The Special Investigative Unit of RJN Investigations, Inc. was notified by the Riverside County District Attorney that their office filed criminal charges against a County Employee who alleged to have sustained Continuous Trauma Injuries during the course of her employment. Based on the claimant’s deposition testimony, it was noted that the claimant denied prior similar symptoms, however records show that the claimant did in fact have prior complaints with treatment which was in contrast to what she testified to. When provided the prior records for review, the claimant’s treating doctor indicated that the claimant had exhibited “poor credibility.” The case went before the WCAB and based on the Judge’s review of records and comments made by the claimant, he ruled and issued a “Take Nothing” decision. Due to this decision combined with the claimant’s material misrepresentations made at the time of her deposition, RJN SIU submitted a formal referral to both the Riverside County District Attorney’s Office as well as the California Department of Insurance Fraud Division. Our office was notified by the Riverside County District Attorney’s office that an arrest warrant and criminal charges were filed against the claimant. Five felony counts in total were filed, two counts of Section 550, subdivision (a)(1), two counts of Penal Code section 118 and one count of Insurance Code section 1871.4, subdivision (a)(1). The claimant was not arrested and rather turned herself in on 05/20/2024 and was arraigned. Her next criminal court date has been set for 08/05/2024.
ABOUT R.J.N. SIU:
Formed in 1996, the RJN SIU Division was created to assist California employers, governmental agencies, 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 4,000 examiners and the documented referrals by this unit have resulted in over 245 convictions for workers’ compensation insurance fraud in California. In just the last 4 years, we have secured $1,802,021.82 in court ordered restitution on behalf of our valued clients.
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