For release on April 15, 2015
David F. Soares, Deputy District Attorney
Insurance Fraud Unit
Economic Crimes Group
LODI MAN CHARGED WITH WORKERS’ COMPENSATION INSURANCE FRAUD
A 32-year-old Lodi man has been arrested and charged with felony Workers’ Compensation Fraud after he was videotaped repeatedly skydiving despite claiming that he was unable to work due to a workplace injury.
Donald Ray Simmons, Jr., a Santa Clara concrete cutter, is accused of defrauding Arch Insurance Company of approximately $52,000. Simmons, Jr. faces a maximum of 5 years and 4 months incarceration if convicted of making false or fraudulent material statements in order to claim Workers’ Compensation benefits, and attempted perjury. He would also be ordered to pay full restitution. Simmons, Jr. has posted $20,000 bail and will be arraigned on April 23, 2015.
Deputy District Attorney David Soares said: “The California’s Workers’ Compensation system is designed to quickly help workers who suffer job-related injuries recover and get back to work. When a worker is slow to rehabilitate, it is not unusual for an insurer to conduct surveillance in public places to determine whether the injured worker is engaging in activities beyond his or her stated limitations. Sometimes we see cases such as this one, where the misrepresentations are too blatant to ignore, and we feel compelled to file felony charges.”
In December 2013, the defendant, who worked for a Santa Clara construction company, claimed an injury was causing him excruciating pain, making it so he could not use his left arm to drive. Yet he was videotaped using his left hand to drive a car with no apparent restriction of movement. Insurance investigators filmed him during March and April of 2014 repeatedly boarding an airplane in full jump gear and later landing with tandem clients strapped to his body, controlling his parachute and gathering it in using his left arm with no apparent distress or difficulty.
The California Workers’ Compensation system is in place to protect both workers and employers by providing medical and lost income coverage to workers injured on the job. If an injured worker is not truthful about how the injury occurred, about their pain level, or about their abilities to his or her medical treatment team, then the injured worker may receive treatment that is not needed or compensation they are not entitled to, thus increasing the cost of doing business and of medical care for everyone.