates thrown about elsewhere." The Labor Research Association article concluded by stating:
"The presumption of widespread malingering and dishonesty undercuts any meaningful discussion of the adequacy of benefits and provides a convenient response for those opposed to the benefit increases that are so critically needed in many states. Until the misplaced focus on claimant fraud is over-come, district attorneys will continue to fry the small fish while the big fish go free, and the voting public will remain distracted by anecdotes."
Some assistance in assessing the extent of the identified fraud problem can be found in statistics compiled by the Department of Insurance Fraud Division (Fraud Division) summarizing for FY 1999-2000, by county, the number or amount of arrests, prosecutions, convictions, penalties and court-ordered restitution. The summary is enclosed as "Attachment A." (It should be noted that not all counties participate in the anti-fraud grant program.) Those statistics indicate that from July 1999 through June 2000, 478 people were arrested for various types of workers compensation fraud, and that 390 people were convicted. These numbers are similar to those reported for prior years. The courts ordered payments of $8,821,239 in restitution and $190,743 in penalties. The total amount of fraud charged was $141,055,765.
Another approach is to look at the issue on a relative basis, how bad is workers compensation fraud today compared with the early 1990s, when the anti-fraud program was enacted? Although there is strong disagreement, there appears to be a general belief that there is not as much fraud in evidence now as there was then. In the words of the then Acting President of the California Workers Compensation Institute (CWCI):
"Recent CWCI surveys on statewide fraud prosecution activity reflect a significant diminishment of fraud referrals since 1992 although late 1999 and early 2000 may reflect the start of an upward trend. The peaks in the number of fraud arrests and convictions naturally lag behind higher levels of referrals due to the time to develop a case for prosecution. However, CWCI and other payor data suggests these rates may be tailing off as well. Whether this is due to the sentinel effect, lower claim frequency, more difficulty in successfully pursuing fraud, or a lessened commitment is arguable and not worth pursuing as a means to enhance the fraud effort."
What should be the scope of the anti-fraud campaign?
When the workers compensation anti-fraud program began in 1992, the primary targets appeared to be medical treatment fraud, medical reporting fraud, claimant fraud, "capping" by attorneys and others, and, ostensibly, employer and insurer fraud that discouraged or prevented injured workers from obtaining benefits. The program was subsequently broadened to include employer premium fraud.
The question of whether the scope of the anti-fraud program should be broadened to include illegally uninsured employers remains unsettled. Some district attorneys assert that it make no sense to prosecute insured employers for felony premium fraud under the anti-fraud program while leaving illegally uninsured employers subject to a simple misdemeanor and their prosecution beyond the support of program funding. However, there is a legal opinion by the Department of Insurance that the current anti-fraud statutes do not encompass the act of being an illegally uninsured employer. In addition, there are others who argue that the problem of illegally uninsured employers should be dealt with by the Divisions of Labor Standards Enforcement (DLSE) and Workers Compensation (DWC) and should not be a part of the anti-fraud program. What is undisputed is that illegally uninsured employers are a major problem for their injured employees, for similar businesses with whom they unfairly compete, for the workers compensation adjudication process, and for many other private and public programs (including the Uninsured Employers Fund) that have to shoulder the medical treatment and benefit burdens that illegally uninsured employers have improperly avoided. In light of this problem, it appears that the Legislature should consider raising the criminal penalty for knowing failure to secure the payment of compensation, and also consider statutory changes to increase the identification and pursuit of illegally uninsured employers, including possible amendment of existing anti-fraud laws.
As noted, current anti-fraud provisions make it unlawful to fraudulently discourage injured workers from claiming workers compensation benefits or pursuing a claim. These same laws also make it unlawful to make or present a fraudulent statement in opposition to a claim for compensation or for the purpose of denying compensation. However, despite reports that employers are directing or encouraging industrially injured workers to use other benefit programs, rather than file workers compensation claims, and despite charges that employers and insurance carriers are fraudulently denying compensation and opposing claims, there is little indication they are being prosecuted for such offenses. Attorneys for injured workers claim that they have frequently reported these offenses, but that prosecutors fail to bring charges. District attorneys assert that they are quite willing to pursue such matters, but workers and their attorneys have failed to complete reports of the alleged offenses. In this regard, it was notable that the East San Jose Community Law Center reported that it has made referrals to the Santa Clara County District Attorney and that those referrals are being pursued. However, to encourage reporting, investigation and prosecution of suspected employer and insurer fraud, steps should be taken by the Fraud Division and district attorneys to publicize the means for filing such complaints and to publicly document the number and outcome of those complaints.
A separate, but related issue, is so-called "insider fraud," where claims managers, claims administrators, outside investigators and agents engage in fraudulent schemes involving the handling of policies and claims for personal gain. The LA DA indicates that a wide variety of criminal cases have been successfully prosecuted throughout the state, but that many cases are handled administratively by insurers without official reports to authorities. Although insider fraud is seldom mentioned in connection with the anti-fraud program, it appears to be a recurring problem that should be included as a specifically identified subject of anti-fraud enforcement, as it is in some other states. To this end, the Fraud Division should work with the special investigation units (SIU) of each insurance company, as well as self-insured employers and third party administrators, to insure that all cases involving suspected insider fraud are referred to law enforcement authorities for investigation.
The East San Jose Community Law Center has also proposed that an employers "knowing and material omission" that delays, discourages, or deprives an injured worker from receiving benefits should constitute fraud to the same extent as an affirmative representation. They note that Insurance Code section 1871.4 makes it unlawful to knowingly make, or cause to be made, a material mistatement in order to deny or discourage a claim. There is, however, no explicit statutory safeguard to protect an injured worker who is deprived of benefits because of an employers knowing material omission. The Law Center states:
"Labor Code Section 5401(a) imposes the legal duty upon employers to provide employees within one day of a reported injury, a claim form and notice of potential eligibility for benefits. The Law Center regularly counsels clients who are denied benefits because their employers violate this duty; we commonly see cases where employers have failed to inform the employee of the right to file a claim or of potential eligibility. These victimized employees suffer the same direct and proxi-mate damages as those in the fraud and uninsured employer situation. We therefore suggest that measures be taken to make it explicitly unlawful to prevent, delay, deny, or discourage a claim through material omission. This should at least be done when the material omission is a violation of a statutory duty."
What should be the focus and priority of anti-fraud efforts?
In response to the Commissions call for information, the LA DA reported that "[e]ven though more claimant fraud is reported, it is the providers, by far, who generate most of the fraud within the workers compensation system." In its response, the Fraud Division added:
"While many of the most flagrant [medical] mills operating in Los Angeles County have been investigated and prosecuted, with several being tried in fiscal year 1998-99, some medical-legal mills are still operating in Southern California. Due to the complex nature of the workers compensation system and minimal accountability demanded of its service providers, documenting medical-legal fraud and determining criminal responsibility are exceptionally difficult."
Similarly, CWCI responded that:
" Provider fraud is the most difficult for payors to uncover. Finding aberrant and fraudulent provider treatment and billing patterns is difficult because few insurers or self-insured employers have enough signal from a given provider group to reliably identify any pattern of care, let alone a fraudulent one. We think a lot of fraud may be slipping through the cracks because there is currently no centralized resource that can look across all of the payors for these patterns."
Based upon these responses, it appears that medical provider fraud, both in medical treatment and medical-legal reporting, continues to have a significant impact on the economic cost of the workers compensation system to employers and insurers. The fact that these schemes are often difficult to identify, investigate and prosecute should not keep them from being one of the primary focuses of the anti-fraud program.
In its response to the Commissions call for information, CAAA claimed that "from an economic standpoint, employer premium fraud and medical provider fraud is 3-4 times more costly than claimant fraud." Some examples of the economic costs of these types of fraud are found in the "Cases Examples" provided to the Commission by the Fraud Division and enclosed as "Attachment B." It is noteworthy that all but two of the examples involved either medical provider fraud or employer premium fraud. In this connection, the head of the Fraud Division (recently renamed as the "Criminal Investigations Branch") stated:
"Employment misrepresentation does have a direct impact on the business climate of the state. Unfairly assessed premiums each year cost employers millions of dollars. Employers, who misrepresent the facts about their business or their employees in order to reduce their workers compensation cost, tarnish the business climate, especially for small employers. Employment misrepresentation hits certain sectors hard, such as construction, and the garment industry, where the margin of profit is already small. "
The LA DA added that "prosecutors and investigators agree that prosecution of high impact cases, i.e., cases against providers, employers, or large premium fraud cases, gives the public and those working within the system a greater sense of justice and satisfaction." Because of their economic and community impact, it appears that cases of employer premium fraud should continue to be one of the primary focuses of the anti-fraud program.
