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Devoted to Helping
the Injured.

Looking at workers' compensation fraud in California

Workers' compensation benefits are vital to the health and well-being of the California workforce. Thousands of employers offer these benefits to their employees in Stanislaus and throughout the state. The best thing about workers' compensation insurance in California is that it is a no-fault system, which means workers don't have to prove that their injury was caused by someone else. A big issue facing workers' compensation is fraud.

Because the workers' compensation insurance system in California is a no-fault system, it has easily become a target for fraudsters. Scams involving workers' compensation occur in the simplest and most complex of matters. Either way, they lead to lengthy investigations that cost time and money.

Some common fraudulent workers' compensation issues include the following:

  • Making up or exaggerating an injury
  • Conspiring with doctors to create an injury
  • Doctors over-treating a patient
  • Doctors prescribing too much medication for an injury

All workers' compensation scams are paid by the insurance companies until it is discovered that it was fraud. The cost of these scams is then passed to policyholders and even taxpayers.

The state of California created the Workers' Compensation Fraud Program back in 1991. The legislature in the state turned workers' compensation fraud into a felony. The program is funded by employers in the state that are required to be self-insured or insured for their employees.

Workers' compensation insurance helps injured or sick workers continue to live without the worry of where their next paycheck will come from. It helps them stay on their feet until they are able to return to work in California.

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Making a false or fraudulent workers’ compensation claim is a felony subject to 5 years in prison or up to $50,000 or double the value of the fraud, whichever is greater, or by both imprisonment and fine.

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