Employees or others are encouraged to report all known or suspected instances of misuse of University resources, as well as known or suspected instances of improper government activities by University employees. Anyone reporting such instances are protected from retaliation for making such reports. This includes suspected worker's compensation fraud.
What can I do if I think an employee's workers' compensation claim is not valid?
The University is committed to providing benefits to injured workers and equally committed to preventing fraud and abuse, this includes workers' compensation fraud. Contact UCLA Whistleblower 24-hour Hotline at (800) 403-4744 or send an email to wcreports@irm.ucla.edu.
Isn't Workers' Compensation fraud a crime? Who investigates these cases?
"Yes, workers' compensation fraud is a crime and it can come in many forms: a worker saying they were injured on the job when their injury really occurred while skiing; an employer saying their employees work at desk jobs when they're really construction laborers; a medical provider billing for six treatments for an injured worker when they only provided two; etc. These are just a few examples of fraud in the Workers' Compensation system. Fraud is a serious problem and should be reported." [Source: Department of Industrial Relations, Division of Workers' Compensation FAQs].
All tips received are reported to Sedgwick, CMS, the entity that administers the University's Workers' Compensation Program.
Sedgwick, CMS Special Investigation Unit (SIU) will complete an investigation into each tip and work directly with the California Insurance Fraud Unit.
What if the fraudulent activity I want to report is something other than workers' compensation?
Any activity by UC or a UC employee that violates a state or federal law or regulation, such as corruption, bribery, theft, fraud, misuse of government property; wastes money; or involves gross misconduct, gross incompetence, or gross inefficiency should be reported to the UC Whisteblower Hotline at (800) 403-4744 | www.universityofcalifornia.edu/hotline.
