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Archive for July, 2012

Smart phones call for even smarter forensics

Digital forensics unit gravatarEach day, there are at least 10 times more mobile devices being produced in the world than babies being born (Global). Recent research conducted by the Ohio Bureau of Workers’ Compensation Special Investigations Department examined such growth in mobile technology, its uses within the workers’ compensation realm, and its future implications on fraud investigations. Mobile devices are projected to be the most common way Americans access the Internet by 2015, with a compound annual growth rate of 16.6% according to the International Data Corporation (DeGrasse). 

The health information field is leading the growth, with investment in companies that make health information mobile apps rising 78% in 2011 to $766 million (Edney; Bloomberg). In 2012, nearly 420 million smart phones and 44 million tablets will ship worldwide (Canalys). With smart phones and tablets increasingly being used to perform work previously done on a laptop or PC, the workers’ compensation system can expect to see increased use of mobile devices and applications in the daily activities of its healthcare providers, employers, and workers.

Taking advantage of recent trends, the BWC formulary went mobile in April 2012, allowing healthcare professionals immediate access to a formulary at the point of care and helping to ensure prescription safety and accuracy. Epocrates, Inc., available through app stores, can also be utilized by employers and workers. Another app, called PillManager, boasts of “unparalleled connectivity between consumer and pharmacy” where consumers can track their own medications and submit a repeat request for any prescription directly from their handheld device.

Mobile devices can be used outside of the healthcare realm, however, with apps aiding employers and workers during work activities. The U.S. Department of Labor and OSHA teamed up to allow worksite heat index tracking in order to reduce heat-related illnesses for workers outdoors. Using GPS data and information from the U.S. National Oceanic and Atmospheric Administration the app addresses risk levels and advises of rest breaks, fluid consumption, and adjustment of work operations. The NIOSH Lift Calculator app is also within the public domain, utilizing real-time feedback to reduce lower-back injuries; the app uses variables, such as horizontal distance, to calculate stress on the lower back during lifts.

Conversely, workers’ comp officials are concerned that injury exposure may grow as more workers go mobile – 2012 is expected to see nearly 35 million people working from home or other locations (Simpson). Mobile devices, although helpful in many realms, can prove to be a dangerous distraction while walking or driving; if the devices are owned by the employer, injuries while using such devices may present unclear compensability situations.

Mobile phones are being used in virtually all levels of criminal activity, making it easier for investigators to use mobile technology as incriminating evidence in an investigation. Personal surveillance has evolved with social media and mobile technology; as a result, officials can conduct investigations through “open source intelligence”. It has become common for investigators to identify false worker’s comp claims from social media websites like Facebook and Twitter documenting able-bodied activity (Newberry).

In addition, mobile applications create a full electronic audit trail enabling the tracking of people and transactions in both space and time. Within workers’ compensation, claims data can be correlated with information from apps to identify “hotspots” of activity at different pharmacies; problem pharmacies or providers can be identified and investigated more quickly (Savitz; Forbes).

Mobile technology, although helpful in a variety of field investigative aspects, can prove to be a challenge to a digital forensic examiner. The number of operating systems is much greater for mobile devices (>10) than for desktops (3) and each OS differs from the next in the way data is stored and security is provided. DFE’s must have the knowledge and tools to access information from each type of OS. In addition, the move to mobile technology has increased the use of cloud data storage, making it commonplace; Strategy Analytics forecasts U.S. spending on cloud services to grow $50 billion by 2016. Digital evidence has shifted to the cloud, where information may be found in multiple places and on a variety of platforms; also, data processing is decentralized in the Cloud, with a lack of physical access to servers (Grispos, Glisson, & Storer). As a result, traditional approaches to evidence collection are void Investigators must identify that an individual is using the cloud, obtain a search warrant, and overcome the final obstacle that current digital forensics tools are intended for media that is under the investigator’s control. As the transition is made to mobile device storage, investigators must be ready to make the change to better (and more expensive) technology for digital forensics labs.

As technology changes, the BWC Special Investigations Department continues to change its investigative efforts.  While the majority of people use technology to improve business operations or enhance communication, we are prepared to investigate those that use these types of technologies to commit fraud against the Ohio BWC.

To report suspected workers’ compensation fraud, call 1-800-OHIOBWC, visit ohiobwc.com, or visit www.facebook.com/ohiobwcfraud.

Sources:

Apple App Stores. Available from: http://www.apple.com/iphone/from-the-app-store or http://www.apple.com/ipad/from-the-app-store; 2012 [accessed 06.26.12]

“App stores; direct revenue to exceed $14 billion next year and reach close to $37 billion by 2015.” Canalys. Available from: http://www.canalys.com /newsroom/app-stores-direct-revenue-exceed-14-billion-next-year-and-reach-close-37-billion-2015; 2012 [accessed 06.26.12]

DeGrasse, M. “Mobile devices projected to overtake PCs as connections to Internet.” RCR Wireless. Available from: http://www.rcrwireless.com /blog/20110912/devices/mobile-devices-projected-to-overtake-pcs-as-connections-to-internet/; 2012 [accessed 06.26.12]

Edney, A. “iPad-toting doctors spur venture funding in medical apps.” Bloomberg Report. Available from: http://www.bloomberg.com/news/2012-06-18/oprah-aids-doctors-as-app-investments-soar-health.html; 2012 [accessed 6.26.12]

Grispos, G., Glisson, W., & Storer, T. “Calm before the storm: the emerging challenges of cloud computing in digital forensics.” 2009. [accessed 06.26.12]

Hobson, E. “Securing the cloud: digital investigations for the cloud.” Qinetiq. 2010. [accessed 06.26.12]

