Workers' Compensation Fraud Program

The Siskiyou County District Attorney’s Office is dedicated to investigating cases that are submitted regarding Worker’s Compensation fraud.  Additionally, the District Attorney’s Bureau of Investigation works closely with investigators from the State and local agencies to assure the protection of employees by three simple principles, community outreach, education and enforcement.

In California:

• Injured employees need not prove an injury was someone else’s fault to receive benefits for an on-the-job injury.
• Some injured workers are entitled to recover a portion of lost wages in addition to medical expenses.
• Fraudulent workers’ compensation claims can be enticing for non-law-abiding individuals.

Fraud Investigation:

• Can be very simple or complex causes lengthy, difficult investigations.
• Employees may exaggerate or even fabricate injuries.
• White-collar criminals, including doctors and lawyer, entice, pay and conspire with individuals to defraud the system by creating false or exaggerated claims, over treating and over prescribing harmful drugs.
• Insurance companies “pick up the tab” while passing the cost onto policy holders taxpayers and the public.
• We identify, investigate and prosecute unscrupulous docs, lawyers, employers and employees with fraudulent claims.
• We investigated and prosecute any employers who unlawfully deny an injured worker their entitled benefits.

Types of Workers’ Compensation Fraud Crime:

• Uninsured Employers:  Failing to have workers’ compensation insurance coverage for their employees.
• Application Fraud:  An employee who lies to receive Workers’ Compensation benefits.
• Employer Fraud:  Employers that wrongfully deny an injured worker their entitled benefits or discourages them from pursuing a claim.
• Premium Fraud:  Employers who lie to reduce their insurance premium
• Provider Fraud:  Medical providers who commit fraud in connection with workers’ compensation.

Reporting Workers’ Compensation Fraud

Any information you have regarding potential fraud in any for should be reported to either:

• California Department of Insurance, Sacramento Office
• Siskiyou County District Attorney’s Office, Workers’ Compensation Fraud Unit

The more information you provide the better we are able to follow up on the report of suspected fraudulent activities.

Report as an Employer:

If you think someone is committing worker’s compensation fraud, report it to your workers’ compensation insurance carrier.  They are required to have a special investigation unit to handle these cases.  Self-insured employers can report the fraud to their third-party administrator.

Report as an Employee:

If you have information that your employer does not care workers’ compensation insurance or discourages you from pursuing a claim, report it to either of the entities above.

The Siskiyou County District Attorney Fraud Hotline is 530-842-8215

Alternately, you may complete the Online Fraud Report.  Please provide as much information as possible, including your contact information which is kept confidential.