On October 6th, 2026, RJN Investigations, Inc.’s Special Investigative Unit was notified that the Ventura County District Attorney’s Office had successfully prosecuted the claimant for material misrepresentations made during her deposition. At the time of her deposition, the claimant testified that she always uses a walker, however, RJN Investigations’ surveillance footage showed her shopping on multiple days without a walker or cane while she remained on TTD status. Her statements during the deposition and to treating physicians contributed to her receiving costly Home Healthcare services based on her reported inability to perform simple activities of daily living. Her continued complaints also prompted diagnostic studies of her lumbar spine, which ultimately produced limited permanent disability findings. Without the surveillance footage and diagnostic results, the case’s value would have been significantly higher because of her subjective complaints. Based on the statements, combined with the surveillance footage, the case was submitted to both the Ventura County District Attorney and California Department of Insurance Fraud Division. The claimant was arrested, notified of the charges which included 17 Felony Charges and arraigned. After several months of hearings, the claimant accepted a plea agreement and pleaded guilty to five felony counts. A restitution hearing is scheduled for November 24th, 2026.
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 266 convictions for workers’ compensation insurance fraud in California. In just the last four years, we have secured $2,594,531.00 in court ordered restitution on behalf of our valued clients.
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