Report Fraud

The State Disability Insurance (SDI) defines insurance fraud as any claim for SDI benefits (Disability Insurance or Paid Family Leave) where a person, alone or in collusion with any other person, willfully makes a false statement or misrepresentation, or withholds a material fact for the purpose of collecting SDI benefits. For example, filing a claim with DI for an injury or illness that does not exist or helping another person file a false claim is insurance fraud. The California Unemployment Insurance Code (CUIC), sections 2101, 2116, and 2122 states that it is a violation to willfully make a false statement or knowingly conceal a material fact in order to obtain the payment of any benefits, such violation being punishable by imprisonment and/or by a fine not exceeding $20,000 or both. To detect and discourage fraud, SDI continually monitors claim payments, vigorously investigates suspicious activity, and will seek restitution and conviction through prosecution.

In section 1143 of the CUIC it states that if the director finds that any individual falsely certifies the medical condition of any person in order to obtain disability insurance benefits, including Paid Family Leave insurance benefits, with the intent to defraud, whether for the maker or for any other person, the director shall assess a penalty against the individual in the amount of 25 percent of the benefits paid as a result of the false certification.

To report Disability Insurance or Paid Family Leave fraud:

  • Submit a Fraud Reporting Form Online, OR
  • Call: 1-800-229-6297 EDD Fraud Tip Hot-Line (anonymous calls are accepted)

Note to Business Owners/Employers:

To deter fraud, please respond immediately if you are not the employer shown on the DE 2503 or DE 2503F, or if the claimant:

  • Is not your employee.
  • Has quit his/her job.
  • Is receiving wages.
  • Has not stopped working.
  • Is known to be working for another employer.
  • Has filed for Workers’ Compensation or is believed to be planning to do so.
  • Is using a Social Security number incorrectly.
  • Is working under another name.

Note to Physician/Practitioner:

To deter fraud, please respond immediately if you are not the physician/practitioner of a claimant or care recipient the shown on correspondence that you receive from SDI or if the patient:

  • Is no longer under your care and treatment.
  • Is no longer disabled.
  • Has not stopped working.
  • Is known to be working for another employer.
  • Has filed for Workers’ Compensation or is believed to be planning to do so.
  • Is using a Social Security number incorrectly.
  • Is working under another name.

You may be asked to verify that you submitted medical data, to answer some brief medical questions, or submit copies of medical records.

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