Home > Fraud Awareness, SID Information > Exceptional criminals? – No way, but those who commit workers’ compensation fraud are exceptions

Exceptional criminals? – No way, but those who commit workers’ compensation fraud are exceptions

Browsing through the cases summarized on our OhioBWCFraud Facebook page, one might draw the conclusion that those who commit workers’ compensation fraud are lurking behind every tree and signpost. Admittedly — thanks to all of our fraud allegation sources — we have had success in identifying and prosecuting fraud.

Therefore we have dozens of Facebook articles that highlight many of the cases we have closed founded in just the last two years. In fact, the more than $23 million in savings we have identified this fiscal year (since July 1, 2013), increases our all time results to nearly $1.6 billion in savings identified since 1993.

However, what is probably not obvious to our readers is most often our thorough and objective investigation proves the suspect has not committed fraud. This is why, since 1993, just 24,169 (or 40.7 percent) of our 59,335 closed investigations have found that a loss was sustained by the State Fund.

We are successful each time we close a case unfounded — because fraud was not committed. Our purpose is not to “catch suspects committing crimes,” rather it is to determine the truth. This may seem like a fine distinction to some, but for the investigative professional it is a critical difference. Further, each time we close an unfounded case, we are reminded that we are meeting the first part of our departmental mission to relentlessly deter crimes against the State Insurance Fund.

When the State Fund is protected, we minimize the premiums paid by compliant employers, while nonetheless ensuring the system is adequately funded. This ensures the State Fund’s essential resources are available to pay for the effective treatment and lost-time benefits deserved by all legitimately injured or ill workers.

As our Director of Investigations Rick Gregory recently noted in an August 29, 2013 Associated Press interview: “When people follow the rules and do it right, they are punished by virtue of the fact that other people don’t do it right,” Gregory said. “And I just think that’s unfair.”

Therefore, we continue to need and want every fraud allegation. Do not hesitate to report your suspicions using our online form or our calling our toll-free fraud hotline, 1-800-OHIOBWC. Know that we will faithfully do our jobs, determining whether or not the State Fund has been victimized.

Thank you for your interest in learning more about a workers’ compensation system that serves hundreds of thousands of deserving, law-abiding citizens in the State of Ohio. Check out archived articles in OhioBWCFraud to learn more about how you may help us protect the State of Ohio.

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