Fraud Investigation Services

When individuals knowingly lie to:

• obtain some workers' compensation benefit that is not due
• cause denial of some workers' compensation benefit that is due
• obtain a workers' compensation policy at less than the proper rate, cost, or premium

They may be guilty of workers' compensation fraud.

It doesn't matter whether the benefit obtained or denied is for themselves or others. Furthermore anyone who assists, abets, conspires with, or solicits any person in this unlawful act may also be guilty of workers' compensation fraud.

You may someday witness or receive a written or oral statement that points to a potential case of workers' compensation fraud. if so, please contact your local Human Resources office, and ask to speak with the department's claims coordinator, Return-to-Work coordinator, or health and safety Officer. Any of these staff members will officially convey your report to a local State Fund fraud liaison.

Each State Contract Services Office has a Fraud Liaison who is there to help in report a suspected fraudulent claim and to provide information on fraud prevention. In addition, anti-fraud training and education materials are available upon request. Among the most useful materials are Warning Flags of Suspicious Activities, 13 Ways to Fight Fraud in The Workplace, and an anti-fraud video training tape for employees

If you have reason to believe someone has committed workers' compensation fraud, remember that you can always use the State Fund Fraud Hot Line: 1(888) stopfraud or 1(888)786-7372!

Felony, Fines & Jail: The Story of Workers Comp Fraud - Fraud within the workers' comp system is harming the economy of California. This is a compelling short (11 mins) video that lays out the case for everyone to be vigilant in peventing fraud, and the negative results for those who try to cheat the system. For more information about getting a copy of this video, contact Maggie Blevins via e-mail at mjblevins@scif.com or call 1(323) 727-5653