Home > Annual Reports > Special Investigations Department identified $56.6 million in savings last year

Special Investigations Department identified $56.6 million in savings last year

We’re pleased to announce that SID identified $56.6 million in savings for the State Insurance Fund over the past year due to workers’ compensation fraud committed by claimants, employers and medical providers.

cvr4Recovered funds will go back to the State Insurance Fund to care for workers injured in Ohio. The Spe cial Investigations Department Fiscal Year 2016 Annual Report was released today, and includes an overview of statistics and strategies for preventing and detecting fraud.

Since its inception in 1993, SID has completed nearly 64,000 investigations and identified $1.7 billion in savings to the Ohio workers’ compensation system.

Among the more than 1,500 cases that were closed during FY 2016, 668 were closed founded, meaning the original allegation was proven. The average savings identified among the 668 cases was more than $84,000. This average savings identified per closed case was the second highest annual average generated by SID. Nearly 200 of these cases were referred for prosecution, or 29.6 percent of the founded cases. SID obtained 119 indictments and 127 convictions.

SID employees are able to generate these results because of their effective and efficient day-to-day investigative techniques and tactics, including collaboration within the law enforcement community. SID employees maintain effective partnerships with our colleagues within local, state and federal investigative bodies. These benchmarking partners recognize that SID embraces technology, such as electronic surveillance equipment and data analysis, including predictive modeling, to proactively detect fraud. During FY 2016, the total savings identified from allegations detected by our intelligence unit and referred to field teams for investigation exceeded $36 million.

However, enforcement is not the only method used by SID to achieve its departmental mission. SID employees promote fraud prevention strategies to internal and external stakeholders by means of articles in periodicals, presentations, and social media, such as this article. These efforts educate, inform and build understanding of BWC’s overall mission “to protect Ohio’s workers and employers through the prevention, care and management of workplace injuries and illnesses at fair rates.”

sid mission
Thank you for supporting our agency’s mission and efforts. Please keep those tips coming!

  1. September 2, 2016 at 9:05 am

      What are the benefits of saving it

  2. September 2, 2016 at 9:46 am

    The benefits of identifying and putting an end to workers’ comp fraud are numerous. The workers’ comp premiums Ohio employers pay to protect their employees in the event of a workplace injury go into the State Insurance Fund (SIF). When an injury does occur, those dollars are used to ensure the worker receives necessary medical care and payment for time away from work, if needed.

    Those who commit fraud receive benefits illegitimately, unfairly drawing from the resources reserved for those who are truly injured on the job. The money that’s recovered from those who commit fraud is returned to the SIF, ensuring care for those who need it, and keeping employers’ premiums as low as possible.

    Thank you for your question.

  3. Ross L Poling
    August 4, 2017 at 2:32 pm

    So does that mean if you to a file a claim your are defrauding the State of Ohio BWC? The Ohio BWC is the 2nd largest in the US, BWC is so big they have people doing other peoples job because they do not know how to process any paperwork. JUST REMEMBER THE # D’S DENY, DELAY, AND DEFER. Asked BWC about the word timely, they have no idea as to the word or do they care. Need to start with BWC and start at the top and work down until you get the fat cut from the system then the rates and cases will follow. You will see rates go down in the state.

    • August 7, 2017 at 2:19 pm

      Workers’ comp benefits are intended to assist those who are injured on the job with medical care and compensation if they need time away from work to recover. BWC’s Special Investigations Department works to protect the premium dollars employers pay so they do not go to dishonest claimants, employers or medical providers. Fortunately, only a small percentage of claims filed are fraudulent but BWC is committed to finding and pursuing those who do cheat the system. The vast majority of claimants, employers and medical providers that do play by the rules deserve no less from BWC.

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