CWES Fraud Referrals - Suspected Employee Fraud Referral

Definition of Employee Fraud

Employee fraud occurs when an employee knowingly and willfully:

• Authorizes or issues benefits to an ineligible person such as to a non-existent client or to a *friend or family member.
• Illegally accessed client’s benefits through use of the EBT system or checks/warrants.
• Uses coercion to extort benefits from an applicant or recipient.

Reminder: *Friends and family members of employees are considered confidential/sensitive cases and are NEVER to be processed by the employee involved. Refer to “Confidential/Sensitive Cases”, page 52-6, in the Common Place Handbook for more information.

New Employee Training

New workers receive fraud referral training which will now include a segment on employee fraud.

Referral Procedure

When it comes to the attention of any staff member that another employee may be committing fraud, staff MUST follow these procedures:

• Contact Toni Garcia, Supervising Welfare Fraud Investigator at (408) 755-7183 to make the referral of suspected employee fraud.
• Be sure to use a private office to ensure confidentiality.
• IMMEDIATELY notify Angela Shing, DEBS Director at (408) 755-7777 of the referral.
• Be sure to use a private office to ensure confidentiality.
• Must NOT discuss the matter with any other staff members unless authorized to do so. Remember that:
  • The employee has the RIGHT to confidentiality, and
  • Discussing the matter may alert the suspected employee and hinder the SIU’s investigation.