This case involves the claimant, a 34-year-old security guard, who filed a workers’ compensation claim for a knee injury that he allegedly sustained on February 6, 2020. Shortly before this date, the claimant requested two days off, only one of which was granted. After the alleged injury, he was placed off work on the day he was denied. He met with an on-site nurse and then went to a clinic for treatment, claiming a pain level of eight out of 10. He was given a leg brace and work restrictions, including “weight-bearing as tolerated, no bending or twisting, no kneeling or squatting, and no lifting or pulling over five pounds”. He was also to wear a leg brace extending from his thigh to his calf. 

The employer was suspicious of the injury and ordered surveillance of the claimant. On February 8, 2020, Apex obtained a surveillance video of the claimant at a Monster Jam event at Angel Stadium in Anaheim, California. He was seen at the event walking and standing for extended periods, up and down stairs and on inclines. He was also captured lifting a barricade over his head and lifting and carrying his 20-pound daughter for more than 15 minutes without wearing his leg brace.  

During an interview with Apex on February 12, 2020, the claimant was dishonest about his limitations and activity level. He stated that he could not walk or stand for more than 10 minutes and could not ascend or descend stairs or inclines. He claimed he could not lift more than five pounds or lift anything overhead. He said he could hold his daughter for up to 15 minutes wearing the leg brace. He added that he could not walk or be active without his leg brace between February 7 and 9, 2020. He denied going anywhere on February 8, 2020, other than to the grocery store, and he claimed he wore his brace during the trip. The claimant was only recorded wearing the leg brace when he attended the doctor’s visits. 

As a result of the above evidence, an SIU Investigation was initiated, and the case was referred to the Los Angeles County District Attorney’s Office. Throughout 2023 and 2024, Apex SIU Investigators worked closely with the Los Angeles County District Attorney’s Office and provided additional information to assist their investigation. On December 4, 2024, the claimant pleaded guilty to one felony count of Workers’ Compensation Insurance Fraud. He will not serve jail time if he completes the terms of his plea deal. He was placed on two years of formal probation, ordered to pay $29,000 in restitution plus court fees, and required to complete 15 hours of community service.  

This case was successfully prosecuted by the Los Angeles County District Attorney’s Office, Workers’ Compensation Fraud Unit.