On January 6th, 2021, the Special Investigative Unit of RJN Investigations, Inc. was formally notified by the San Bernardino County District Attorney’s Office as to the successful prosecution in the case of People of California v. E. Barajas. In this particular case, the claimant denied pre-existing issues and injuries to her low back to her industrial treating physicians as well as to the claim’s examiner. Subpoenaed records revealed the claimant filed a workers’ compensation claim for a cumulative trauma against her prior employer, which included injury to the low back, bilateral upper extremities, neck, stress, sleep, psyche, and high blood pressure. Records showed the claimant received medical treatment benefits, and a $73,000 settlement to resolve her prior claim. Additionally, during her deposition, the claimant admitted to filing a prior workers’ compensation claim, however she testified her prior claim only involved her wrist. In compliance with the regulations set forth by the California Department of Insurance, the RJN SIU formally referred the case to their Fraud Division as well as to the San Bernardino County District Attorney’s Office. Upon completion of their criminal investigation, on February 6th, 2020 the claimant was arrested and charged with four felony counts in violation of Insurance Code Section 1871.4(a)(1). At her most recent criminal hearing on January 5th, 2021 she entered a no contest plea to one felony count of insurance fraud. As a result of that plea, she was sentenced to formal probation and ordered to pay restitution in the amount of $ 9757.80.
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 3,750 examiners and the documented referrals by this unit have resulted in over 200 convictions for workers’ compensation insurance fraud in California. In just the last 3 years we have secured $ 585,599.00 in court ordered restitution on behalf of our valued clients.
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