Claimant fraud is another important issue. Approximately three out of four of the people convicted of workers compensation fraud are claimants. To some degree, this is due to the fact that claimant fraud is easier to detect, investigate and prosecute. However, the fraud committed is, nonetheless, an unfortunate reality. It occurs even in cases of legitimate injuries, where injured workers lie in order to obtain additional benefits. Employers and insurers correctly believe that one of the proper purposes of the anti-fraud program is to deter such conduct in the first place, and to punish it when it occurs. Many injured workers and their attorneys are understandably sensitive to the energetic prosecution of claimant fraud, arguing that it is not that common, that what there is has less economic impact than other types of fraud, that the approach of the anti-fraud program is not evenhanded, and that the program tends to create a public image that all injured workers are cheats. Despite some rhetoric to the contrary, it appears obvious that the great majority of injured workers are not cheating the system, they are unintentional participants in the workers compensation process, seeking only the medical treatment and other benefits to which they are statutorily entitled. However, there is enough claimant fraud occurring to continue to make it an important part of the anti-fraud program. If it goes unchecked, more workers will be tempted to file false claims or exaggerate disabilities, leading to improper awards and increased premium payments for California employers.
In a letter dated May 15, 2001, the president of CAAA stated that his group questioned "the failure to more clearly condemn the focus on claimant fraud as well as the failure to recommend actions that would enhance the prosecution of employers and insurers who illegally discourage workers from filing claims, lie to workers about coverage, and outright deny benefits to which a worker is legally entitled." He added that "[s]uch timidity surely is a disservice to fairminded parties."
As stated in the preceding paragraphs of this section, it appears that, due to their economic impact, the foremost targets of the anti-fraud program should be medical provider fraud and employer premium fraud. We also have suggested that steps should be taken by the Fraud Division and district attorneys to publicize the means for filing complaints of suspected employer and insurer fraud and publicly document the number and outcome of those complaints. One significant step in improving the reporting of suspected employer and insurer fraud would be to change the form generally used for reporting fraud. The title and basic focus of the form (FD-1) is on claimants, not on employers or insurers who may be violating the fraud provisions. The title of the form is "Suspected Fraudulent Claim (SFC) Referral Form." Section I of the form asks for the "reporting party code." None of the codes specifically refers to claimants, providers or attorneys. Five of the ten codes are for employers and insurers, two are for law enforcement and the other three are generic (e.g., "CDI Information Source"). Section II of the form asks for "loss/injury information," including claim and policy numbers, the premium and potential loss, etc. Section VI asks for the name of the insured or employer involved. Section VII asks for the names of other parties to the loss/injury. None of this is oriented toward or "user friendly" to an injured worker who is attempting to report fraudulently denied benefits.
Fraud by employers and insurers in connection with injury claims also needs to be a visible focus of the anti-fraud program. It is important to the programs success that it be seen as evenhanded and that it be so in reality, particularly in light of the fact that it is employer funded. However, for this to happen, injured workers, their attorneys, and even employer and insurer personnel have to be willing to report suspected fraud in sufficient detail for it to be investigated. Further, the Fraud Division and district attorneys must not only document such referrals, they must understand why the reported conduct or statement is suspected to be fraudulent and have the determination to investigate the case. To some extent, it may be necessary to reach out to more groups and educate them about what "fraud" is, and is not.
All of the above are appropriate targets of the anti-fraud program. However, due to their economic impact, it appears that the foremost targets of program budgets and resources should be medical provider fraud and employer premium fraud. In addition, the program should remain vigilent in investigating claimant fraud and be much more responsive to allegations of employer and insurer fraud in connection with injury claims.
What should be the source and the level of funding for anti-fraud efforts?
In a letter dated April 26, 2001, Commissioner Steinberg raised as an issue the "need to specially fund the investigative activity of the Department of Insurance and the prosecutorial activity of the local District Attorneys at their current very substantial financial levels or the policy implications of privately funding these activities at all."
Since its inception, the anti-fraud program has been funded entirely by assessments on employers. The amount of the annual employer assessment is determined by the Fraud Assessment Commission, with the approval of the Insurance Commissioner and Governor. The Fraud Assessment Commission is made up of only employer and insurer representatives. It reviews funding requests from the various district attorneys whose counties are interested in participating in the program. The overall funding is divided almost equally between the district attorneys and the Fraud Division. On August 6, 2000, the Los Angeles Times ran a feature article entitled "Public Fraud Favors Those Who Privately Fund It." That article suggested, among other things, that the Fraud Division and district attorneys would not prosecute employers and insurers for claims fraud because they did not want to "bite the hand that feeds it." Both the Fraud Division and local district attorneys have denied that charge.
However, in response to the Commissions call for information, the LA DA did report, in part:
" The [Fraud Assessment] Commissions authority to review and comment on the district attorneys funding has led to criminal defense attorney accusations and lengthy legal motions alleging bias. In order to successfully prove a conflict of interest allegation, the defense must show, in part, that the district attorneys discretionary decision making has been placed within the influence and control of a private party with a particular interest in the prosecution of the defendant. To date, these conflict of interest allegations have been deemed by reviewing courts to be unfounded and without merit. However, defending the funding scheme is needless waste of prosecution resources."
The response goes on to suggest that the funding assessment should continue to be levied on all employers. However, "the funding should be applied toward criminal investigations and prosecutions on a per county basis based on a formula which analyzes the number of employees in each county." Such an approach "would still require a review of data by the Insurance Commissioner and Fraud Division, but would eliminate the need for the FAC." The response further suggests that the "Fraud Division should be reviewed and funded on a regional and not statewide basis."
According to the August 6, 2000, Los Angeles Times story, there were two reasons behind employer funding of the anti-fraud program:
"[Senator Robert] Presleys legislation, which passed in 1991, was unusual in that it required employers, rather than taxpayers in general, to pay for investigations and prosecutions through a surcharge collection on their insurance premiums.
"There were two reasons Presley took the private money approach. The state was in the red and Presley said any general fund appropriation would not pass. County prosecutors were unwilling to use tax money already assigned to them. They had higher priorities: violent crimes.
"[James] Morris, the Presley aide, recalled speaking to several county prosecutors including representatives of the Los Angeles County district attorneys office who told him: Unless we see any money, were not going to prosecute this type of case."
In subsequent years, the needed money came. What began in 1992 as a $3 million a year program has rapidly expanded to more than $30 million a year in funding. Many district attorneys have grown attuned to the program and its anti-fraud targets. Over the past nine years, there have been several high profile fraud prosecutions, some successful, some not. According to district attorneys, the scope of the program has grown and the perpetrators of fraud have become more sophisticated. Investigating and prosecuting these sophisticated operators, they say, requires substantial and continued funding.
CWCIs response discusses the overall amounts spent on the program, rather than the funding source:
"Each year the Fraud Assessment Commission generates through assessments $30,000,000 to be distributed to the Fraud Division and local district attorneys. Each insurer licensed to do business in the State must maintain a Special Investiga-tions Unit. Annual costs range between $50,000 and $200,000 or more depending on the size of the insurer, the amount of workers compensation insurance written, and whether the SIU is out-sourced or not.
"To our knowledge, no one has been able to put a price tag on the total system cost of the anti-fraud effort nor for that matter have we been able to get a good handle on the cost-benefit of pursuing fraud in workers compensation."
In a letter dated May 15, 2001, the president of CAAA attempted such a cost-benefit analysis. Referring to the amounts of court-ordered restitution and penalties, he stated:
"Compare these figures with the costs of investigation and prosecution. This figure can be approximated by adding the cost of the fraud assessment ($30 million) with the cost of the Special Investigation Units (estimated by CWCI at $50,000 to $200,000 per licensed insurer). Then ask the question: Is it appropriate to spend $30 million annually plus the cost of the SIUs to successfully prosecute 390 cases to obtain $9,012,132 in penalties and restitution? And of that, to obtain only $3,660,856 in collections? Only when these figures are appropriately analyzed can this issue be intelligently discussed. We urge the Commission to examine this data."
In another letter dated July 6, 2001, the head of the Fraud Division responded, in part, as follows:
" Back in the early 90s, doctors and attorneys sent their cappers out to the Employment Development Department (EDD) offices to recruit clients. These potential clients were employees applying for unemployment benefits. There was no enforcement and cappers had no real fear of reprisal. But soon, with funding from California employers and a recommendation by the Fraud Assessment Commission, resources were in place providing an aggressive anti-fraud effort. These efforts resulted in the prosecution of many attorneys and medical clinic doctors. Today some doctors and lawyers have developed different or more sophisticated fraudulent schemes to avoid detection and prey upon the system. Others have gone to other states and some are just continuing their illegal activities with other forms of insurance fraud.
"An effective anti-fraud campaign in California has played and will continue to play a substantial role protecting workers, reducing costs of the WC system and (sic) to honest employers statewide. Fraud Division is eager to investigate those cases that make the greatest economic impact in order to protect businesses and the public. Measurements of results by numbers alone overlooks the societal value of a program. However, on the numbers side of the ledger, in fiscal year 1999-2000, the district attorneys reported $141,055,765 was charged in workers compensation insurance fraud in cases that went to trial. The joint anti-fraud efforts are achieving a valid economic impact as well as a deterrent effect."
