A delivery driver who falsely claimed she was unable to work due to an injury has been convicted of perjury after an SIU investigation uncovered physical activities that directly contradicted her reported limitations.

The claimant filed a workers’ compensation claim, alleging a left ankle injury sustained while working as a delivery driver. Based on her subjective complaints and reported limitations, she was placed on total temporary disability (TTD).
TTD payments were terminated once the insured reported being able to accommodate her work restrictions. However, suspicions arose when a company representative spotted the claimant at the shared delivery loading station—wearing a uniform and engaging in work-related activity—while she was still deemed medically unfit to return to work.

Argus West initiated surveillance and conducted a social media investigation, uncovering public posts that directly contradicted the claimant’s reported limitations.

Evidence included:
•    Participation in high-energy dance performances during the San Francisco Carnaval Parade and Western Weekend in Point Reyes Station, CA
•    Social media posts showing the claimant dancing, hiking, traveling, and jumping off a platform
•    Continued complaints of pain to her treating physicians, resulting in extended work restrictions

Despite her claims of being unable to perform modified duty due to pain, the claimant was observed engaging in physically demanding activities without any visible limitations.

The Argus West Special Investigations Unit (SIU) submitted a comprehensive referral package to the Sonoma County District Attorney’s Office. The claimant was subsequently charged with one count of insurance fraud and one count of perjury. She pled not guilty to the fraud charge and no contest to the perjury charge. As a result, she was found guilty of misdemeanor perjury and ordered to pay restitution in the amount of $16,504.83, which has now been paid back to our client in FULL!

This case highlights the value of coordinated efforts between claims professionals, insured employers, and SIU. Through proactive surveillance and strategic use of open-source intelligence, a fraudulent claim was exposed—protecting employer resources and upholding the integrity of the workers’ compensation system.