Working While Collecting TTD Benefits Results in Criminal Charges

On January 6th, 2020 the Special Investigative Unit of RJN Investigations, Inc. was formally notified by the Los Angeles County District Attorney’s Office regarding the arraignment of a claimant charged with felony insurance fraud. In this particular case, the examiner received a tip indicating that the claimant was working for his own construction company while out on workers’ compensation collecting TTD benefits. The examiner proactively authorized surveillance and the claimant was indeed found to be performing constructions related work on a private residence. The claimant’s deposition was then secured where he made several material misrepresentations pertaining to his work history and income while collecting TTD benefits. The homeowner of the residence was then interviewed, and it was established that he paid the claimant $3,000.00 cash for the work performed. Armed with that additional evidence, the RJN SIU then formally filed this case with the California Department of Insurance Fraud Division and with the Los Angeles County District Attorney’s Office Workers’ Compensation Fraud Unit. Upon completion of an extensive criminal investigation performed by the Los Angeles County District Attorney’s Office, the claimant was formally charged with one count in violation of Insurance Code Section 1871.4(a) and penal Code Section 550 (a)(1). At the arraignment the claimant entered a not guilty plea and his next court date will be in February.

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 3,500 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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