Others view the current source and level of funding to be appropriate, but believe that the total monies could be used more effectively. They point to the claimed duplication of investigative efforts by the Fraud Division and district attorneys. And like CAAA, some argue that the anti-fraud program is not getting enough "bang for the buck" when evaluated by the number of convictions obtained and amounts collected in restitution.
Prosecutors respond that investigation and prosecution of high impact cases involving medical provider fraud or employer premium fraud require substantial resources and are very difficult and time consuming. Too much program emphasis on increasing the number of convictions will cause more effort to be spent harvesting only the "low hanging fruit" of claimant fraud. There also appears to be a widespread view among the Fraud Division and district attorneys that more specialized resources are needed, particularly forensic auditors and experts in computer science. In some cases, these experts need to be available on very short notice or for lengthy periods of time. Acquiring this important expertise would require increased program funding.
Should there be greater interagency coordination of anti-fraud efforts?
It is undeniable that the more information is shared among those who collect it, the more likely it is that major fraudulent schemes will be detected, adequately investigated and successfully prosecuted. In this regard, CWCI states:
"A collaborative, multi-payer transactional data warehouse increases the potential of detecting true fraud and abuse signals while discounting singular or aberrant anecdotes that distract special investigations. A centralized specialized investigation unit removes duplicative expenses associated with each payer trying to identify fraudulent activity. It can also serve to coordinate the efforts of payers, the Department of Insurance, and local district attorneys. Depending on the data content of the warehouse, it can be used to address employer and claimant fraud as well as provider fraud."
In this connection, the LA DA adds:
"The Workers Compensation Insurance Rating Bureau (WCIRB) is the depository for workers compensation insurance policy information. WCIRB computers are able to communicate with the Employment Development Department computers, as demonstrated by the [Commissions] Illegally Uninsured Employer Pilot program. Additionally, software is available to identify employers that are reporting payroll figures inconsistent with those reported to insurance carriers for premium purposes. These anomalies could point to premium fraud cases. [P]rosecutors should establish a memorandum of understanding with the [Department of Insurance] to create a system of direct access between the WCIRB database and the various District Attorney offices throughout the state."
On the same topic, but from a somewhat different perspective, CAAA has recommended that the Commission "actively support the DWC Workers Compensation Information System efforts, which will provide an independent public database for tracking the timeliness of benefit payments to workers and medical providers, thus eliminating policymakers reliance on the insurance industry for information." However, CAAA also expresses significant reservations about the sharing of information between public and private agencies, to the extent allowed by law and regulation. They contend that approving of this practice "without a discussion of the possible privacy concerns is irresponsible." Further, they state that a "collaborative, multi-payer transactional data warehouse," as proposed by CWCI, "is an invitation to abuse privacy rights under the guise of investigating fraud."
In addition to sharing of information, some have suggested that there should be greater interaction between public agency employees (primarily in DWC) and those investigating and prosecuting workers compensation fraud. For example, DWC Information & Assistance Officers, members of the Audit Unit and the staff of the Uninsured Employers Fund all may have contact with information suggesting suspected fraud. In some cases, the information may be considered privileged by law or regulation. In other instances, however, the information may not be privileged or may even be unshared public record. One prime example is the annual report of DWCs Audit Unit. The most recent Audit Unit report, for calendar year 2000, is at http://www.dir.ca.gov/dwc/audrpt00.pdf and contains important information about current claims handling practices. This information may be of use to those investigating alleged fraudulent claims practices. However, to do this there needs to be greater cooperation and coordination between agencies and law enforcement in sharing of collected information and reporting suspected fraud.
In some instances, public employees who are not in law enforcement may question whether it is their proper "role" to be reporting suspected fraud. Generally, it is. However, a rather more debatable case involves the workers compensation judges who must impartially decide disputed cases. They often are in an advantageous position to recognize suspected fraud and to gather the information needed to pursue an investigation. However, some WCJs believe that if they report the suspected fraud themselves, instead of letting attorneys handle the problem, they are creating an appearance of bias or prejudgment in future cases involving the same medical provider, employer, insurer, attorney, etc. To avoid that appearance, they may need to "recuse" themselves from hearing those cases.
At the first roundtable, it was reported that some WCJs have referred cases of suspected fraud to investigative authorities. In addition, as part of DWCs training program, the Fraud Division has been making presentations to all WCJs about the anti-fraud laws and how to report suspected fraud. Some of the roundtable participants thought that WCJs should be required to report all cases of suspected fraud. Others who were present (in addition to WCJs who were not present) indicated misgivings about such a requirement.
Based upon the information and comments received, it appears that, to the extent allowed by law and regulation, private and public agencies should share information that may assist in the detection and investigation of suspected fraud. Further, private and public employees should be encouraged to report suspected fraudulent activities and to cooperate in the investigation of those activities.
Are there new ideas or innovative approaches that might improve the anti-fraud program?
The East San Jose Community Law Center proposes that the Fraud Assessment Commission should have employee representation. They state:
" Because the [Fraud Assessment Commission] funds prosecution efforts, the absence of employee representation creates an inherent imbalance. Prosecution efforts against employers have, thus far, focused almost exclusively on premium fraud violations; there has been a virtual absence of employer fraud prosecution. Because premium fraud prosecution directly protects the interests of the insurance industry, while employer fraud prosecution more directly benefits victimized employees, this imbalance must be remedied.
"We believe that a balance of interests should be represented on the Commission. Employees, who are presently silenced through exclusion, should be provided an official voice on the Commission. "
At the initial roundtable, there was general support for this idea, including agreement by the members of the Fraud Assessment Commission who were present. Accordingly, it is recommended that Insurance Code section 1872.83(b)(1) be amended to include employee representation on the Fraud Assessment Commission. (CAAA raises the question of whether one appointment is "enough to create a true balance.") In addition, the LA DA has suggested that the Fraud Divisions Fraud Advisory Committee "should be more representative of the workers compensation system."
Another suggestion concerned the civil immunity afforded to insurers, and their authorized agents, who provide information in reporting fraud, so long as they are acting "in good faith, without malice, and reasonably believe that the action taken was warranted by the then known facts." The LA DA stated that "[t]his immunity should be available to anyone who reports fraud in the system employee, co-employee, attorney, medical provider, workers compensation judge or WCAB employee." On the other hand, CAAA argued that the Commission ought to "consider legislative changes to eliminate the insurers immunity from civil liability." Further, in its letter of May 15, 2001, CAAA stated: "We support broadening immunity only if it is limited to injured workers. We believe that the recommendation to broaden civil immunity to everyone would be paramount to encouraging reckless misconduct." (Italics in the original letter.)
At the first roundtable discussion, it was suggested that other civil immunity provisions are adequate to protect both insurers and others who report suspected fraud. That appears to be the case. In a 1996 opinion, the Court of Appeal observed that "another statute, section 47 of the Civil Code, already gives everybody including insurers the right to report crimes to the police, the local prosecutor or the appropriate regulatory agency, even if the report is made in bad faith." (Italics in the courts opinion.) The broad immunity from civil tort liability that flows from the section 47 privilege is nearly absolute. The exception under state law is that the person reporting a suspected crime may be subject to later suit for malicious prosecution.
Based on existing law, it appears that no "broadening" of the statutory civil immunity provisions is necessary. (There is some additional protection for those who report suspected fraud in Insurance Code section 1879.5. That section applies to "any person" who notifies the Department of Insurance of suspected fraud. However, that section is more narrowly applied than Civil Code section 47.)
It also is unlikely that the current civil immunities afforded to insurers will be abolished. In addition to their immunities under Civil Code section 47 and Insurance Code section 1879.5, insurers, their employees, and agents are also protected by specific provisions of Insurance Code sections 1872.5, 1873.2, 1874.4, 1875.4 and 1877.5. And even if all of those Insurance Code sections were repealed, it appears highly unlikely that the long established immunity under Civil Code section 47 would be restricted. (However, it should be noted that Mr. Indravadan Jayaswal, who appeared at the second roundtable, was able to successfully sue the insurance carrier that furnished false information concerning his alleged fraud. The details of his case are in the August 6, 2000, Los Angeles Times article that was included in materials provided by CAAA. Mr. Jayaswals suit against the workers compensation carrier was for malicious prosecution.)
Another injured worker who appeared at the second roundtable was Gary Vincelet. The issue in his case was reimbursement of approximately $100,000 in expenses incurred in successfully defending against criminal charges of workers compensation fraud. According to the case summary, after the jury in the criminal trial deadlocked, the judge declared a mistrial. Subsequently, the charges against Mr. Vincelet were dismissed at the request of the district attorney. Following that, Mr. Vincelet filed a petition with the WCAB seeking reimbursement of his court expenses from his employer, who had reported the alleged fraud. In ruling against Mr. Vincelet, the WCAB stated (1) that the issue of whether to allow costs in a proceeding in the Superior Court lies within the Superior Courts jurisdiction, (2) that the WCAB was unaware of authority that would allow costs to be imposed against a non-party in a [criminal] action, and (3) that the criminal defense costs incurred were not subject to reimbursement under the provisions of Labor Code sections 4607, 5410.1 or 5811. Both the Court of Appeal and Supreme Court denied Mr. Vincelets petitions for review of the WCABs decision.
