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 50-5]]

Training

All new workers will receive fraud referral training prior to completion of their academy and on-going fraud training will be provided to all workers by the SIU staff on a yearly basis.

Referral Procedure

When it comes to the attention of any staff member, that another employee may be committing fraud, the following procedure is to be followed:

STEP	WHO	Action
1	Staff Member	Contacts their assigned District Office SSPM- Be sure to use a private office to ensure confidentiality. The staff member will be advised not to discuss the matter with any other staff member unless authorized to do so.
2	SSPM	After conducting a cursory confidential investigation, contacts the Supervising Welfare Fraud Investigator if the SSPM believes the allegation is found to have merit of suspected employee fraud. The SSPM must NOT discuss the matter with any other staff members unless authorized to do so. Also notifies the DEBS Director and the Deputy Director for Administration. Remember, the employee has the RIGHT to confidentiality, and -DO NOT discuss the matter with the suspected employee as it may thwart or hinder the SIU investigation.

Related Topics

Fraud - General Information

Suspected Unemployment Insurance Fraud and Identity Theft Information