Report Workers' Compensation Fraud

If you would like to report workers' compensation fraud, complete the form below and press the "Submit" button.

Complaints are kept strictly confidential.

Are you reporting an Employee or an Employer?

Employee Employer

Name of the person you are reporting:

Company name:

Describe alleged fraudulent activity: (Please provide as much detail as possible, including names, dates, documents and witnesses.)

Complaint Submitted By (optional)

Name:
Phone #:
E-mail address: