City Maintenance Worker Convicted of Workers Compensation Insurance Fraud and Ordered to Pay Back His Employer $17,064.00 in Restitution

On November 25th, 2019 the Special Investigative Unit of RJN Investigations, Inc. was notified by the Los Angeles County District Attorney’s office as to the successful prosecution based upon a documented referral submitted. In this case, the claimant worked in the maintenance department for the City. An initial social network level investigation revealed that the claimant has his own flooring business. A subsequent surveillance investigation performed by the RJN SIU unit found the claimant engaged in significant physical activity while working for his own business. Over 4 hours of video evidence was secured during a period of several dates. In the claimant’s deposition taken 2 months later in Los Angeles County he made several material misrepresentations as to his activity level and outside employment activities. Subpoenaed records also revealed a prior back injury that he denied in his deposition. In compliance with the regulations set for by the California Department of Insurance the RJN SIU then formally referred the case to the Los Angeles County District Attorney’s Office as well as to the Department of Insurance Fraud Division. The case was accepted for criminal investigation by the Los Angeles County District Office. Upon completion of their investigation the claimant was formally charged with two felony counts for 1871.4(a) (1) and violation of penal code section 664-118(a) attempted perjury. The claimant was subsequently arrested, and his arraignment took place at the Clara Shortridge Foltz Criminal Justice Center on August 22nd, 2019. The claimant entered a not guilty plea at that time. Upon reviewing all the evidence against him, the claimant changed his plea at the recent criminal hearing. As part of his sentencing, the claimant was placed on probation and ordered to perform 100 hours of community service. Moreover, he was ordered to pay back the City $ 17,064.00 in restitution

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 3,000 examiners and the documented referrals by this unit have resulted in over 195 convictions for workers’ compensation insurance fraud in California.


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