Investigators for the California Department of Insurance (CDI) Investigators arrested a Santa Ana, Calif. resident Carlos Cristo, 31, on charges of insurance fraud.
Cristo, arrested at his residence pursuant to an arrest warrant issued by the Orange County Central Court, was transported to Orange County Central Jail and his bail was set at $10,000.
Cristo was working as a jockey at Los Alamitos Race Course in December of 1994 when he fell off a horse and injured his back. He filed a workers’ compensation claim for this accident and received medical treatments. Cristo recovered from the injury and resumed his employment as a jockey.
According to investigators, in December of 1997, Cristo again fell off a horse at Los Alamitos Race Course, sustaining injuries to his forearm, hip and back. He again filed a workers’ comp claim against his employer and received medical treatments. However, during his medical evaluations, Cristo allegedly denied any prior injury to his back.
Investigators also allege that in August 1998, Cristo returned to riding horses part-time at Los Alamitos. While riding, Cristo fell off and once again allegedly injured his back. Cristo filed a workers’ comp claim and received medical treatments for this injury at the same time he was receiving treatments for his December 1997 injury. During medical evaluations with treating physicians, Cristo again allegedly denied any prior injuries to his back.
Cristo received Total Temporary Disability (TTD) benefits from Golden Eagle Insurance and State Compensation Insurance Fund (SCIF) at the same time. In addition, Cristo received money from the Jockey’s Guild and a non-profit organization called “To Aid Disabled Jockeys,” and allegedly did not report any of this income to either Golden Eagle or SCIF. Cristo also received vocational rehabilitation benefits from Golden Eagle and SCIF as a result of his alleged industrial injuries.
Cristo allegedly lied about his employable job skills during his second vocational rehabilitation interview and received benefits he was not entitled to. Cristo received TTD and vocational rehabilitation benefits from Golden Eagle and SCIF in the amount of $50,000.
Topics California Fraud Workers' Compensation
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