On November 15, 1999, former Commissioner OHara wrote a letter to the Commission stating that he planned to review this issue with CAAA and California Labor Federation and to develop legislation for introduction in the Legislature. He stated it would be helpful to have the Commissions "thinking and possible resolve on this matter" and that it also "is incumbent upon the workers compensation community to remedy this bar to workers approaching their benefits."
The potential legal difficulties in attempting to address this type of situation include (1) determining the proper forum, (2) circumventing the immunity from civil liability in Civil Code section 47, (3) bringing the costs of a criminal defense within the statutory ambit of workers compensation benefits, (4) determining whether employer liability should be contingent on having made an improper fraud referral, and (5) deciding whether the benefit should limited to only those acquitted of all criminal charges. However, in view of the Legislatures broad powers to amend the workers compensation laws, perhaps legislation addressing this situation could be introduced.
In his letter dated July 12, 2001, the president of CAAA has urged the Commission to "recommend elimination of the fraud program in its current form." He states that the issue at stake is one of equity. Medical providers who overbill are not being prosecuted and issues relating to nonpayment or denial of benefits to workers are considered a "regulatory problem" and not acted upon by district attorneys. This leaves workers to bear the brunt of criminal prosecutions and penalties. In order to remedy this, he states:
"Our Association has not deterred from our concern that fraud, to the extent that it exists, must be prevented but our Associ-ation believes that the correct means in dealing with this issue is through the civil system. The civil system can more fairly deal with the problem rather than the current harsh treatment of innocent injured workers in the criminal system. We therefore urge the Commission to take this opportunity to recommend that criminal penalties be eliminated in favor of civil penalties. The unfair prosecutions against defenseless workers must cease."
At present, Labor Code section 3820 provides for civil penalties for various types of workers compensation fraud. However, that provision is in addition to the criminal penalties specified in the Insurance Code and Penal Code. While the Insurance Code sections could be amended to reduce the group of persons subject to criminal penalties for specified acts of workers compensation fraud, it is unlikely that the common perjury, theft and fraud provisions of the Penal Code would ever be amended to exclude workers compensation claimants from potential prosecution.
Another issue raised in Commissioner Steinbergs letter of April 26, 2001, concerned the "pursuit of criminal prosecutions of applicant fraud for essentially exaggerated claims of disability prior to the workers compen-sation proceedings in which the alleged fraud was committed being allowed to reach resolution." Among the complaints mentioned by the commissioner were (1) arrests of workers at the WCAB in the midst of scheduled hearings, (2) district attorneys usurping the function of WCJs to determine the facts in accordance with workers compensation laws, and (3) the res judicata effect that a criminal conviction can have on a valid workers compensation claim.
Basically, the issue is whether a criminal prosecution should be held in abeyance pending completion of a workers workers compensation case. The difficulty is that criminal prosecutions generally must proceed according to established statutory timelines. In light of the length of time it reportedly takes to investigate most fraud referrals, district attorneys might not have the latitude to delay arrests and prosecutions, even in the unlikely event that they wanted to. Also, there are statutes, such as Insurance Code section 1871.7, which provide that certain civil proceedings involving substantially the same conduct shall be stayed until the criminal action has been concluded at the trial court level. Although there have been cases where the appellate courts have allowed workers compensation proceedings to continue in the face of pending criminal prosecutions, at least where reopening is possible, it would be anomalous to see a criminal prosecution stayed pending the outcome of a workers compensation case.
Another suggestion, from the LA DA, was that the Information for Injured Workers pamphlet should provide information to workers regarding fraud:
" It must be clearly emphasized to injured workers that if they are [temporarily totally disabled] and they work, they could be committing a crime. Workers compensation fraud should be clearly defined, as well as the ways to avoid involvement in fraudulent practices. Employer fraud should be clearly described and claimants should be advised to report it and told how to report it. Employees should be informed that employers are required to have workers compensation coverage, instructed to report violations, and told the way in which to do so. These pamphlets should detail the consequences of fraud and how fraud affects the employer, employee, consumer, taxpayers, and the state."
In the initial roundtable discussion, there was general support for providing early and complete information to injured workers about all types of workers compensation fraud, how to avoid it, how to recognize it, and how to report it. The group felt that DWC should include this information in the information pamphlet that is provided for injured workers.
A number of other significant matters were raised in response to the Commissions call for information which may require additional information and discussion. One of the most pressing issues concerns what to do about insurer Special Investigations Units (SIUs). In the view of several district attorneys, only a half dozen SIUs are providing consistent support for the anti-fraud program. Most of the SIUs refer almost no suspected fraudulent claims to the Fraud Division or to district attorneys. This also is borne out in the quarterly fraud statistics published by CWCI. In the view of some, the remedy is for the Insurance Commissioner to take more aggressive action against insurers who are not complying with statutory requirements. Some also contend that SIU requirements should be expanded to include self-insured employers. On the other hand, some appear to believe that SIUs are costly and ineffective in detecting or preventing fraud and should be replaced by either a voluntary reporting structure or an entirely different mechanism for collecting and reporting information about suspected fraudulent activities. At the present time, virtually no one is satisfied.
Another sore subject is restitution. At present, even when fraud claims are successfully prosecuted, very little comes back to the victim in restitution. Even when the criminal court orders restitution, the recovery is often limited. In many counties, restitution is handled by the probation department, not the district attorneys office. Probation officers often have very large case loads and other pressing responsibilities to attend to. Further, Penal Code section 1203.2(a) provides that probation shall not be revoked for failure of a person to make restitution unless the court determines that the defendant has willfully failed to pay and has the ability to pay. In an effort to obtain some amount of restitution for the victim, prosecutors will discount the term of incarceration. In effect, a defendant can buy his or her way out of jail by repaying a portion of the ordered restitution. This concept is frustrating not only to prosecutors, but also to the victims and the community. Another complaint is that even when restitution is obtained, it sometimes flows only to the insurer, not to the employer. Still another form of frustration involves seeking restitution before the WCAB. When restitution has been ordered by a criminal court judge, the WCJ may not feel that he or she has jurisdiction or authority to order either additional restitution or measures to enforce the criminal courts order. A final point is that in cases where injured workers are the victims of fraud, they also should be entitled to restitution, either through the criminal courts or the WCAB.
Based on the information and comments received, the Commission makes the following recommendations:
1. The Legislature should consider raising the criminal penalty for knowing failure to secure the payment of compensation.
2. The Legislature should consider making statutory changes to increase the identification and pursuit of illegally uninsured employers, including possible changes to the existing anti-fraud laws.
3. The Fraud Division and district attorneys should take steps to publicize the methods for filing reports of suspected employer and insurer fraud and should publicly document the number and outcome of the reports.
4. The Fraud Division should work with insurance company SIUs, as well as self-insured employers and third party administrators, to insure that all cases involving suspected "insider fraud" are referred to law enforcement authorities for investigation.
5. Due to their economic impact, the foremost targets of fraud program budgets and resources should be medical provider fraud and employer premium fraud.
6. The Fraud Division and district attorneys should also remain vigilant in investigating claimant fraud and be more responsive to allegations of employer and insurer fraud in connection with the reporting and handling of injury claims.
7. To the extent permitted by law and regulation, private and public agencies should share information that may assist in the detection and investigation of suspected fraud.
8. Private and public employees should be encouraged to report suspected fraudulent activities and to cooperate in the investigation of those activities.
9. The Legislature should consider amending Insurance Code section 1872.83 to include employee representation on the Fraud Assessment Commission.
10. The Division of Workers Compensation should provide an information pamphlet for injured workers that has, among other things, complete information about the general types of workers compensation fraud, including how to avoid it, how to recognize it, and how to report it.
Additional recommendations voted at August 24, 2001, meeting:
11. The Department of Insurance should change the form generally used for reporting suspected fraud to make it more "user friendly" to injured employees.
12. Further review should be conducted of the role of insurer special investigation units in reporting suspected workers compensation fraud.
13. Full restitution to the victims of workers compensation fraud should be made a more important aspect of the anti-fraud program.


