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District Attorney Programs - Workers' Compensation Fraud

The Siskiyou County District Attorney’s Office is dedicated to investigate 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, workers' compensation insurance is a no-fault system. Injured employees need not prove an injury was someone else's fault in order to receive workers' compensation benefits for an on-the-job injury. In addition to medical expenses being covered for injured employees, some injured workers are entitled to recover a portion of lost wages resulting from injury. Fraudulent workers' compensation claims can be an enticing target for non-law abiding people.

Workers' compensation insurance fraud occurs in simple and complex schemes that often require difficult and lengthy investigations. Employees may exaggerate or even fabricate injuries. At the other end of the spectrum, white-collar criminals, including doctors and lawyers, entice, pay, and conspire with others to defraud the system by creating false or exaggerated claims, over treating, and over prescribing harmful and addictive drugs. Insurance companies "pick up the tab," while passing the cost onto policyholders, taxpayers and the general public.

We are determined to identify, investigate and prosecute any unscrupulous doctors, lawyers, employers and employees who have filed fraudulent claims.  The unit also investigates and prosecutes any employers who unlawfully deny an injured worker their entitled benefits.

Workers' Compensation Fraud is a crime.  There are many types of fraud within the workers' compensation system:

Uninsured Employers: Failing to have workers’ compensation insurance coverage for their employees when required by law. 

Applicant Fraud: An employee who lies to receive Worker’s Compensation benefits.

Employer Fraud: Employers that wrongfully deny an injured worker their entitled benefits or discourage an injured worker 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.