About BWC’s Special Investigations Department

The Ohio Bureau of Workers’ Compensation (BWC) Special Investigations Department (SID) aggressively pursues cases of claims fraud, medical provider fraud and premium fraud. As a result of our investigations, the department declares overpayments, identifies actuarial savings, disallows claims, pursues prosecutions and recovers dollars — all of which directly impact the effectiveness BWC experiences in decreasing premium costs.

The SID is comprised of several types of teams:

  • Three regional claimant fraud special investigation units operate in most customer service offices;
  • The health care provider team, employer fraud team and safety violations investigation unit (SVIU) are each comprised of team members located throughout the state;
  • The intelligence unit; digital forensics unit; and BWC security services operate through BWC’s central office.

Ohio Revised Code (ORC 2913.48) permits the criminal prosecution of those who defraud the workers’ compensation system.

Since its inception in 1993, SID had achieved the following *:

  • Researched 117,249 allegations;
  • Completed 63,968 investigations;
  • Closed 26,194 founded cases;
  • Identified $1.7 billion in savings;
  • Identified $26,741 per closed case;
  • Referred 4,864 subjects for prosecution;
  • Secured 2,570 criminal convictions.

To report fraud online, please visit: http://bit.ly/reportfraud.

To speak with a fraud hotline agent, please call 1-800-644-6292.

*As of 06/30/2016

 

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