| What is Fraud? | en español | |
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Fraud costs the Washington State workers' compensation system millions of dollars each year. Employers, employees, insurance carriers and Washington consumers pay the cost of fraud in lost jobs and profit, lower wages and benefits, and higher costs for services and premiums.
Report-a-Fraud Hotline1-888-811-5974 |
Workers' compensation fraud can be committed by employees, employers, health care providers, attorneys and others. The amount assessed by the Department of Labor & Industries through administrative fraud orders, settlements, assessments and court orders in fiscal year 2000 was $30.4 million.
L&I is serious about detecting, investigating and deterring fraud. The department's fraud investigation staff works with state and federal law enforcement, and other regulatory agencies, to detect and prosecute individuals and businesses involved in fraudulent activity related to Industrial Insurance. Investigations often lead to criminal prosecution and recovery of money.
To learn more about what workers' compensation fraud really is and about what L&I is doing to reduce it, look at the different types of workers' compensation fraud listed in the navigation at left.
Fraud comes in many forms. It ranges from a business under-reporting worker hours to providers billing for services not performed, to an injured worker collecting time-loss compensation benefits while working at another job. All of this costs Washington workers and employers millions of dollars each year. The Washington State Legislature has provided statutory authority to L&I to punish those businesses, health care providers, and workers who commit Workers' Compensation fraud.
RCW 51.32.240 (5) states in part that .."Whenever any payment of benefits under this title has been induced by willful misrepresentation the recipient thereof shall repay any such payment together with a penalty of fifty percent of the total of any such payments."
RCW 51.48.020 provides for felony (class C) charges to be filed against any employer who knowingly misrepresents to the department the amount of payroll or worker hours. The employer shall be liable for up to ten times the difference in premiums due as well as any reasonable expenses of auditing the employer's books. It further states that .."any person claiming benefits under this title, who knowingly gives false information required in any claim or application under this title shall be guilty of a felony, or gross misdemeanor in accordance with the theft and anticipatory provisions of Title 9A RCW." Title 9A is the criminal statute under which a business or individual may be charged for the commission of theft against the department.
If you suspect a business, health care provider or injured worker may be committing fraud, go to the appropriate page below and submit a fraud allegation form.
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