What to Do if You Are Falsely Accused of Workers' Comp Fraud

 Posted on May 13, 2025 in Workers' Compensation

Being injured on the job is stressful enough, but being accused of workers' compensation fraud adds a layer of fear and confusion that no honest worker should have to face. If you have received a notice of investigation or charges related to your workplace injury claim, you are not alone. False or mistaken fraud allegations happen more often than many people realize.

In California, workers’ compensation fraud is a serious accusation that can lead to criminal charges, job loss, and financial penalties. If you are facing this situation, it is important to take immediate steps to protect yourself with the help of our California workers’ compensation attorneys.

What Is Workers' Compensation Fraud?

Workers’ compensation fraud occurs when someone knowingly provides false information in order to obtain benefits. Under California law, this can include actions such as:

• Claiming an injury that did not happen

• Exaggerating the severity of an injury

• Working while receiving temporary disability payments without reporting income

• Using false documents or identities in the claims process

The law applies to employees, employers, healthcare providers, and even legal professionals involved in the process. While fraud is a real issue that state agencies try to prevent, it is also true that honest workers sometimes get caught up in accusations without having done anything wrong.

Why Do False Workers’ Compensation Fraud Accusations Happen?

Sometimes, miscommunication between an employee and employer gives rise to suspicions or accusations of fraud. Other times, surveillance footage or eyewitnesses may show a workers’ comp recipient doing something within medical restrictions that is misunderstood. Coworkers may leave anonymous tips if they believe someone is faking an injury. Even paperwork mistakes could raise red flags. 

Sometimes, accusations are driven by an employer's frustration with the claim process or a desire to reduce costs. In other cases, a private investigator may misunderstand your activity level or daily limitations.

What Should You Do if You Are Accused of Workers’ Compensation Fraud?

If you are notified that you are under investigation or have been charged with fraud, take the situation seriously but do not panic. Your first step should be to consult with a criminal defense attorney who understands California workers’ compensation law. In the meantime: 

• Do not speak to investigators without an attorney. Even if you believe you can clear things up, anything you say can be used against you.

• Gather all documentation. Medical records, wage information, correspondence with your employer, and any surveillance or incident reports may be useful in your defense.

• Review your activities carefully. Be honest with your attorney about your daily habits and any work or side income you may have had.

• Avoid social media posts that could be taken out of context or misinterpreted.

• Follow your doctor's instructions. Attending appointments and complying with treatment plans helps reinforce the legitimacy of your claim.

Contact a Santa Clara County, CA Workers’ Compensation Lawyer

If you have been accused of workers’ compensation fraud, you need skilled legal representation as soon as possible. Contact a Morgan Hill, CA workers’ compensation attorney at Cramer + Martinez to schedule a free consultation. We can help you understand your rights and develop a strong defense strategy to protect your future. Call 408-848-1113 today.