CACI No. VF-4600. False Claims Act: Whistleblower Protection (Gov. Code, § 12653)
Judicial Council of California Civil Jury Instructions (2024 edition)
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VF-4600.False Claims Act: Whistleblower Protection (Gov. Code,
§ 12653)
We answer the questions submitted to us as follows:
1. Was [name of plaintiff] an employee of [name of defendant]?
1. Yes No
1. If your answer to question 1 is yes, then answer question 2. If you
answered no, stop here, answer no further questions, and have
the presiding juror sign and date this form.
2. Did [name of plaintiff] [specify acts done in furthering the false
claims action or to stop a false claim]?
2. Yes No
2. If your answer to question 2 is yes, then answer question 3. If you
answered no, stop here, answer no further questions, and have
the presiding juror sign and date this form.
3. Did [name of plaintiff] act [in furtherance of a false claims action/
to stop a false claim]?
3. Yes No
3. If your answer to question 3 is yes, then answer question 4. If you
answered no, stop here, answer no further questions, and have
the presiding juror sign and date this form.
4. Did [name of defendant] [discharge/specify other adverse action]
[name of plaintiff]?
4. Yes No
4. If your answer to question 4 is yes, then answer question 5. If you
answered no, stop here, answer no further questions, and have
the presiding juror sign and date this form.
5. Were [name of plaintiff]’s acts [in furtherance of a false claims
action/to stop a false claim] a substantial motivating reason for
[name of defendant]’s decision to [discharge/other adverse action]
[him/her/nonbinary pronoun]?
5. Yes No
5. If your answer to question 5 is yes, then answer question 6. If you
answered no, stop here, answer no further questions, and have
the presiding juror sign and date this form.
6. Was [name of defendant]’s conduct a substantial factor in causing
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harm to [name of plaintiff]?
6. Yes No
6. If your answer to question 6 is yes, then answer question 7. If you
answered no, stop here, answer no further questions, and have
the presiding juror sign and date this form.
7. What are [name of plaintiff]’s damages?
[a. Past economic loss
[lost earnings $ ]
[lost profits $ ]
[medical expenses $ ]
[other past economic loss $ ]
[a. Total Past Economic Damages: $ ]
[b. Future economic loss
[lost earnings $ ]
[lost profits $ ]
[medical expenses $ ]
[other future economic loss $ ]
[b. Total Future Economic Damages: $ ]
[c. Past noneconomic loss, including [physical
pain/mental suffering:] $ ]
[d. Future noneconomic loss, including [physical
pain/mental suffering:] $ ]
[d. TOTAL $
Signed: Presiding Juror
Dated:
After [this verdict form has/all verdict forms have] been signed, notify
the [clerk/bailiff/court attendant] that you are ready to present your
verdict in the courtroom.
New December 2015; Revised December 2016
WHISTLEBLOWER PROTECTION VF-4600
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Directions for Use
This verdict form is based on CACI No. 4600, False Claims Act: Whistleblower
Protection - Essential Factual Elements.
The special verdict forms in this section are intended only as models. They may
need to be modified depending on the facts of the case.
Questions 4 and 5 may be modified to allege constructive discharge. Questions 2
through 5 of CACI No. VF-2408, Constructive Discharge in Violation of Public
Policy - Plaintiff Required to Endure Intolerable Conditions for Improper Purpose
That Violates Public Policy, should be adapted and included in such a case.
If specificity is not required, users do not have to itemize all the damages listed in
question 7 and do not have to categorize “economic” and “noneconomic” damages,
especially if it is not a Proposition 51 case. The breakdown of damages is optional
depending on the circumstances.
If there are multiple causes of action, users may wish to combine the individual
forms into one form. If different damages are recoverable on different causes of
action, replace the damages tables in all of the verdict forms with CACI No. VF-
3920, Damages on Multiple Legal Theories.
If the jury is being given the discretion under Civil Code section 3288 to award
prejudgment interest (see Bullis v. Security Pac. Nat’l Bank (1978) 21 Cal.3d 801,
814 [148 Cal.Rptr. 22, 582 P.2d 109]), give CACI No. 3935, Prejudgment Interest.
This verdict form may need to be augmented for the jury to make any factual
findings that are required in order to calculate the amount of prejudgment interest.
VF-4600 WHISTLEBLOWER PROTECTION
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