(Colusa, CA) – October 8, 2018 – Yolo County District Attorney Jeff Reisig and Colusa County District Attorney Matthew Beauchamp announced that on September 12, 2018, 32-year-old, Daniel Ayala, of Colusa, was sentenced to 365 days of county jail, 5 years felony probation, and an $890 fine. Ayala plead no contest to one count of felony workers’ compensation insurance fraud. As part of the plea agreement, Ayala’s remaining felony counts were dismissed in the interest of justice. The defendant’s county jail time is stayed pending successful completion of probation and a monthly restitution payment of $350 per month to fulfill his court ordered restitution in the amount of $19,324.68.
While working for Greenwood Dairy in Orland, CA in January 2014, Daniel Ayala claimed he was injured while working. Ayala received $15,876.63 in workers’ compensation benefits due to his reported injury. Based on Ayala’s medical complaints from his reported industrial accident in January 2014, Ayala was diagnosed with cervical strain and disc herniation according to his probation report. Zenith Insurance contracted a private investigations company who recorded Ayala performing activity and tasks not consistent with his reported injury and his clinical symptoms. Ayala intentionally misrepresented his industrial injury in order to obtain workers’ compensation benefits that he would not otherwise be entitled to.
This case was investigated by the Fresno County District Attorney’s Office. The Fresno County Superior Court determined this case would be best prosecuted in the county of Colusa. The Colusa County District Attorney’s Office is a member of the Yolo County DA’s multi-jurisdictional Workers’ Compensation Insurance Fraud Program which covers the counties of Colusa, Sutter, and Yuba.
The Yolo County multi-jurisdictional Workers’ Compensation Insurance Fraud unit works to prevent and investigate claimant fraud, medical provider fraud, premium fraud, and uninsured employers. The most common type of workers’ compensation insurance fraud is claimant fraud, which Daniel Ayala was convicted of. Claimant fraud occurs when an employee lies or omits a material fact in order to obtain benefits that they would not have otherwise been entitled to. Examples would be to lie about how an injury occurred, the extent of their injury, or not to report outside employment and income.
Both Yolo County District Attorney Jeff Reisig and Colusa County District Attorney Matthew Beauchamp believes that the cost of doing business in these counties is impacted by the cost of labor and the necessary insurance to cover employees in the event they are injured on the job. When fraud is introduced, it negatively impacts a fair marketplace as it raises the cost that we would otherwise have to pay for goods and services.
While government resources are dedicated to determining fraudulent action, the public’s attention to this workers’ compensation fraud is important. To report workers’ compensation insurance fraud, call the DA’s hotline at 530-406-4524. Additional resources can be found at www.yoloda.org.