People v. Oshana

2012 IL App (2d) 101144
Appellate Court of Illinois·Decided February 9, 2012·No. 2-10-1144·Published·Cited by 5 cases

Opinion

ILLINOIS OFFICIAL REPORTS Appellate Court

People v. Oshana, 2012 IL App (2d) 101144

Appellate Court THE PEOPLE OF THE STATE OF ILLINOIS, Plaintiff-Appellee, v. JIM Caption OSHANA, Defendant-Appellant.

District & No. Second District Docket No. 2-10-1144

Filed February 9, 2012

Held On appeal from defendant’s convictions on two counts of workers’ (Note: This syllabus compensation fraud and the entry of an order for restitution, the appellate constitutes no part of court reversed the conviction on the count charging that defendant made the opinion of the court a false claim for workers’ compensation benefits, since there was but has been prepared insufficient evidence of such a violation, especially in the absence of a by the Reporter of showing that defendant did not have a compensable claim or that some Decisions for the other aspect of his claim was fraudulent, but his conviction on the count convenience of the charging that he intentionally made a false or fraudulent material reader.) statement to obtain benefits was upheld on the ground defendant misrepresented his level of pain and his inability to use his right hand and arm, and, further, the restitution order was reduced by the cost of surveillance that occurred before defendant’s fraudulent statements came to light and was not the result of his criminal acts.

Decision Under Appeal from the Circuit Court of Kane County, No. 09-CF-1166; the Review Hon. Timothy Q. Sheldon, Judge, presiding.

Judgment Affirmed as modified in part and reversed in part. Counsel on Joseph Younes, of Law Offices of Joseph Younes, of Chicago, for Appeal appellant.

Joseph H. McMahon, State’s Attorney, of St. Charles (Lawrence M. Bauer and Scott Jacobson, both of State’s Attorneys Appellate Prosecutor’s Office, of counsel), for the People.

Panel JUSTICE SCHOSTOK delivered the judgment of the court, with opinion. Justice Burke concurred in the judgment and opinion. Justice Hutchinson specially concurred, with opinion.

OPINION

¶1 On August 5, 2010, the trial court found the defendant, Jim Oshana, guilty of two counts of workers’ compensation fraud (820 ILCS 305/25.5(a) (West 2006)). He was sentenced to 24 months’ probation, fined, and ordered to pay restitution in the amount of $22,594.61 to Gallagher Bassett, the administrator of workers’ compensation benefits for the defendant’s employer, to reimburse it for the costs of investigating the defendant’s workers’ compensation claim and its attorney fees. The defendant appeals, arguing that the statute is unconstitutionally vague, that there was insufficient evidence to convict him, and that Gallagher Bassett is not entitled to restitution for certain expenses. We affirm as modified in part and reverse in part.

¶2 BACKGROUND ¶3 The defendant began working for Plote Construction, Inc., in February 2006. On October 12, 2006, the defendant missed his footing as he was climbing out the back of a truck trailer he had been washing out and he fell to the ground, injuring his right arm and shoulder. He reported the injury to Plote’s safety director, left work, and went to the emergency room at Alexian Brothers Medical Center. Staff there took X-rays of his shoulder. He was told not to go back to work and advised to see a specialist at Sherman Clinic. Plote’s safety director contacted Gallagher Bassett that same day to report the defendant’s injury. ¶4 On October 16, 2006, the defendant visited Sherman Clinic, where he was given medication, restrictions on his physical activities, and an order to stay off work. Around this time, Pamela Hathaway, a senior claims representative for Gallagher Bassett, contacted a private investigation company named Infomax to perform surveillance on the defendant. ¶5 The defendant saw an orthopedic surgeon, Dr. Sarmed Elias, on October 19, 2006. The defendant reported that his level of pain from his shoulder was 9 on a scale from 1 (the least

-2- pain) to 10. Dr. Elias had an MRI taken of the defendant’s shoulder and told him to remain off work for two weeks. ¶6 On October 25, 2006, Infomax employee Wayne Otto conducted surveillance of the defendant’s home, beginning at about 6 a.m. At about 3 p.m., Otto observed (and videotaped) the defendant returning home. The defendant carried groceries from the car to the house using his right hand and also pulled garbage cans out to the curb. On October 31, 2006, Otto again conducted surveillance on the defendant and followed him as he drove from his home to a construction site at Benito Juarez High School in Chicago. Once there, the defendant put on a hard hat and appeared to be involved in overseeing various contractors, doing tasks such as carrying blueprints and multiple cups of coffee without any signs of disability. The defendant worked an entire day there. ¶7 On November 2, 2006, Otto again followed the defendant to the high school, where the defendant again wore a hard hat. Otto described the defendant’s movements as “uninhibited.” Otto lost sight of the defendant about noon. The defendant saw Dr. Elias that same day. The defendant filled out an Oswestry (intake) form on which he reported that his level of pain was between a 9 and a 10. Dr. Elias used the Oswestry forms his patients gave him to calculate their levels of disability. On November 2, 2006, Dr. Elias computed that the defendant was 70% disabled because of his neck. (At trial, Dr. Elias explained that there was an overlap between shoulder symptoms and the neck.) Dr. Elias reviewed the defendant’s MRI with him, opining that the defendant had suffered a staggered complete tear of the right shoulder rotator cuff tendon. Dr. Elias recommended that the defendant undergo a carpal tunnel release and an epidural injection for herniated disks in his lower back, and he made a note that the defendant’s rotator cuff would need repair. Dr. Elias gave the defendant medication and ordered him to stay off work for another two weeks. ¶8 The next day, November 3, Hathaway conducted a telephone interview with the defendant covering various topics. Early in the interview, Hathaway asked the defendant whether he had graduated from high school. The defendant replied that he did not graduate and then said, “I do have a diploma high school background, but a different country.” Hathaway then asked the defendant to tell her about the October 12 accident and he did so. After that, the following exchange occurred: “Q. [Hathaway]: And I’m going to go back to your employer. You work for Plote and you work. So you’re full-time, correct? A. [the defendant]: Correct. Q. Alright [sic]. And you work the night shift. Now do you work for anyone else? A. No. Q. No other employers. Are you an independent contractor for anybody? A. No ma’am. Q. And do you own your own business? A. No ma’am.” ¶9 On November 8, 2006, the owner of Infomax, Dean Gluth, conducted surveillance on the defendant. Gluth observed that the defendant was carrying a beverage cup in his right hand

-3- as he left his house. Gluth followed the defendant as he drove to a different construction site at the 68th Street Pumping Station. Gluth videotaped the defendant using both hands as he used his cell phone, gave directions, took pictures of the site, and carried and rolled and unrolled blueprints throughout the day. The defendant also picked up some temporary fencing and moved it. ¶ 10 The next day, November 9, Otto followed the defendant to the 68th Street work site again. When he arrived, the defendant began tightening the orange plastic fencing around the site, using both arms without any apparent restriction.

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People v. Oshana, 2012 IL App (2d) 101144 (Ill. Ct. App. 2012).

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