Audit Enforcement in Workers Compensation Cases

Just the word “audit” can trigger stress to anyone who’s heard a story about tough IRS audits and penalties, but audits don’t need to be scary. They are a necessary part of the workers’ compensation process. To ease some of that stress, it’s good to know just what the Audit Enforcement Unit does in the State of California.

The State of California Department of Industrial Relations summarizes the Audit Enforcement Unit like this: “The DWC Audit and Enforcement Unit audits insurance companies, self-insured employers, and third-party administrators to ensure that they have met their obligations under the Labor Code and the California Code of Regulations under the direction of the Administrative Director of the Division of Workers’ Compensation. The DWC Audit and Enforcement Unit conducts compliance audits for a random selection of claim files. The Audit Unit assesses penalties and orders that unpaid compensation be paid. This unit ensures that proper benefits are delivered accurately and in a timely manner.”

As long as a claim is legitimate, the injured worker shouldn’t need to worry about audits. The process is there to ensure workers are properly compensated and get the help they need to recover from workplace injury. The Audit Enforcement Unit is not there to punish injured workers.

A comprehensive description of the unit can be found in the California Division of Workers’ Compensation 2024 Audit Program Description. That is probably more information than the average person wants to read, but it may be helpful when looking for answers. If you have questions or concerns about audits as they relate to your case, you can always contact us. If you’re not yet a client, you can find our intake form here.