Newberry, L. “Social media footprint helps Pa. investigators.” Officer.com. Available from: http://www.officer.com/news/10731208/social-media-footprint-helps-pa-investigators; 2012 [accessed 06.26.12]

Ohio BWC Web. [accessed 06.26.12]

Savitz, E. “5 ways mobile apps will transform healthcare.” Forbes. Available from: http://www.forbes.com/sites/ciocentral/2012/06/04/5-ways-mobile-apps-will-transform-healthcare/; 2012 [accessed 06.26.12]

Simpson, A. “As more workers go mobile, workers’ compensation exposure grows.” Insurance Journal. Available from: http://www.insurancejournal.com /news/national/2011/06/01/200720.htm; 2012 [accessed 06.26.12]

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Cleveland real estate agent guilty of workers’ compensation fraud

COLUMBUS – A Cleveland (Cuyahoga County) man must repay more than $30,000 after he was discovered working as a real estate agent while collecting injured worker benefits.  Greg Robinson pleaded guilty to workers’ compensation fraud after an investigation by the Ohio Bureau of Workers’ Compensation revealed his wrongdoing.

“There are undoubtedly many people who would jump at the opportunity to collect $30,000 on top of their income, but they would never consider it if it involved committing fraud,” said BWC Administrator/CEO Steve Buehrer.  “Those who commit workers’ comp fraud are unfairly drawing resources away from the majority who are only interested in utilizing the system to assist in recovery and return to work.”

BWC’s Special Investigations Department began investigating after receiving an allegation that Robinson was selling real estate while receiving temporary total disability benefits for an injury that occurred while he was a custodian for the Berea schools.  The investigation found that after his injury, Robinson worked for two real estate agencies selling homes and conducting broker price opinions of properties. 

Robinson pleaded guiltyto one count of felony count of workers’ compensation fraud. He was sentenced to six months incarceration, suspended for five years of community control. As a condition of his community control, Robinson must pay restitution in the amount of $31,305.87.

To report suspected workers’ compensation fraud, call 1-800-OHIOBWC, visit ohiobwc.com, or visit www.facebook.com/ohiobwcfraud.

BWC Investigations Result in Eight Workers’ Comp Fraud Convictions in June

Columbus – Ohio Bureau of Workers’ Compensation (BWC) Administrator/CEO Steve Buehrer today announced eight individuals were convicted of or pleaded guilty to charges related to defrauding Ohio’s workers’ compensation system during June. The court actions are the result of investigations conducted by BWC’s special investigations department (SID). The department works to deter, detect, investigate and prosecute workers’ compensation fraud.

“Working while receiving disability benefits and filing false claims direct employer premium dollars away from their intended purpose,” said Buehrer. “Caring for those who truly are injured and not ready to return to work is the only suitable use of employer dollars, and the reason our investigators work to track down and put an end to fraud.”

A sampling of cases that resulted in a guilty plea or conviction during June follows.

Kelly Hart (Diamond, Portage County) pleaded guilty June 12 to two counts of theft for working while receiving benefits.  An allegation indicated Hart was working while receiving temporary total disability benefits. Investigators found Hart returned to employment as a car detailer for Just the Details LLC while receiving benefits.  The business owner and Hart himself confirmed his employment.  Hart was sentenced to 18 months prison, suspended for five years of Community Control.  He was ordered to pay $4,861.91 in restitution and $500 in investigative costs as a condition of his community control.

Ronald J. Richards (Weirton, West Virginia) pleaded guilty June 12 to one count of theft for working while receiving benefits.  Richards was awarded temporary total and living maintenance benefits after he was injured as a truck driver for Riley Petroleum Products LLC in Toronto (Jefferson County).  Working on a tip, investigators found he was employed as a truck driver for Bee Mack Trucking in Ambridge, Pennsylvania, while receiving these benefits.  Richards was ordered to pay restitution in the amount of $5,153.05 and sentenced to 180 days incarceration suspended for 36 months of community control. The judge also ordered him to maintain viable employment and will serve an immediate 30 day sentence if he misses a single restitution payment.

Robert T. Howland (Millersburg, Holmes County) pleaded guilty June 12 to one count of theft for working while receiving benefits. SID received an allegation from a BWC claims service specialist that Howland may be working for the Robinson Country Inn/Hotel in Millersburg while receiving Living Maintenance benefits. These payments are available to an injured worker instead of Temporary Total Disability while he or she is actively involved in an approved rehabilitation program. The claims service specialist submitted the tip after reviewing a paystub submitted by Howland and suspecting he may be receiving wages from the hotel. The investigation confirmed that Howland did work for the hotel performing kitchen duties in conflict with his collection of benefits. Howland was ordered to pay restitution of $5,928.43.  He was also sentenced to 90 days of incarceration suspended for 60 months of community control.

Benjamin Lawrence (Covington, Kentucky) pleaded guilty June 4 to one count of workers’ compensation fraud for filing a false claim.  Lawrence was allegedly injured on the job and was receiving benefits until a co-worker secretly taped him confessing to faking the injury.  The co-worker supplied the employer with the tape, in which Lawrence states he purposely injured himself and knowingly filed a false claim.  He also brags that he was able to receive pain pills. Lawrence pleaded guilty to one count of workers’ compensation fraud in a Franklin County courtroom and the judge ordered him to pay restitution of $2,057.92 to BWC.  He will serve 180 days in jail he does not pay the full amount by October 1, 2012.  He paid $500 towards his restitution the day of sentencing. The surveillance video is available here.

To report suspected workers’ compensation fraud, call 1-800-OHIOBWC, visit ohiobwc.com, or visit www.facebook.com/ohiobwcfraud.