How to file a complaint with the Audit Unit
The Audit Unit does not resolve disputes about benefits, but it tracks complaints against all workers' compensation claims administrators (insurance companies, self-insured employers and third party administrators) and takes action to make sure the law is followed. While not all complaints result in investigations or audits, it is important for the Audit Unit to hear your complaint. The audit referral form (DWC-AU-906) may be used to file a complaint against the claims administrator. When not using the audit referral form, please include the following information in a complaint: 1. 2. 3. 4. 5. 6. Claims administrator company name, address and telephone number Injured worker name, address and telephone number Claim number and date of injury Employer name Workers' Compensation Appeals Board case number, if applicable Attach copies of any supporting documentation.
Send the completed audit referral to: DWC Audit Unit Attention: Complaint Desk 2424 Arden Way, Suite #305 Sacramento, CA 95825-2403 Complaints may also be filed electronically with the Audit Unit at [email protected] Any complaint with more than five pages of supporting documentation should be submitted to the Audit Unit by mail. A copy of any complaint can also be sent to the claims administrator. Sometimes this helps to resolve a problem. Because of confidentiality restrictions imposed by Labor Code Section 129, you will not be informed of the results if your claim is audited. Any dispute over benefits must be brought before the Workers' Compensation Appeals Board (WCAB). Further information about the provision of workers' compensation benefits is available from the Division of Workers' Compensation Web site: http://www.dir.ca.gov/dwc.
Form DWC-AU-905 (Rev 06/06)