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FCN Investigates: City of Jacksonville Spends to Spy, Won't Pay for Health Care

10:59 PM, Feb 9, 2011   |    comments
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JACKSONVILLE, Fla. --  Medals and commendations line the walls of Rusty Butler's home, awards for saving lives and homes.
 
"When you go in, and find somebody and bring them out it's just, it's a good feeling, a good feeling," said Butler.

A Jacksonville firefighter for more than two decades, Butler had no choice but to retire in 1996. "At a real hard working fire, I would just, my face would turn red. Guys on rescue would check my blood pressure, and it would be sky high," said Butler. "And they would have a fit."

Butler was diagnosed with heart problems and high blood pressure. For years, his medication and doctor's appointments were paid for by the city of Jacksonville under a decades-old state statute called the Heart and Lung Bill, which protects Butler as well as other firefighters and police officers.

The statute said if there's a health problem "....caused by tuberculosis, heart disease or hypertension resulting in total or partial disability or death (it) shall be presumed to have been....suffered in the line of duty unless the contrary be shown by competent evidence."

The presumption is high blood pressure and heart disease are a direct result of a firefighter or officer's stressful job. Before law enforcement or firefighters can even start on the job, they have to pass a physical showing that heart disease or high blood pressure are not problems. Butler said he passed.

He also said for seven years after he was diagnosed, the city  covered medical bills dealing with his heart problems. But in 2003, he said it just stopped and started denying his claims.

"After seven years...doctor wanted me to have a test, workers comp refused to pay for it,"  Butler said.

He was shocked, but his situation is not that unusual.

According to city records, there have been 441 heart and lung claims in the last five years. More than 65 percent of them were denied by the city's Division of Risk Management.

Requests for comment from Jacksonville's chief of risk management, chief of human resources and general counsel were denied.

The response to 41 basic questions about the denials emailed to city personnel, was either that the information was protected or that it would cost more than $362,000 to do research and provide answers.

"I've had 50, 60 cases and they've probably denied 50-60 cases," said attorney Jake Schickel, who represents Jacksonville firefighters he said have to battle it out for their workers' compensation payments.

There was never a problem getting coverage until around 2003, said Schickel.

"The city of Jacksonville has taken the position since then and has fought virtually all of them and denied compensability," said Schickel, adding that he can't understand why because the law is clear.

"When virtually everyone is denied, there is a pattern of denial," said Schickel, who said he has asked the city why and was told, "that's their business and not mine." 

The city also has not responded to questions about how much in total attorney's fees have been paid out to lawyers representing employees.  

In two cases, which went to Florida's District Court of Appeals, the city paid attorneys more than $97,000.

"Why in the world would you waste this taxpayer money?" asked attorney Marc Hardesty, who has fought the city numerous times for heart and lung bill benefits for JSO officers.

The system has gone from bad to worse since 2003, he said.

"There's a number of cases...I've learned that 10, 15, 20 thousand dollars have been spent and thrown away on some surveillance that nets absolutely nothing," said Hardesty.

Some surveillance  taken since 2002 of a retired firefighter who had to leave his job after being trapped in a fire and losing part of his lungs showed him visiting a barbecue joint and a fire station. There are pictures of him walking around a job site, unloading boxes, putting up a tent, running a bulldozer and standing around at a job site.

The city would not comment on why it paid to follow him to these places; state law does not allow it to.  

But his attorney said the firefighter's doctor signed off doing "a few things on a limited short term basis.

"(He) lost ... over half of his lung capacity rescuing some people out of a fire. He won a national award, as a hero," said Schickel. 

So far, $52,750 has been spent on watching the retired firefighter. "$52,000 is just horrendous. I don't mind them going and looking in the first instance  - can he do it or not - (but) there becomes a limit," said Schickel.

Schickel said nothing ever happened with the case because of the surveillance pictures, but he questions why the surveillance continued and taxpayer money was spent in the first place. 

"I think that, that is an enormous amount of money, and if they were able and successful in proving the person was committing fraud then presumably the money was worthwhile. But if they didn't, then it's a tremendous waste of taxpayer money."

The city spent slightly more than $105,000 on surveillance in 2006. That number grew over the years. In 2010, it was well over $304,000.

In five years, more than $831,000 was spent on surveillance alone. More than $3,000 of that was spent on Rusty Butler's case. "I had hired a guy to do some tractor work, and they thought it was me on the tractor, but it wasn't."

The city's response was once again, a request for more than $362,000 to get some answers on surveillance questions. It also said some information wasn't releasable. 

When asked how much fraud has been uncovered in the last five years because of surveillance, the city asked for a definition of  fraud. But even provided the definition, the city has not responded.

"I would ask them why they didn't hold up their end of the bargain when I retired under the Heart and Lung Bill," said Butler. 

Every day, Butler said it feels like his life is a gamble. The city's risk management department recently denied another claim, and he had to go to court to fight for the coverage, which he ultimately received. But the process delayed needed medical help.

"It scares me. I'm thinking, doggone, what if something serious was to happen, (a) stroke or something...I might not get taken care of because workers comp denies it."

Thursday night at 6, First Coast News will continue our investigation into the city's worker compensation program. You will see how other basic job injuries are being disputed by the city, as well as just how much taxpayer money goes to area doctors as part of the workers comp program. 

MORE: The city's response

MORE: THE $362,000 ESTIMATEGRID FOR HEART AND LUNG APPEALS/DENIALS | CITY'S QUESTIONS AND ANSWERS 

WANT TO SOUND OFF?:

Click here to email Mayor John Peyton and head of Department of Risk Management Charles Spencer

Click here to email the presidents of the Jacksonville Firefighters Association and Fraternal Order of Police

Click here to email the city council          

 

 

 

 

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