</s>FACTIONS FIRST REPONIY WORK INFLY IMmediately after msn examination, mill use only directly to the Division of Labor Statistics and Research P.O. Box 906, San Francisco 1, and two copies to Enterprise Insurance Company at address. shown above. Failure to file a report with the Division is a miscellaneous. (Labor Code, Section 6-107-06113). Answer all questions fully. 1. EMPLOYER. 2. Address (no. 1) 3. Business (no.) 4. Business(no. 2) 5. Address(no.) 6. Employee (no ., No ., 7. Occupation. 6. Date injured. Hour. A. Age. Date last worked. 7. Date expired. 8. Injured in the Examination. Hour. M. Who engaged your services? 10. Name other doctors who treated employees for this injury. 11. ACCIDENT OR EXPOSURE: Did employee notify employer of this injury? of Cause of injury or illness. Employee's statement 12. NATURE AND BETWEENT OF INJUNY OR ESTAER (Include all objective findings, subjective complaints, and diagnoses. H. Occupational disease state of cost, occupational history, and exposuences.) 13. Knees By whom taken? (Sue if none.) 14. 15. Knees of care (co.of.s.a.g.s.) If hospital/therd, date. Name and address: 16. Further assistance for: Regular work. 17. Distinctive period of disability for: Registrar work: 18. Describe any permanent disability or disguentent expected (Suse if none) Madified work. 19. If If I/S/L/R/S(Not any pre-pre-previous injuries or diseases, need for special examination or laboratory tests, other personal information.) 20. Degas. Date of report. (No. 2, 0) Address No. 2. (no, S. 0) Uco rvouvous state is more spors required FUNNEL CL 4 10M 11-61 P.A. 669

Summary:  
The documents consist of medical records, insurance claims, and legal proceedings related to Sirhan Sirhan’s injuries sustained in a horse fall on November 12, 1966. Medical treatment occurred at Corona Community Hospital, where Dr. Richard A. Nelson initially evaluated non-serious injuries, followed by ongoing care for eye trauma from December 1966 to 1968. Radiologic findings from September 25, 1966, showed no fractures but noted shadows near T7 vertebrae. FBI FD-302 forms from June 7, 1968, reference interviews with optometrists and ophthalmologists regarding Sirhan’s medical history, including referrals to Dr. Milton A. Miller and Dr. E. Gordon Kiehn. Insurance claims involve Argonaut Insurance Company for workmen’s compensation related to injuries at Granja Vista Del Rio Ranch. Legal actions include a Compromise and Release Agreement with Altfillich Construction Company, Inc., involving payments to attorneys, medical professionals, and surveillance by Carl H. Laffoon Investigations. Medical records reference disability assessments, permanent disability ratings, and billing codes for services rendered by Drs. Kiehn, Nugent, and others.  

Key People:  
- Sirhan Sirhan (injured individual)  
- Dr. Richard A. Nelson (initial treating physician)  
- Dr. Milton A. Miller (optometrist)  
- Dr. E. Gordon Kiehn (ophthalmologist)  
- Dr. Maurice W. Nugent (medical professional)  
- Frank Stasik (insurance company representative)  
- John F. McLaughlin (attorney)  
- J. D. Stiner (claims examiner, Argonaut Insurance Company)  

Key Locations:  
- Corona Community Hospital, Corona, California  
- Granja Vista Del Rio Ranch, Corona, California  
- 48 North El Molino Avenue, Pasadena, California  
- 1001 Wilshire Blvd., Los Angeles, California  
- 824 South Main, Corona, California  

Key Events:  
- Sirhan Sirhan’s horse fall injury on November 12, 1966, treated at Corona Community Hospital.  
- Ongoing medical treatment for eye injuries from December 1966 to 1968, including optometric and ophthalmologic evaluations.  
- FBI FD-302 interviews regarding potential malingerering and insurance claims.  
- Workmen’s compensation case involving Argonaut Insurance Company and Altfillich Construction Company, Inc.  
- Legal settlement via Compromise and Release Agreement with payments to attorneys, medical professionals, and surveillance firms.  
- Disability assessments and permanent disability rating discussions before the Workmen’s Compensation Appeals Board.  

Key Organizations:  
- Federal Bureau of Investigation (FBI)  
- Argonaut Insurance Company  
- Corona Community Hospital  
- Granja Vista Del Rio Ranch  
- McLaughlin, Evans, DalbeY & Cumming (law firm)  
- California Department of Industrial Relations  
- Workmen’s Compensation Appeals Board (California)  
- Permanent Disability Rating Bureau

RFK Declassified Files

166-12c-1_serial_1_section_3_56-la-156_la_report_6.9.68-part_2_of_6.pdf

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