DPSS ePolicy

To convert existing policy to new writing style only – No concept changes

Fraud exists when a person (e.g., GAIN participant) or agency (e.g., GAIN Service Provider or Child Care Service Provider), on behalf of themselves or others has:

1. Knowingly and with intent to deceive or defraud, made a false statement or representation to obtain benefits, obtain a continuance or increase of benefits, or avoid a reduction of aid benefits.
2. Knowingly and with intent to defraud, failed to disclose a fact which if disclosed, could have resulted in denial, reduction, or discontinuance of benefits.
3. Accepted benefits knowing they were not entitled to or accepted any amount of benefits knowing it is greater than the amount to which they were entitled to.
4. For the purpose of obtaining, continuing, or avoiding a reduction or denial of benefits, made statements which they knew to be untrue with reckless disregard of the truth.

The prevention and detection of fraud on welfare cases are primary responsibilities of the case worker who determines eligibility, including cash benefits and benefit amounts for the individual programs.  In most situations, fraud referrals are made by the case worker, who determines eligibility for the program in which fraud has occurred.  However, there is a dual responsibility between CalWORKs eligibility staff and GAIN staff in situations involving GAIN participants.

Special Investigation Referral Page

System page used to submit fraud referrals to the Special Investigations Unit (SIU) online.

Allegation Reason

The reason fraud is suspected.

Allegation Description

A detailed description of the reason fraud is suspected..

Referring Person

Person making allegation of fraud or informant.

GAIN staff shall take prompt action on information received or personal observations whenever it appears that GAIN funds and/or CalWORKs benefits are being received based on misrepresentation, incorrect, false, or withheld information.

With the implementation of the Statewide Automated Welfare System fraud referrals are now submitted to the SIU online.

The public may call one of the following fraud hotlines available for anonymous use:

1. Central Fraud Reporting Line: 1 (800) 349-9970
2. We Tip Hotline: 1 (800) 782-7463

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