Karyn Stanley worked as a firefighter for the City of Sanford, Florida, starting in 1999. At first, she planned to serve for 25 years. Part of the reason for that had to do with health insurance. When Ms. Stanley was hired, the City offered health insurance until age 65 for two categories of retirees: those with 25 years of service and those who retired earlier due to disability.

In 2003, the City changed its policy to provide health insurance up to age 65 only for retirees with 25 years of service, while those who retired earlier due to disability would receive just 24 months of coverage.

Ms. Stanley later developed Parkinson’s disease, a disability that forced her to retire in 2018, entitling her to only 24 months of health insurance under the revised policy.

Ms. Stanley sued, claiming the City violated the Americans with Disabilities Act by providing different health-insurance benefits to those who retire with 25 years of service and those who retire due to disability.

The City responded by filing a motion to dismiss Ms. Stanley’s complaint for failure to state a claim. The district court denied that motion in part, allowing some of Ms. Stanley’s claims to proceed. But with respect to her ADA claim, The district court dismissed her ADA claim, reasoning that the alleged discrimination occurred after she retired, when she was not a “qualified individual” under Title I of the ADA, 42 U. S. C. §12112(a), because she no longer held or sought a job with the defendant. The Eleventh Circuit Court of Appeals affirmed the trial court.

The Supreme Court of the United States affirmed the the Eleventh Circuit in the case of Stanley v City of Sanford, Florida -No. 23–997 (June 2025).

Title I of the Americans with Disabilities Act bars employers from “discriminat[ing] against a qualified individual on the basis of disability in regard to . . . compensation” and other matters. 42 U. S. C. §12112(a). The statute defines a “qualified individual” as “an individual who, with or without reasonable accommodation, can perform the essential functions of the employment position that such individual holds or desires.” §12111(8).

The question before the United States Supreme Court in this case concerns whether a retired employee who does not hold or seek a job is a “qualified individual.”

The Eleventh Circuit concluded that §12112(a) does not reach allegations of discrimination against a retiree “who does not hold or desire to hold an employment position” that she is capable of performing with reasonable accommodation. 83 F. 4th 1333, 1337 (2023).

But, the court acknowledged, not every court of appeals would agree. Like the Eleventh Circuit, the Sixth, Seventh, and Ninth Circuits (Weyer v. Twentieth Century Fox Film Corp., 198 F.3d 1104, 1112 (9th Cir. 2000) ) have said that Title I’s anti-discrimination provision “does not protect people who neither held nor desired a job with the defendant at the time of discrimination.” Id., at 1341.

But the Second and Third Circuits take a different view. As those courts see it, the ADA’s definition of “qualified individual” is “ambiguous,” and they have resolved that ambiguity “in favor of ” extending the statute to reach retirees like Ms. Stanley. Ibid.

SCOTUS resolved the circuit court conflict, and agreed with the Eleventh Circuit in this case, (and with California and the 9th Circuit which previously came to the same conclusion.) To prevail under the ADA §12112(a), a plaintiff must plead and prove that she held or desired a job, and could perform its essential functions with or without reasonable accommodation, at the time of an employer’s alleged act of disability-based discrimination.

Shawn Pollard sustained admitted injury on October 20, 2016 while employed as an Equipment Operator by Lemstra Cattle Company. This applicant selected Michael Azevedo, M.D., as his PTP. The parties have further selected M. Nathan Oehlschlaeger, D.C., as the QME in chiropractic medicine.

The Defendant obtained surveillance video of applicant on multiple occasions between December 1, 2022 and February 22, 2023. On March 6, 2023, the parties completed the deposition of the QME.

Following the QME deposition, On April 14, 2023, defendant sent a letter to applicant’s counsel attaching surveillance videos and proposing their submission to the QME, barring objection received in twenty days. On April 18, 2023, applicant’s counsel timely objected to the submission of surveillance video to the QME.

On May 23, 2023, PTP Michael Azevedo, M.D., issued a PR-2 interim report in response to a request that he review sub rosa video of applicant. The PTP’s report discussed the films and the physician’s opinions regarding applicant’s work restrictions.

On September 27, 2023, the parties proceeded to trial and framed for decision the issue of whether defendant was precluded from sending surveillance video to the QME. The parties also framed the issue of the admissibility of the May 23, 2023 report of the PTP. The WCJ heard testimony from the claims examiner and ordered the matter submitted for decision.

On December 7, 2023, the WCJ issued the F&O, determining in relevant part that “Defendant is precluded from sending the surveillance videos in question to the QME, Dr. Oehlschlaeger.” The WCJ further ordered the May 23, 2023, report of PTP Dr. Azevedo excluded from evidence.

The Defendants’ Petition for Removal filed with the WCAB over this Order was granted in the panel decision of Pollard v Lemstra Cattle Company – ADJ10675931 (June 2025).

