Created by statute in 1996, Office of the Workers' Compensation Fraud Inspector General's ["WCFIG"] mandate is to conduct and supervise investigations within and without New York State of possible fraud and other violations of laws, rules and regulations pertaining to the operation of the workers' compensation system. Through its investigations, audits, and reports, WCFIG focuses on reducing costs to the workers' compensation system by eliminating fraud and by acting to improve the efficiency and effectiveness of the workers' compensation system. Investigations into violations of workers' compensation laws, rules and regulations are complex and often involve detailed analysis of materials, claims and taking of testimony from employers, attorneys, employees, health care providers, and insurance carriers. These investigations result in many criminal referrals and arrests/prosecutions throughout the State of New York, as well as recoveries for overpayments made as a result of the fraud identified.

The WCFIG investigates allegations of fraud committed by any party to the fraud, including: attorneys, employees, employers, health care providers, brokers, and insurance carriers.

Anyone can notify the Inspector General about their concerns.

Allegations and complaints include:

• Fraud by individuals filing for benefits to which they are not entitled
• Fraud by employers trying to evade paying proper workers' compensation insurance premiums
• Fraud by professionals [attorneys, physicians, etc.], who facilitate workers' compensation fraud or overpayment of benefits
• Actions by government employees that result in the improper payment of workers' compensation benefits

All WCFIG investigations are confidential