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Tag: analogue lifestyle
Pictures Inside My Headwritten by kiwikoh on 2011-07-03
What will happen when silhouette meets multi-exposure?35 189 Share Tweet
Remembering Fellow Lomographer lakandulawritten by plasticpopsicle on 2013-09-18
For anyone who has known, met, and worked with communtiy member lakandula, today truly is a sad day. Friends have confirmed that he passed away in his 30s from Stage 4 brain cancer.75 78 Share Tweet
The Lomographer at Work: Welcome to My Studiowritten by jaybees80 on 2013-05-21
I wanted to present my work and where I realize my ideas. After leaving my job teaching art, I decided to devote myself to the evolution of my personal work. That's why I converted part of my home into an art studio.28 125 Share Tweet
Out & Proud: The Man with The Child in His Eyeswritten by jaybees80 on 2013-06-07 #videos
For LGBT month, it seemed important to me to talk about the love of my life through my photos. He is the one who inspires me the most, the one I never miss when it comes to taking pictures. His love and strength makes him my muse. Even if life has not always been kind to us (and especially lately), it will always be there for me and I'll always be there for him.42 108 Share Tweet
Top 10 Reasons Why I Love Lomographywritten by wuxiong on 2011-10-12
I am certain that every lomographer in this loving site has his or her own reasons for loving Lomography. Here are mine.29 103 Share Tweet
Rare Kodak Video Shows the Making of Medium Format Filmswritten by plasticpopsicle on 2011-05-10 #videos
Ever wondered how the films we all love and crave for are made? Kodak has the answer, in an interesting 1958 documentary showing early production process of medium format films!44 84 Share Tweet
5 Questions on Analogue Photography with adi_totpwritten by istionojr on 2011-11-06
It is adi_totp's turn to answer the analogue lifestyle questions. From 2007, he started to use Lomography cameras and kept busy on his LomoHome that same year. Find out more about him!72 55 Share Tweet
Of Wanderlust and Film Cameraswritten by plasticpopsicle on 2011-05-06
Travel and photography are without a doubt inseparable, but film makes the trip more exciting!28 90 Share Tweet
The Importance Of Lomographywritten by mattcharnock on 2010-06-16
For a while now I have been wanting to write about the importance of Lomography, not just in terms of keeping analogue alive, but the importance of the community and the actual effect of Lomography on the individual. Until recently I did not really know how to begin but now I do.43 74 Share Tweet
Am I Too Old for Lomography?written by orchid on 2012-03-20
Read about the thoughts of a thirty-something engineer based in Tokyo on the correlation of age, Lomography, and the realization of doing something you love other than a 12 hours a day job.37 77 Share Tweet
DearPhotograph: Photographs Are Like Memorieswritten by thewretched on 2011-07-12
What you see is never quite what was actually there. Colors and contracts are false, light leaks erase parts of the scene. With time, photos - just like memories - can fade completely.20 92 Share Tweet
Analogue Girl About Town: Now that I'm 30, I've become painfully aware of my own mortalitywritten by blueskyandhardrock on 2013-01-28
I had this week's article written and ready for publishing two weeks before my deadline but a lot has happened since then so I decided to write an entirely different article, one that would be more fitting. I also dusted off my trusty Mamiya C330 so I could capture the sense of this piece on film.30 85 Share Tweet
I Do (Shoot Weddings in Lomo)!written by renenob on 2011-07-10
It is one of my frustrations that our wedding was not covered by fellow lomographers; and so, I am compensating.28 85 Share Tweet
A True Tale of Lomographic Lovewritten by tomas_bates on 2011-02-11
She was an analogue ambassador known as Golfpunkgirl and he was a dastardly digital doter called benbenbenbenben. He lived in the UK and she in Brussels, their story began when he commented on this photo on her Flickr stream....37 69 Share Tweet
Using Google Maps for an Analogue Lifestylewritten by t82 on 2011-09-21
Who wants to play a game? Exploring different cities with Google maps is so yesterday; now, its time for an analogue lomo-walk game!31 72 Share Tweet
The Beauty of Found Filmswritten by bbijlhout on 2013-04-04
After reading a bunch of articles about 'forgotten films,' I finally got a chance of my own. After buying a new analog toy I discovered a used film inside. I decided to get it developed and I got to tell you, I'm really pleased with the results I got from the lab.12 71 Share Tweet
Art Inspired by Film Cameraswritten by plasticpopsicle on 2011-05-09
Film photography has been a source of inspiration not only for aspiring photographers, but also for many artists! Take a look at some beautiful artworks inspired by various film cameras.21 60 Share Tweet
My First Professional Photo Shoot2011-07-03
I Hate Paris. No, I don't hate Paris. It's just that my client, an independent band, is called I Hate Paris.22 57 Share Tweet
My Wedding Shootwritten by ripsta on 2011-07-23
I like to take the picture of weddings. I can feel a sense of satisfaction and joy with each moment of happiness and beauty that I could capture using film and a Lomography camera.30 50 Share Tweet
Purifying Photography: Group f/64written by fivedayforecast on 2011-01-24
The Portland Museum of Art did a showing of photos to display the motives and photographic work of the legendary Group f/64, a powerful collective of photographers who all desired to purify photography, an idea that now has a strange irony to lomographers.23 58 Share Tweet
Every Lomographer's Best Models: Cats!written by tomkiddo on 2012-01-25
We lomographers adore cats. They are always the best models for our lomographs. Their eyes, their whiskers, their fur--all are so good-looking in their own ways. Below are some fun facts about cats I found on the internet and some awesome lomographs taken by our fellow lomographers and me myself. Read on after the jump.15 62 Share Tweet
Florian Imgrund's Double Exposures in Monochromewritten by plasticpopsicle on 2012-03-14
A German photographer got his first film camera two summers ago, and has been taking amazing photos ever since. Among them are some beautiful, nicely done double exposures. Take a look at some of his work after the jump!10 64 Share Tweet
Meet Malaysia's Active Community Members from Perak #3: Ripstawritten by eva_eva on 2012-07-15
Perak, is the second largest state in Peninsular Malaysia. Perak means silver in Malay. The name comes probably from the silvery colour of tin. Today, let's discover Perak – The Land of Grace together with our famous LomoStar, Ripsta!30 39 Share Tweet
Vintage Camera Adswritten by plasticpopsicle on 2011-08-18
This coming World Photography Day is not only about celebrating the art of photography, but also putting cameras in the spotlight, especially the analog classics! Let us go back in time and take a look at some vintage camera ads that likewise showcased the timeless beauty of analog cameras.15 57 Share Tweet
My 2013 Analogue Bucket List: I Would Like to Have Some Hard-to-Find Cameraswritten by giovannidecarlo on 2013-01-29
I started with the analogue photography and lomography just one year ago. I have collected 38 different cameras. I am missing only other 3 cameras. They are HARD TO FIND!26 50 Share Tweet
Analogue Everyday: Bring Your Camera to the Food Tablewritten by duringmyheyday on 2012-04-24
Keep a food diary in analogue and let the simplest meals become the best memories.15 53 Share Tweet
Everything I Know About Photography, I Learned from My Catwritten by 0live on 2012-11-27
Read about how snapping pictures of my cat has given me inspiration and valuable lessons about film photography.12 53 Share Tweet
My First Born Son: Iffat Altamiswritten by myvitaminx on 2012-01-03
I have an ongoing project dedicated for my very first born child.Special moment that every married couple waited. It feels good to be a daddy!19 47 Share Tweet
The Analogue Reader: 15 Bookswritten by plasticpopsicle on 2012-02-26
Let's do something fun that everyone can take part in for this installment of the Analogue Reader. I'm not sure if this is familiar to you, but let's do 15 Books, where you share with the community 15 books that you've read that will always stick with you. Are you ready?37 26 Share Tweet
The Cancer Patientwritten by emperornorton on 2013-07-31
Last year, my wife fought off uterine cancer. My analog cameras helped capture what I saw with my eyes, what I felt with my heart.17 43 Share Tweet


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Ikkitousen Description:
Plot Summary: Seven schools are constantly 'at war' with each other, and the students within - both male and female - have become skilled fighters and constantly battle with rival schools. Their lives and fates are guided by strange jewels that contain the spirits and destinies of warriors from the Sangokushi period. One girl, Sonsaku Hakufu, has recently moved to Japan and is apparently destined to unite the schools as her counterpart united seven countries long ago. But, like all heroes, there is a darker side to her fate, and as always there is a constant struggle by those around her to break the chains of their own destinies and make their own lives.
Genres: action, adventure, comedy, tournament Themes: Bishoujo, ecchi, Historical, Martial Arts, School, War
Ikkitousen Episodes:


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Steve Ralston's sterling 15-year career was highlighted by four MLS Cup appearances, seven all-star selections a host of all-time league records
FOXBOROUGH, Mass. – Major League Soccer and New England Revolution legend Steve Ralston will forever be known as one of the "Originals."
The league's original rookie of the year, having claimed the award in the inaugural season of 1996 when he was a 21-year-old kid out of Florida International University. The original "iron man," establishing career marks for appearances (378), starts (372) and minutes played (33,143). The original playmaker, recording more assists (135) and game-winning assists (41) than anyone in league history.
But while Ralston's accomplishments on the field will forever be etched in the record books after he announced his retirement from professional soccer, it's his selfless personality which made the biggest impression on those who had the distinct pleasure of playing alongside him. Or coaching him. Or working with him. Or simply speaking with him for a few minutes.
"It's no surprise when you hear him talking, he spends more time talking about everyone else than himself," said Revolution head coach Steve Nicol, who arrived in New England the same year Ralston did back in 2002. "That sums him up. He said he enjoyed coming out to training every day. We enjoyed coming out and watching him every single day. He's a guy who I would call one of the originals."
