Opinion ID: 37885
Heading Depth: 2
Heading Rank: 3

Heading: Sufficiency of Evidence on Counts 16-18

Text: 11 In his motion for judgment of acquittal, Dotson cited Gonzales v. Prudential Insurance Co. of America, 901 F.2d 446, 450 (5th Cir.1990), which discusses the well-settled rule[] of Louisiana insurance law that [r]egardless how the policy itself may define `total disability,' . . . the term means the inability of the insured to do substantially all of the material acts necessary to the prosecution of his business or occupation in his usual and customary manner. As described in Gonzales, an insurer therefore may not withhold disability benefits solely on the basis of a claimant's working at a different occupation. Id. Later in the year that Gonzales was decided, the Louisiana legislature enacted LA. REV.STAT. § 22:230 concerning the definition of total disability in disability policies issued in the state. This section codifies a rule similar to that described in Gonzales, except that under the statute a claimant could be denied benefits for working at a job with substantially the same earning capacity as his former job, while under the previous rule he would have to be working at the same job. LA.REV.STAT. § 22:230(C). 5 12 Dotson argues that whether the rule described in Gonzales or that of section 230 is applied, Louisiana law made Dotson eligible for the PFIA benefits despite his work at the grocery store. Specifically, he argues that because the government did not establish that Dotson was able to work either at his original job or at a job having substantially the same earning capacity, his work at the grocery store did not disqualify him for benefits. Because he was entitled to the benefits, Dotson claims that he could not have defrauded PFIA, even if he had intended to, because his scheme carried out as intended would not have resulted in fraud. 6 In other words, Dotson argues that it was a pure legal impossibility for him to have defrauded the PFIA by receiving benefits while working at the grocery store, because the legal impossibility was one which occurs when the actions which the defendant performs or sets in motion, even if fully carried out as he desires, would not constitute a crime. United States v. Farner, 251 F.3d 510, 513 (5th Cir.2001). 13 To prove mail fraud under 18 U.S.C. § 1341 7 in this circuit, the government must show (1) a scheme to defraud; (2) use of the mails to execute that scheme; and (3) the specific intent to defraud. United States v. Strong, 371 F.3d 225, 227 (5th Cir.2004). For the crimes of larceny and robbery, there have been cases holding that taking of money from another in the good-faith belief that the money was owed to the defendant does not constitute larceny or robbery, in that the defendant did not intend to deprive the victim of the victim's property. See, e.g., Barton v. State, 88 Tex.Crim. 368, 227 S.W. 317, 318-19 (1921), overruled by Crawford v. State, 509 S.W.2d 582 (Tex.Crim.App.1974); People v. Gallegos, 130 Colo. 232, 274 P.2d 608, 609 (1954) (en banc), overruled by People v. Moseley, 193 Colo. 256, 566 P.2d 331, 335 (1977) ( en banc ). This rule, to the extent it ever held sway, appears to have been widely abandoned. See, e.g., State v. Ortiz, 124 N.J.Super. 189, 305 A.2d 800, 801-02 (1973); Commonwealth v. Dombrauskas, 274 Pa.Super. 452, 418 A.2d 493, 496-97 (1980); State v. Russell, 217 Kan. 481, 536 P.2d 1392, 1393-94 (1975). In some cases, courts have rejected the rule by reasoning that money owed to a creditor is not the same as money owned by the creditor. See Edwards v. State, 49 Wis.2d 105, 181 N.W.2d 383, 387-88 (1970); State v. Bull, 259 N.J.Super. 120, 611 A.2d 672, 673-74 (1992), overruled on other grounds, State v. Mejia, 141 N.J. 475, 662 A.2d 308, 320 (1995); Russell, 536 P.2d at 1393-94; Fanin v. State, 51 Tex.Crim. 41, 100 S.W. 916, 917-18 (1907) (all noting distinction between money and specific property in this context). In other cases, courts have invoked public policy arguments against self-help. See Dombrauskas, 418 A.2d at 497; Ortiz, 305 A.2d at 802; Henderson v. State, 149 Tex.Crim. 167, 192 S.W.2d 446, 447 (1946). 14 Dotson's argument of legal impossibility goes even farther than a claim that he lacked the intent to defraud. After all, to invoke the defense to larceny discussed above, the defendant had to prove he had a good-faith belief in his right to the property. Openness of the taking and reasonableness of the belief have been considered indicative of such a good-faith belief. 3 WAYNE R. LAFAVE, SUBSTANTIVE CRIMINAL LAW § 19.5(a) (2d ed. 2003). Although Dotson testified that he believed he was entitled to the PFIA benefits, there was sufficient evidence for a rational jury to find otherwise. Rather than being open about his claim to the PFIA benefits despite his work at the store, Dotson declined to inform PFIA about the work. Furthermore, he did not bring up the apparent discrepancy between the policy's use of your job and the claim form's use of work of any kind in defining total disability, but repeatedly signed the claim forms during the period he was working. Dotson does not argue that the evidence fails to establish the intent to defraud. Instead, he argues that even if he had such an intent, his actions could not have resulted in fraud because he was entitled to the benefits. Continuing the above analogy to larceny or robbery, an example of Dotson's legal impossibility argument in that context might involve a defendant who intended to steal a victim's property and did so, only to later discover that the property actually belonged to the defendant. In such a scenario, the argument goes, the defendant could not be guilty of theft or robbery because he would not have taken the property of another. 15 Dotson's situation does not present a case of legal impossibility, however. The money used by PFIA to pay Dotson's claims was unmistakably PFIA's property, and it was certainly possible for Dotson to defraud PFIA of it. Not only were the benefits not property of Dotson, it was not contemplated that Dotson would receive them unless and until a proper determination was made by PFIA or by a court that Dotson was entitled to the benefits. Mail fraud includes using the mail in a scheme for obtaining money or property by means of false or fraudulent pretenses, representations, or promises, 18 U.S.C. § 1341, and there was sufficient evidence for the jury to reasonably determine that Dotson did just that. A rational jury could find that Dotson's failure to inform PFIA of his other employment and his signing of claim forms asking whether he was able to work at any job constituted a misrepresentation to PFIA. The misrepresentation must be material, Neder v. United States, 527 U.S. 1, 119 S.Ct. 1827, 1841, 144 L.Ed.2d 35 (1999), but there was sufficient evidence for the jury to find that Dotson's misrepresentation was. Both a vice president of PFIA and Dotson's local agent testified that Dotson would not have received PFIA benefits if PFIA had known about his other work. Even if PFIA had interpreted the policy to allow a claimant to do some other work, the jury could reasonably infer that the fact that Dotson was working at all would have been material to a determination of whether he could in fact perform his police job. 16 Even assuming that Dotson would have prevailed in a court action to obtain benefits from PFIA under Louisiana law, 8 he is not entitled to speed up the process by obtaining the benefits through misrepresentation. The Supreme Court has repeatedly noted that misrepresentation cannot be justified by incorrectness of the position of the party to whom the misrepresentation is made. See United States v. Mandujano, 425 U.S. 564, 96 S.Ct. 1768, 1776-77, 48 L.Ed.2d 212 (1976) (sanctions for false statements or perjury allowed even when inquiry was unconstitutional); Dennis v. United States, 384 U.S. 855, 86 S.Ct. 1840, 1846-47, 16 L.Ed.2d 973 (1966) (It is no defense to a charge based upon [conspiracy to circumvent a law through deceit] that the statutory scheme sought to be evaded is somehow defective.); United States v. Lawton, 366 F.3d 550 (7th Cir. 2004) (citing cases). 17 Because there is sufficient evidence for a rational jury to find that Dotson devised a scheme to obtain money from PFIA through misrepresentation, we affirm Dotson's conviction on Counts 16-18. Accordingly, we need not reach Dotson's claim that his convictions on the remaining counts were tainted by spillover.