Stop Workers' Compensation Fraud

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SERVING AMADOR, CALAVERAS, STANISLAUS, TUOLUMNE AND MARIPOSA COUNTIES

Workers’ compensation fraud poses a huge problem in Northern California. Fraudulent claims have cost the region jobs and undermined the integrity of the system, causing unnecessary delays in treating real injuries and casting a shadow over thousands of legitimate claims that are filed each year. Everyone suffers because of workers’ compensation fraud. Tax dollars are wasted, the price of consumer goods increases and employers and legitimately injured workers lose money.

The District Attorney’s Workers’ Compensation Fraud Unit pursues an aggressive approach to identify, investigate and prosecute workers’ compensation fraud. If you or someone you know suspects any of the fraudulent activities mentioned below, or if you are suspicious of certain activity and merely need to ask whether it is fraud, please contact us at (209) 223-6444, or click below to complete a Suspect Complaint Form.

Suspect Complaint Form to Report Workers' Compensation Fraud

MOST COMMON TYPES OF WORKERS' COMPENSATION FRAUD

Claimant Fraud

Claiming a job-related injury that never occurred

Claiming a non-work related injury as a work-related injury

Obtaining other employment while allegedly disabled and not reporting income

Exaggeration of symptoms

Falsifying reports, i.e., mileage, disability, medical

Employer Fraud

Under reporting payroll or misclassifying employees for lower insurance premiums

Deducting premium dollars from employee’s wages

Dissuading employees from claiming job-related injuries or seeking medical attention

Failing to provide employees required forms after a job-related injury

Knowingly failing to have necessary workers’ compensation coverage

Medical Provider Fraud

Billing for services or treatment never performed

Billing the workers’ compensation insurer and the workers’ health insurer for the same services

Providing unnecessary testing or treatment of injured workers to recap financial benefit

Please contact our office at (209)223-6444 if you have any questions or concerns regarding workers' compensation insurance fraud.

The District Attorney’s Office recommends the following agencies for further assistance:

To report insurance fraud occurring outside of Amador, Calaveras, Tuolumne, Stanislaus or Mariposa Counties: California Department of Insurance Fraud Division

To find out if a contractor is licensed and carrying workers’ compensation insurance: Contractors State License Board

Contractors State License Board 1(800)321-CSLB (2752) www.cslb.ca.gov

Contractors State License Board Consumer Guides

https://www.cslb.ca.gov/about_us/library/guides_and_publications/