Ralston entered the league as a starry-eyed rookie in 1996 and immediately made his presence felt, scoring seven goals and adding two assists for the Tampa Bay Mutiny to claim MLS' first-ever rookie of the year award. The accolades that first season were just the beginning, however, as the coming years saw Ralston blossom into one of the best midfielders this league has ever seen.
He moved to New England in 2002 when the Mutiny was retracted and the Revolution selected him sixth overall in the MLS Allocation Draft. It was a decision the club would never regret, as Ralston ultimately led the Revs to four MLS Cup appearances (2002, 2005, 2006, 2007) and helped them lift the first two trophies in team history (2007 U.S. Open Cup, SuperLiga 2008).
His individual accomplishments were just as impressive. In addition to the five league records he leaves behind, Ralston was also a seven-time all-star and a three-time MLS Best-XI selection. The St. Louis native represented the U.S. National Team more than 30 times, scoring four goals and claiming a place as an alternate on the U.S.' 2006 FIFA World Cup squad.
Oh, and as for that whole "selfless personality" thing? Ralston is the league's only three-time winner of the Fair Play Award.
Unsurprisingly during his modest retirement press conference following the Revolution's 1-0 win over Morelia on Tuesday night, Ralston not once mentioned his own accomplishments. Instead he spent the majority of his unscripted speech thanking anyone and everyone whom he'd worked with throughout his career.
"I think most importantly, all the players I've been able to play with," Ralston said as he recalled the most rewarding aspects of his playing days. "I've made a lot of great friends and have a lot of great memories. I've had the opportunity to play with some really amazing people … I've had teammates for a few years, but I have friends for the rest of my life."
While Ralston shied away from touting his own accomplishments, the friends he'd made throughout his career had no such reservations.
Nicol called Ralston "as good a player as we've had at this club, ever," while third-year midfielder Pat Phelan lauded Ralston as both a player and person.
"He's just class all the way around – there's no two ways about it," said Phelan. "Win or lose, he's just a classy guy, a good sport, just a true competitor who, when he's out there, gives it everything he's got. You know his time has run out here, but I think that will live on with us for the rest of the year."
Ralston hadn't planned on retiring so soon when he re-signed with the Revolution in early June, but another professional opportunity presented itself and he felt the timing was right to step away from the game.
After Ralston trained with the Revs on Monday morning, the Revolution released a statement that evening notifying the media that the 36-year-old planned to announce his retirement following the Revs' SuperLiga game on Tuesday evening. Just like that, Ralston's illustrious career came to an abrupt end.
"To quote my friend Taylor (Twellman), it's been a 'worldwind'," Ralston chuckled, taking a playful jab at one of his closest friends and perhaps the biggest benefactor of his playmaking expertise. "It has been – my head is still spinning and this has happened so fast. I really haven't processed the whole thing … I haven't had that moment yet."
The unexpectedness of Ralston's retirement also caught some of his teammates off guard, but they didn't need much time to come up with the necessary superlatives to describe their colleague.
"It came so sudden," said goalkeeper Matt Reis, who played with Ralston for eight years in New England. "It was a sad day for me and I have been fortunate enough to play with a lot of great players including Mauricio Cienfuegos, Alexi Lalas, Cobi Jones and I think that Steve Ralston is right up there with all of them. It's been a pleasure. There are really not enough positive things I can say about him."
In the midst of its 15th season, Major League Soccer is still in its infancy, and as such, the league is short on players who've reached that epic "legendary" status. As he steps away from the playing field, Steve Ralston is undoubtedly one of the first to achieve that level of greatness.
Once again, he'll always be an original.


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Saturday, January 03, 2009
Back to the mundane--got any advice on Charter telephone?
AT & T has gotten increasingly aggressive in their marketing, sending pairs of salesmen (one older woman and one young man each time) to thunder on my door repeatedly. They want to sell me a package in which I have to sign up for cable TV, which I do not want, have my house wired for it, and then cancel it. I really do not want to do this.
However, I am indeed paying too much for Charter internet service. Having internet with one company and phone with a different company does get you a poor price for each. So I'm thinking of switching my phone to Charter. Somehow I feel less nervous about making a change in my phone technology than making a change in my internet technology. This may not be rational, however.
Do any of my esteemed readers have experience with either AT & T internet (I hear it's DSL rather than cable modem) or Charter telephone? On Facebook I have so far one very negative review of AT & T internet service. In December, my Charter internet has had a few connectivity problems, but I will say that they have resolved them. More importantly, when I called tech support and talked to a person, I got a nice American guy with a charming southern accent who knew what he was talking about. This was a big improvement over someone with an Indian accent you could cut with a knife who patronized the customer and was clearly working from a flip chart. So I'm cautiously still satisfied with Charter internet. But they are charging me too much, which they will stop doing (they say) if I switch my phone to them.
Hmmm. One doesn't want one's phone suddenly not to be working right, either.
It would be ironic if A T & T's pushiness lost them a phone customer, though. The devil in me would sort of like to make that happen.
All advice taken in the spirit in which it is intended.
9 comments:
- alaiyo said...
We have AT&T DSL internet (live in SE TN) and have had no appreciable problems. Now and then it gets slow, but not often (usually it turns out one of us is downloading something massive), and we've never had it just quit on us. We don't have the top-grade speed option, either, but except for those occasional times, it's always fast and available. I think we're paying $20.00 a month. I wouldn't switch.
- Mary said...
I've had DSL from AT&T ever since it was first offered under the old Bell South -- 15 years or so, I think. I experienced some problems in the early years but none during the last 5 yrs or so. I'm very pleased with the speed and the overall service/
- Mary said...
Forgot to give you my location - SW TN, the Memphis area/
- Lydia McGrew said...
Thanks for the info, guys.
On the other side, I'm getting very little data, period, good or bad, on Charter telephone. I think this must be because Charter's nationwide phone services are relatively new, so not many people have Charter for phone. Even Google isn't turning up many customer reviews, though I've seen one negative one. I looked at their FAQ and was struck by their even having to address the issue of a power outage. Seems their service comes with a battery backup to keep your phone service going in case of a power outage. Hmmm. That issue doesn't even arise with plain old telephone.
- Jeremy said...
AT&T customer service is really pathetic. The fact that you would need to connect and then cancel seems pretty typical to me. I swore never to use them again after a bad experience when I switched to them, but that was in 1998 or so, so I have softened somewhat.
I have phone and internet through the same company, and it is a pain when service is interrupted, no outside connection at all. I have to go digging for my pay-as-you go cell phone.
- Lydia McGrew said...
My husband raised that very question, Jeremy: Just occasionally Charter has had connection problems during the past month. If I switched my phone service to them, and they had a similar connection problem in the future, would my phone be out as well? That would be a huge bummer. At least this way, with the two independent, I could always call customer service when there was a problem with the Internet connection.
This is all beginning to sound like I should just stay put. Charter may be best for internet and is the "devil I know," and AT & T has been doing phone for longer than anyone else and never seems to have any connection problems, even in the worst storms. Perhaps it's worth it to pay a little more to let each company do what it does best and not put all my eggs in one basket.
- TS said...
We got AT&T everything (phone/cable/internet) last week and so far everything's fine (for what that's worth). I was told by Time Warner I could expect slow internet service from AT&T since the bandwidth is shared by any HD TVs we have, so if they are on the 'Net slows.
But then our internet was dead slow with Time Warner and our cable pretty much sucked so it was a no-brainer to switch since AT&T is cheaper.
- Todd McKimmey said...
We have AT&T Uverse which is outstanding. It's gone out once in a year and that had more to do with the over-enthusiastic backhoe driver than anything with AT&T itself. They even rolled our phone, internet, cable and cell phone packages together and got a great discount.
- vishal said...
- This comment has been removed by a blog administrator.


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Airline Perks for Tweeters?
Many of the perks once reserved for elites can now be purchased or earned on the merit of something other than miles flown, such as social media standing. Kelli Grant reports.
This transcript has been automatically generated and may not be 100% accurate.
... I ... our frequent flier miles pointless I'm Kelli Grant for MarketWatch and fliers who had been saving up all of their miles in the hopes of a free ticket might want to reassess their airline loyalty ... Airlines have been keeping away more of the perks usually reserved for elite frequent fliers in ... first class business class passengers which ... can bode well if you're in the market for an individual flight but isn't so great if you were hoping for an excellent free ticket and some of the perks that go along with it ... we've seen United in recent months they started settling ... clarity access to security lines and priority boarding for his little is nine dollars a segment ... mimic the American Airlines earlier this week announcing a partnership with social media influencers like clout ... to basically it's clean enough in Facebook enough they might be a will weasel your way into three airline lounge access which usually sells for about fifty dollars a day ... and all that spells out for frequent fliers that the smile might just not be as valuable shifting even on the redemption side were seen fees going up for that free ticket ... might actually cost you a couple hundred dollars to redeem depending on when you try to cash in the miles and we are headed ... to the basic advice is ... in addition this reassessing where even a fly look for those great airline deals and think about saving some money there may be even thinking about getting a general travel rewards card you think those points are a little more flexible than miles sometimes you can redeem them directly for airfare pretty good rate ... but oftentimes even just getting cash back will leave you with plenty of time to ... get the fear that you want to price the coupon ... and still have some awards left over ... read more on MarketWatch dot com I'm Kelli Grant ...


