2021 Georgia Code
Title 34 - Labor and Industrial Relations
Chapter 9 - Workers' Compensation
Article 1 - General Provisions
§ 34-9-24. Fraud and Compliance Unit; Creation and Duties; Limitation on Liability; Authority; Whistle Blower Protection

1. There is established within the office of the State Board of Workers' Compensation a fraud and compliance unit. This unit shall assist the chairperson in administratively investigating allegations of fraud and noncompliance and in developing and implementing programs to prevent fraud and abuse. The unit shall promptly notify the appropriate prosecuting attorney's office of any action which involves criminal activity. When so required or requested by the chairperson or the specific district attorney, the unit shall cooperate with the district attorney in the investigation and prosecution of criminal violations.
2. The State Board of Workers' Compensation or any employee or agent thereof is not subject to civil liability for libel, slander, or any other relevant tort, and no civil cause of action of any nature exists against such persons by virtue of the execution of activities or duties under this Code section or by virtue of the publication of any report or bulletin related to the activities or duties under this Code section.
3. Fraud investigators employed in the fraud and compliance unit who are certified in compliance with Chapter 8 of Title 35 shall have the authority to execute search warrants and make arrests pursuant to warrants only if such warrants have been issued as the result of a criminal investigation of an alleged violation of this chapter. Such fraud investigators are authorized to serve subpoenas in connection therewith.
4. In the absence of fraud or malice, no person or entity who furnishes to the board information relevant and material to suspected fraud under or noncompliance with the workers' compensation laws of this state shall be liable for damages in a civil action or subject to criminal prosecution for the furnishing of such information.

(Code 1981, §34-9-24, enacted by Ga. L. 1995, p. 642, § 5; Ga. L. 1997, p. 1367, § 2; Ga. L. 1998, p. 128, § 34.)

- Ga. L. 1995, p. 642, § 13, not codified by the General Assembly, provides for severability.

- For annual survey on workers' compensation law, see 66 Mercer L. Rev. 247 (2014). For article, "Whistleblowing in the Compliance Era," see 55 Ga. L. Rev. 147 (2020).

JUDICIAL DECISIONS

Referral to fraud and compliance unit.

- Fact that the Workers' Compensation Fraud Unit was not established until three years after the claimant's alleged fraud occurred did not bar referral of claimant's case to the unit. Bahadori v. Sizzler, 230 Ga. App. 52, 505 S.E.2d 23 (1998).

- Based on ample evidence that an employee performed work for the company and derived income therefrom while at the same time receiving temporary total disability benefits, an award of attorney fees to the employer's insurer pursuant to O.C.G.A. § 34-9-108(b)(1), the assessment of a civil penalty against the employee pursuant to O.C.G.A. § 34-9-18(b), and the referral of the matter to the Enforcement Division of the Board pursuant to O.C.G.A. § 34-9-24 should have been affirmed by a trial court under the "any evidence" standard of review. Trax-Fax, Inc. v. Hobba, 277 Ga. App. 464, 627 S.E.2d 90 (2006).

- Former employer was not liable for filing a fraud complaint with the Georgia State Board of Workers' Compensation because the allegations contained in the complaint were true and, thus, the employer did not commit fraud when the employer filed the complaint. Garcia v. Shaw Indus., Inc., 321 Ga. App. 48, 741 S.E.2d 285 (2013).

- Trial court did not err in granting an insurer summary judgment in the insurer's action to recover premiums due under a workers' compensation insurance policy the insurer issued to an insured because the insurer submitted evidence on the number of workers on the insured's payroll, the amount of the payroll, the classifications of those workers, and the applicable rates; the insured did not come forward with any evidence to show that any of the workers listed were covered by other workers' compensation insurance, and therefore, did not show that any of the workers had been "misclassified" by the audit. Dennis Perry Homes, Inc. v. Companion Prop. & Cas. Ins. Co., 311 Ga. App. 706, 716 S.E.2d 798 (2011).

Records of the State Board of Workers' Compensation Fraud and Compliance Division are subject to disclosure under the Open Records Act, O.C.G.A. § 50-18-70 et seq., except when such disclosure is exempted by the Act, prohibited by law, or prohibited by court order. 1997 Op. Att'y Gen. No. 97-20.

Files and records that would otherwise be confidential under O.C.G.A. § 34-9-24(b) should be furnished to prosecutors in furtherance of a Fraud and Compliance Division investigation. 1997 Op. Att'y Gen. No. 97-20.

Exculpatory information in files should be made available to criminal defendants being prosecuted as a result of an investigation under O.C.G.A. § 34-9-24. 1997 Op. Att'y Gen. No. 97-20.

- Investigators of the Enforcement Division who are certified as peace officers may enforce the aggravated identity fraud statute, O.C.G.A. § 16-9-121.1, by arrest and the execution of search warrants provided that the arrest and search is the result of a criminal investigation of an alleged violation of the workers' compensation laws of O.C.G.A. Ch. 9, T. 34. 2012 Op. Att'y Gen. No. 12-3.