Defendant’s Petition for Removal acknowledges that it obtained multiple dates of surveillance videos and that “[t]he video obtained in 2017 and 2021 was not previously disclosed to any party, partly because the deposition of the applicant had been scheduled, re-scheduled, continued several times, but never actually took place.”

Defendant contends the WCJ’s order disallowing submission of the surveillance videos to the QME is prejudicial because defendant has complied with the applicable statutes regarding submission of information to the QME. Defendant acknowledges that “[t]here is no real dispute here that the surveillance videos in question would have constituted information and had to be sent to the applicant’s attorney 20 days prior to being sent to Dr. Oehlschlaeger … [w]hen applicant’s attorney timely objected, the only way the videos could be sent to the PQME would be by order of the court.” Defendant thus contends it has complied with the provisions of Labor Code section 4062.3 and Administrative Direct (AD) Rule 35 (Cal. Code Regs., tit. 8, § 35) and should be allowed to send the subject videos to Dr. Oehlschlaeger for his review.

Generally, when a party makes a demand pursuant to Hardesty v. Mccord & Holdren (1976) 41 Cal.Comp.Cases 111, 114 [1976 Cal. Wrk. Comp. LEXIS 2406] for service of existing evidence, including sub rosa video, the employer is obligated to promptly serve the requested materials. A failure of timely service of sub rosa video or other demanded evidence may result in the imposition of various monetary or evidentiary sanctions, including the exclusion of evidence from the record. (Lab. Code, §§ 5502(d)(3).

The WCAB noted that “Here, however, it does not appear that applicant’s deposition has been accomplished, nor has the defendant sought to introduce the sub rosa video into evidence at mandatory settlement conference on the case in chief. Rather, defendant has provided applicant with a copy of the sub rosa video and proposed to submit the video to the QME for review unless applicant objected within twenty days pursuant to section 4062.3(b).”

The WCAB panel concluded by saying “On this record, we discern no violation of our Rules or other statutory prohibition that would preclude the QME’s review of sub rosa video. Accordingly, we will grant defendant’s petition, rescind the F&O, and substitute a new finding of fact that defendant may submit the surveillance video dated December 1, 2022, December 9, 2022, December 14, 2022, February 16, 2023, February 21, 2023, and February 22, 2023, to QME Dr. Oehlschlaeger.”

And “having concluded that defendant followed the procedure for submission of sub rosa video to the QME under section 4062.3(b), and that the sub rosa video may be submitted to6 the QME as a result, we discern no basis upon which to exclude the PTP’s reporting following review of the same evidence.”

The Santa Clara County District Attorney’s Office has charged a San Jose fraud prevention expert with submitting more than 150 fraudulent healthcare claims for over $100,000 against her tech company’s health plan.

Faranak Firozan, 47, faces numerous felony charges, including altering medical records with fraudulent intent and preparing false statements in connection with insurance claims. She also faces an Aggravated White-Collar Crime Enhancement. Firozan will be arraigned on July 15, 2025, in Department 23, at 1:30 p.m., at the Hall of Justice in San Jose. If convicted, she could face years in prison and would be ordered to pay any outstanding restitution.

Firozan was a senior manager of privacy and security at NVIDIA and regularly spoke as an expert on fraud prevention. She is accused of submitting 167 fraudulent claims, many of which were entirely made-up, between November 2020 and January 2024 to NVIDIA’s self-insured health plan, which is administered by Cigna.

“It’s crucial for everyone, especially those who are experts in fraud prevention, to uphold the same standards they promote,” District Attorney Jeff Rosen said. “We are grateful for our partners in this investigation that brought this serious matter to light.”

Firozan’s scheme was unraveled through subpoenas, provider interviews, and bank records in a joint investigation by the DA’s Bureau of Investigations (BOI) and the California Department of Insurance (CDI).

In August 2024, CDI received a suspected fraudulent claim referral from Cigna. Firozan had been flagged previously in Cigna’s system in October 2023 after she submitted a large amount of reimbursement claims in one month. Many of the claims featured handwritten codes.

“Insurance fraud drives up costs for everyone and erodes trust in the system,” said Insurance Commissioner Ricardo Lara. “When someone entrusted with preventing fraud is accused of committing it, that betrayal must be met with accountability. I commend our investigators and the Santa Clara County DA’s Office for their strong partnership in this case.”

Firozan is accused of altering bills by changing service dates and often fabricating entire documents. Providers verified that services listed in her claims were either not performed at all or were duplicated claims.

On her LinkedIn page, Firozan described herself as an expert in abuse prevention systems and fraud investigations for financial institutions. In 2020, she provided training on cyber laundering for the Information Systems Security Association Silicon Valley Chapter.

The DA’s Office and CDI urge anyone with further information on this case or any similar fraud matters to contact BOI Investigator Kathleen Rak at krak1@dao.sccgov.org. The DA’s Office emphasizes the importance of maintaining the integrity of insurance systems and its dedication to prosecuting fraudulent activities to the fullest extent of the law.