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Power strips can be a great way to save space, but sure use a lot of energy with all those outlets. Making the switch on the strip easy to reach and turn off makes it super easy to flip off before I go out for the day. I've been switching it off so much now that it has become a habit and I barely have to think about it anymore. Also, when I get home I don't turn it back on until I know I need it.
Energy points
Energy Challenge #1
Challenge Instructions
Quick! Save as much energy as you can in one day. Try a 24-hour Energy Save-A-Thon.
The cheapest energy is the energy you don't use.
Get Started
Rather than pecking away at a problem, sometimes going at it whole hog can be more fun and meaningful. Instead of trying to change the way you live all the time, this challenge is about shake things up a little bit to look at typical energy use in a new way. By giving a few things up for a little while, you might even get a sense of - dare we suggest - gratitude for what you've got...
- Pick a day. (Ideally one that works well for you and your family or friends if they're joining in)
- Plan and prepare (Check out the Resources for help!)
- Do it and **then** complete this challenge by sharing your photos, insights, and tips for others in the box below!)
Can't contemplate making a dent for a day? Get laser-focused on one energy area:
Rather than saving all the energy you can, pick one thing which uses a lot of energy and save as much as you can on that!
- Describe what you did, and why.
- What worked well? What didn't? Any takeaways?
This cute giraffe picture may come in handy:
Save-A-Thon Planning Tips:
- Think up some substitutions to energy-things you'll avoid during
- For things you can't give up, but will try to use less of, try to come up with ways to help you cut back for 24 hours.
- See below for more help!
Things that Use Energy
- Lights, hot water, electronics, cars, lava lamps, space heaters, anything that plugs in
- NOTE: the type of energy we're talking about is electricity or fuels like oil and gas.
Green Mountain Power Customer?
You can login to your account get your actual numbers and personalized tips!
Zero-Energy Alternatives
- Instead of TV, play a tabletop game.
- Instead of turning the heat up/on, dance around the house like nobody's watching!
Ways to Use Less
- Eat dinner before it gets dark.
- See how fast you can shower!
- Put some sticky notes on light switches to remind you not to use them.
Some Light Reading Just Because
The Biggest Innovation in Energy (The Economist)
Challenge Complete
Alternative Challenge


text: Find this wine Find this wine Chat Eu Oeuf 2010 Chat eu Oeuf:::: London at waitrose. Good glass of french red before dining.£5.99 !! Pin It Tweet 7 years ago by jetset WISDOM More posts Chat Eu Oeuf 2009 Great wine-12 bucks in Winnipeg 6 years ago by Duffeyspice Chat-eu-Oeuf 2010 Pretty good wine for it's price point(12.99). Tastes like berries and smells like vanilla and cinnamon. 7 years ago by Mnair207


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Seconda Soft is the soft companion of Seconda. A little friendlier, a little easier on the eye, a little more informal, a little more fashionable — but still the refined and reliable Seconda. Seconda Soft's softness comes from the moderate rounding of the edges of its characters.
Seconda Soft has sixteen styles, extensive language support, eight different kinds of figures, sophisticated OpenType features — so it's ready for advanced typographic projects.
For text and display use. When using Seconda Soft in small text sizes, it will be a reliable and legible text face. When using it in big display sizes, it will show its refined details.
Designer: Ben Blom
Design date: 2011


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Security and privacy are important concerns for anyone, especially in the wake of revelations about NSA intelligence activities and massive data breaches like the one at Target. A new study from Fortinet, however, indicates that security and privacy behavior differs significantly by generation.
Fortinet surveyed 150 Gen-X users and 150 Millenials with an even split between male and female respondents. The sample size may be a bit small to be scientifically conclusive, but the results are interesting nevertheless.
When it comes to password practices, the majority change their passwords periodically, even if it's only once a year. More than 40 percent of both Gen-X and Millenial respondents indicated that they never change their passwords, or only change their passwords when forced to. The good news is that only seven percent of those surveyed report using the same password everywhere. Four out of 10 respondents claim to use a unique password for each site and service.
Nearly half of Gen-Xers also fail to protect their smartphone with a PIN or passcode of some sort, while only 37 percent of Millenials are that cavalier. The standard 4-digit PIN is the most popular method, followed by a more complex alphanumeric password. Swiping patterns are used by just over 20 percent, but only five percent use biometric authentication such as facial recognition.
Social Security numbers ranked as the most valuable personal information to protect for both generations, but after that the responses diverge--particularly when it comes to protecting work email. Work email came in as the fifth highest concern for Gen-X, but it didn't even make the top 5 for Millenials.
John Maddison, vice president of marketing for Fortinet pointed out that this sentiment is concerning. A previous survey from Fortinet found that 51 percent of Millenials would ignore company policies restricting the use of their own devices or cloud services at work. "Taken together, Millennials are essentially saying, We don't care what our employers say. We'll use whatever device we want to at work and if businesses data gets lost or goes missing, too bad.'"
That generation gap--and the difference in philosophy about security and privacy--illustrates changing attitudes about what information is important, and what's not. The cavalier attitude about work policies and protecting work data will be a growing concern for employers as Millenials make up an increasing segment of the working population.
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We're absolutely obsessed with all things Oscar de la Renta.
His clothing is impeccable, his new fall polishes are to-die-for (and available now!!), and the hair (by Orlando Pita) and makeup (by Gucci Westman, who's also Revlon's Global Artistic Director) at his fall 2013 runway show was drop-dead gorgeous. Did we mention it was more than one hair and makeup look? Four to be exact. Swoon.
"Each of the four looks represents a different type of girl: Gypsy, Sophisticate, Urban Chic and East Asian Jet Setter," said Westman. "The one common thread is purity. I created a look that highlights the innate beauty of the face from the eyes to the lip to clear, shiny skin."
The kick off the show, the models started down the runway wearing minimal makeup and a bold coral lip (the "Urban Chic" look), while the hair was up in the back with pieces left down, framing the models' faces (some even wore lampshade hats). To get the lip color, use Revlon ColorStay Ultimate Suede Lipstick in It Girl, $10, drugstore.com.
Next, the lip look changed into a bold red shade ("East Asian Jet Setter") and the hair was parted in the center and thrown into side chignon updo, adorned with bejeweled accessories. For this lip shade, reach for Revlon ColorStay Ultimate Suede Lipstick in Trendsetter, $10 each, drugstore.com
Then, came the nude look ("Sophisticate"), which included barely there makeup and super relaxed chic, wavy hair. To score this lip look, use Revlon ColorStay Lipliner in Natural, $8, drugstore.com, topped with Revlon Illuminance Crème Shadow in Not Just Nudes, $6, drugstore.com.
The final look ("Gypsy"), which was completely different that the previous three, was a very intense blackened burgundy lip (use Revlon Just Bitten Lipstain in Midnight, $9, drugstore.com, topped with Revlon Super Lustrous Lipstick in Black Cherry, $8, drugstore.com) with the color focused in the center, and a blackberry wet-looking shade around the entire circumference of their eyes. This makeup was paired with a 1920's fingerwaves style that was sleek on top and free-flowing from the midshaft of the hair to the ends. The hair was also deeply parted in line with the center of the models' eyebrows and swept to one side.
What do you think about these four looks? And will you be trying one of them out for date night?
Photo: Getty Images


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Baker study reveals better design of healthcare exchanges could save consumers over $9 billion
When the Affordable Care Act's "individual mandate" takes effect in October, millions of Americans will be hard pressed to select the best health insurance coverage for their needs, unless relatively simple design features are incorporated into the state and federal websites they will use to choose a policy. Smart design of those websites, the so-called health insurance exchanges at the heart of Obamacare, could save consumers and the government more than $9 billion annually.
Those are the key findings of a new study, "Can Consumers Make Affordable Care Affordable? The Value of Choice Architecture," co-authored by University of Pennsylvania Law School professor and health insurance expert Tom Baker and colleagues at Columbia University, Hebrew University of Jerusalem, and the University of Miami.
Baker and co-authors caution that the new health exchanges may not be designed in ways that provide consumers with the guidance they need to select the most cost-effective policies.
"While the success of the health exchanges will depend, in part, on the provision of cost-efficient products [by insurance companies], it also will depend, to some extent, on the design of exchanges that will allow consumers to identify them and to choose plans that are good fit to their needs," the study authors write.
Are the exchanges being well designed? "Some states are trying very hard to use good choice architecture, but others are overwhelmed," Baker said. "I have high hope for the federal web portal because we have been providing our research results to the Department of Health and Human Services, and we get the sense that they understand the essential message. My prediction is that it will take a couple of years to learn what works."
