The Special Investigative Unit of RJN Investigations, Inc. was recently notified that the Orange County District Attorney’s Office of the successful prosecution in the case of People of California v A. Verdugo. In this particular case, the claimant filed a workers’ compensation claim and based upon the listed restrictions, the employer was unable to accommodate. As such, he began to receive temporary total disability payments. As the claimant did not appear to be improving despite the medical treatment provided, the examiner authorized the RJN SIU Department to conduct surveillance measures to determine the claimant’s true outside physical activity level. In the course of the surveillance level investigation, substantial video evidence was obtained depicting the claimant performing a variety of outside physical activities showing no sign of restriction or utilization of any artificial support. The claimant subsequently testified at his hearing before the Workers’ Compensation Appeals Board and made material misrepresentations in his testimony before the WCAB Judge under the penalty of perjury. In compliance with the regulations set forth by the California Department of Insurance, the RJN SIU submitted the formal documented referral to their Fraud Division as well as to the Orange County District Attorney’s Workers’ Compensation Fraud Unit. Upon completion of the criminal investigation performed by the California Department of Insurance Fraud Division, the claimant was subsequently charged with two counts in violation of Penal Code Section 550(b), one count in violation of Insurance Code Section 1871.4(a)(1) and one count in violation of Penal Code Section 118(a). Bail was subsequently set at $30,000.00. After attending several criminal court hearings, the claimant changed his not guilty plea and entered into a plea bargain agreement in which he pled guilty to all five counts. His sentencing hearing is now scheduled for June 26th, 2026. Maximum restitution is being sought by the District Attorney’s office in this case.
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 255 convictions for workers’ compensation insurance fraud in California. In just the last 4 years, we have secured $2,172,027.00 in court ordered restitution/savings on behalf of our valued clients.
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