Tuesday, June 27, 2017


 

Celebrating 30 Years (1987 - 2017)

of Superior Service to our Valued Clients

 
   
Press Release

Superior Court Judge Orders Claimant To Pay $146,518.00 In Restitution Back To The Employer

3/31/2017

 On March 31st, 2017, the Special Investigative Unit of RJN Investigations, Inc. was formally notified regarding the outcome of a restitution hearing in the case of People of California v. S. Carver.

 

In this particular case, the claimant alleged to have suffered a low back injury.  Despite substantial medical treatment provided, the claimant’s medical condition was not improving and she began to utilize a cane.  Surveillance by the RJN SIU Department documented the claimant utilizing a cane only at her medical appointments and while testifying at the WCAB.  Surveillance performed on non-medical/legal appointment dates, found the claimant ambulating freely without the utilization of a cane or other artificial support.  In her deposition, the claimant testified that she could only walk a few feet without the use of a cane.  The video evidence along with a copy of the deposition transcript was then provided to the treating doctor for review and comment.  In his supplemental report, the treating doctor changed his medical opinion and returned the claimant back to work full duty.  In accordance with regulations set forth by the California Department of Insurance, the case was then submitted by the RJN SIU Department to the Sacramento County District Attorney’s Office as well as to the California Department of Insurance Fraud Division.  Upon completion of their criminal investigation, the claimant was formally charged with three felony counts of workers’ compensation insurance fraud.  After attending several hearings, the claimant subsequently entered into a plea bargain agreement.  In the subsequent restitution hearing, the Sacramento County Superior Court Judge ordered the claimant to pay $146,518.00 in restitution to her employer.   

 

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 2,750 examiners and the documented referrals by this unit have resulted in over 160 convictions for workers’ compensation insurance fraud in California. 

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