The Special Investigative Unit of RJN Investigations, Inc. was notified by the Riverside County District Attorney that their office filed criminal charges against a Shuttle Bus driver who was employed as a County Employee. The claimant alleges to have sustained fractures to his bilateral lower extremities/femurs. Video secured of the claimant showed that he was capable of working as he was seen completing home maintenance and yard renovation activities in contrast to him and his attorney alleging that he was 100% disabled. During subsequent medical evaluations, the claimant reported to his treating doctors that he needed the aid of a cane for ambulation. There were also reported misrepresentations in regard to his drug use and history and when presented with the evidence, his treating doctors indicated that the claimant’s “lies” about drug use and history called into question his credibility and that the claimant’s objective reporting would be preferred as “he no longer would be able to trust the claimant’s statements.” Based on the doctor’s comments, and the contrast between surveillance and the claimant’s statements, 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, one count of PC section 664/118, one count of PC section 550(B)(1), one count of IC 1871.4(A)(1), one count of PC 186.11(A)(1) and one count of PC 1203.045(A). The claimant was arraigned, and the next court date is scheduled to occur on 09/09/2024.
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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