Verdict Secure in Workers’ Comp Charges

Jeffrey Rene Pilon, 41, of Oxnard, Calif., was sentenced on Jan. 9, in Ventura County Superior Court to three years in state prison for his conviction on 14 counts of workers’ compensation insurance fraud. Pilon was also ordered to pay $48,300 in restitution.

The charges were the result of an investigation by the Valencia Fraud Division of the California Department of Insurance Criminal Investigations Branch that revealed Pilon secretly worked and attended a police academy while under treatment for alleged work injuries and collecting disability.

Pilon is a career private security guard employed briefly by Santa Barbara-based Mission Security and Patrol in early 1999. After he was terminated for cause in February 1999, Pilon filed a workers compensation claim against Mission Security. Pilon’s claim alleged lingering head, neck, and back pain from a work incident in January 1999 that kept him off work for a few days.

Between February 1999 and November 2001, seven different medical providers on more than 260 occasions treated Pilon for his alleged injury. State Compensation Insurance Fund (SCIF), Mission Security’s workers’ compensation insurer, paid Pilon $20,000 in disability benefits and more than $28,000 for his medical care.

Evidence at trial showed that while collecting disability and claiming he was not working due to his injury, Pilon was working full time as a security guard for two companies based in Los Angeles County. While continuing to receive intensive medical treatment and temporary disability payments, Pilon also attended the Rio Hondo College Police Academy in Whittier.

In September 1999, Pilon broke his leg at the police academy when he attempted to climb over a fence as part of his training. Medical providers who treated Pilon for his original alleged work injuries testified that Pilon never disclosed his current work activities or that he was attending a police academy and had broken his leg.

The medical providers all testified that such activity would have terminated his disability status.