If consumers cannot make informed choices, the researchers note, then the insurance exchanges will not produce competitive pressures on health plan costs, one of the main advantages of the Affordable Care Act's reliance upon choice and markets. Under the terms of the health care law, states have the option of designing their own exchanges, or using one developed by the federal government.
Based on a Congressional Budget Office estimate that 20 million Americans will purchase insurance through the new exchanges and the magnitude of error measured in the experiments, Baker and his colleagues estimate that unaided choice represents a cost to consumers of $9.12 billion each year. Moreover, since almost all health insurance policies sold through the exchanges will be subsidized by tax credits, websites with good choice architecture would produce substantial savings not only to individual consumers, but to the federal budget and taxpayers, as well.
Baker is the William Maul Measey Professor of Law and Health Sciences at Penn Law. He and his co-authors conducted a series of experiments to see how well or poorly respondents performed when asked to select the best health insurance policy for their needs. Without aids, most participants had difficulty making good choices. The only group that performed reasonably well in the experiments were financially savvy Columbia MBA students.
Consumers face two tasks when choosing insurance. The first is to estimate their expected usage and out-of-pocket expenses for the upcoming year. The second is to select the right plan given their expected usage.
The experiments, which presented a simplified version of the health insurance choice, focused on the second task. Subjects were asked to imagine they were choosing health insurance for a family of three – themselves, a partner, and one child – with an anticipated number of doctor visits and out-of-pocket health care costs over the next year.
Each subject was required to choose one plan from a set of four plans and one from a separate set of eight plans. With four choice options, respondents selected the best option 42 percent of the time. With eight options, they selected the correct option only 21 percent of the time, a result no different from chance. Compounding the problem, the respondents seemed unaware that they were making poor choices.
The MBA students, on the other hand, chose the right option 73 percent of the time.
With a little assistance, outcomes improved dramatically for typical consumers. When provided with "smart" default options that preselected the most cost-effective plan and a cost-calculator, the performance level of ordinary respondents was comparable to those of the MBA students. Average errors costing individual consumers $533 dropped to $77.
"Our results present a bad news/good news story of particular importance," the authors write. "The bad news: Consumers left to their own devices seem to make large errors when choosing health insurance…..The good news is that we have demonstrated that exchange designers can improve consumers' performance markedly."
The paper, co-authored by Baker and Eric J. Johnson of the Columbia Business School, Ran Hassin of Hebrew University, Allison T. Bajger of the Columbia University Dept. of Psychology, and Galen Treuer of the University of Miami, was issued by Penn Law's Institute for Law and Economics.


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Israel News - Stay Informed, Pray Informed
Hundreds of thousands have been killed and millions displaced in Syria's ongoing civil war. And still, the international community and the Arab world drag their feet, to the growing frustration of Syrian dissidents, many of whom are now ready to seek aid from even their worst enemy: Israel.
The Syrian arena is being used as a kind of chessboard by world powers and powerful regional Muslim groups. And as the Syrian people are paying the price, it is becoming increasingly clear that Israel is one of the few nations that just wants the fighting to end in a way that is most stable and most secure for all involved.
"The Saudis were the worst, followed by the French, the British and the Americans," leading Syrian dissident Kamal al-Labwani told The Times of Israel regarding recent Syria peace talks held in Geneva.
Noting that Washington was making the same mistakes it made in Egypt, Labwani said, "More than once I've heard Americans say that 'the [Muslim] Brotherhood must lead this stage.' We told them: 'The Brotherhood are extremists, not moderates. This is not Islam which is appropriate for civilization.'"
According to Labwani, the Syrian revolution, like those in Egypt and Tunisia, didn't have to descend into civil war. It was only after the Assad regime treated demonstrators in a "criminal, unacceptable way" that people began to take up arms. Assad "intentionally humiliated people and killed them in cold blood. This is why the revolution began," said Labwani.
Of course, with war raging, the situation has been exploited by numerous different radical Islamist groups, many of them originating from outside Syria itself. Nevertheless, there is no turning back until Assad falls. Labwani and many others hope that Israel will increasingly assist in achieving that goal.
"If you want to befriend the Syrians, send a message of friendship. I tell you, my people are ready," he said.
What Labwani and others want is for Israel to use its influence with America, Europe and Russia to spur more serious action on the part of the international community. Ideally, he'd also like to see Israel directly supply weapons to the rebels, and perhaps even enforce a no-fly zone over southern Syria.
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April 12, 2008
The Bisons played Western Kentucky University on April 12th; ending their regular season before the Atlantic Sun Conference Tournament to be held on Apri l8th in Johnson City, TN.
The Bisons were on top of their game in the singles portion of the match. Joe McArdle, and James Murrell all won their singles matches.
Daniel Hangstefer and Mario Hernandez won their doubles match, but the Bisons could not seem to rally to win the doubles point today.
They are now gearing up for the Atlantic Sun Conference Tournament next weekend in Johnson City, TN.
Singles competition
1. Thomas Krug (WKU) def. Daniel Hangstefer (LU) 6-3, 6-2
2. Chad True (WKU) def. Jeff West (LU) 4-0, retired
3. Andy True (WKU) def. Mario Herandez (LU) 6-3, 4-6, 6-4
4. Currie Martin (WKU) def. Cummings (LU) 6-3, 6-7, 6-4
5. Joe McArdle (LU) def. David Bowman (WKU) 7-5, 6-0
6. James Murrell (LU) def. Andrew Swanson (WKU) 6-2, 6-0
Doubles competition
1. Daniel Hangstefer/Mario Herandez (LU) def. Thomas Krug/Chad True
2. Currie Martin/Andy True (WKU) def. Josh Cummings/Andy Mizell (LU) 8-6
3. Quinn Saine/David Bowman (WKU) def. Joe McArdle/James Murrell (LU) 9- 8


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Demand Felony Animal cruelty charges on the Maryland Teenager who killed his puppy.
To: Anne Arundel County Animal Control and others (yet to be named)
Maryland teenager accused of stabbing family puppy to death!
We the undersigned demand a full investigation is held on the 14 year old Linthicum boy who has been charged with STABBING to death the family's 10 week old Saint Bernard puppy in his bedroom.
Although this boy has no history of violent behaviour and there have been no explanations as to the reason why the teen allegedly killed the dog with a kitchen knife - which was found at the base of the bed.
A significant correlation between animal cruelty and violent behavior towards humans has long been established. In a 1997 study by Northeastern University and the Massachusetts Society for the Prevention of Cruelty to Animals, 40 % of animal abusers have committed violent crimes against people.
We understand that this boy has been charged with animal cruelty on a juvenile citation and then was released into the care of his father, but he still poses a risk to other animals and even people after committing such a heinous crime against an innocent puppy. He surely must be considered a danger to others.
Please do the right thing and show this boy that animal cruelty is a wrong, please push to have him fully investigated, evaluated properly by a Mental Health Team and then tried as an Adult with felony animal cruelty.
PLEASE READ and share widely.
News links:
The puppy's remains are now in the custody of the Anne Arundel County Animal Control pending an investigation.
please be polite and request that this boy is held accountable and punished for this animal cruelty killing.
Hours of Operation
Phone Number: Animal Control: (410) 222-8900
Address: 411 Maxwell Frye Road Millersville, MD 21108


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|System: PS3*, Xbox 360
|Dev: CyberConnect2
|Pub: NAMCO Bandai
|Release: March 13, 2012
|Players: 1
|Screen Resolution: 480p-1080p
|Cartoon Violence, Mild Language
Now, the Naruto anime and manga are normally told from Naruto's point of view. However, the story mode of the game tells the stories of other characters independent of Naruto. You'll be able to follow the adventures of loved side characters like Rock Lee and Kakashi during important events in the Naruto timeline. Once again, these events are animated by the official animation team and acted by the official voice actors. Not only that, but these side-stories are officially canon. They are aspects of the Naruto story that you can only see by playing this game. That alone makes this a must-have title for any Naruto fanatic.
The game also has a fully implemented online mode, but the netcode isn't the best around. While you can join lobbies and voice chat, there are times when lag becomes noticeable even through local connections. Finding a match was also rather difficult, but that may have only been because the game was so new.
Naruto Shippuden: Ultimate Ninja Storm Generations is easily the best Naruto fighting game to come out to date. The single-player alone makes the game worth buying, as it boasts one of the most competent and well-put-together story modes ever seen in a fighting game. The game system itself is complicated but easy to learn and accurately simulates an epic Naruto anime battle. Unfortunately, there are still some massive balance issues for some characters and the uses of the chakra button could have been planned out better, but these are just minor gripes. Though I wouldn't recommend this game to the serious tournament fighter that is looking to go to EVO this year, I'd easily recommend it to anyone who has even a passing interest in the Naruto series.
Angelo M. D'Argenio
Contributing Writer
Date: March 13, 2012
Game Features: