On February 14th, 2019 the Special Investigative Unit of RJN Investigations, Inc. was formally notified by the Ventura County District Attorney’s Office in regard to the arrest and arraignment of a custodian employed by the Simi-Valley Unified School District. In this particular case, the claimant alleges to have sustained injuries to his right shoulder while pulling trash bags out of the cans. The claimant sought medical treatment and subsequently filed his claim. During initial treatment, the claimant admitted to owning and operating his own personal business. A Surveillance investigation was quickly authorized, and RJN Investigations obtained video of the claimant lifting furniture, pushing heavy machinery and working. When questioned, the claimant indicated to investigators that his business was still in operation, however because of his injuries, he was no longer doing any of the work himself, rather his family was completing his jobs. Surveillance was provided to his medical doctor, who in turn changed his medical opinion of the claimant returning him back to work with no restrictions. Based on this fact and in compliance with the regulations set forth by the California Department of Insurance, our office provided the Ventura County District Attorney and Insurance Fraud Division with our investigative findings in a documented referral format. On January 22nd, 2019, the claimant was arrested at his place of employment by the Ventura County Sheriff’s department. He was formally advised of his 2 Felony charges of 550(a) PC and 1871.4(a)(1) IC. On February 14th, 2019 the claimant was arraigned in Ventura County Superior Court.
ABOUT R.J.N. SIU:
Formed in 1996, the SIU Division was created to assist California employers, small size insurance carriers and TPA firms in securing professional assistance so as to detect, investigate and prosecute insurance fraud. To date, the unit has trained well over 2,750 examiners and the documented referrals by this unit have resulted in over 187 convictions for workers’ compensation insurance fraud in California.
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