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Video surveillance exposes Sidney couple’s scheme to defraud BWC

August 21, 2020 Leave a comment

Agency closes 11 cases in June, July   

The Ohio Bureau of Workers’ Compensation (BWC) closed 11 cases involving workers’ compensation fraud and related charges in June and July, bringing total convictions for BWC to 47 for calendar year 2020.

“Workers’ compensation fraud can happen anywhere in Ohio,” said BWC Administrator/CEO Stephanie McCloud. “That’s why we have dedicated investigators in every corner of the state to uncover folks — whether they’re employers, injured workers or medical providers — who try to cheat the system.”

Among the June cases is a Sidney, Ohio, couple sentenced on felony charges related to workers’ compensation fraud after a BWC investigation found the husband mowing lawns, using a snow blower, and chopping wood while claiming to be permanently and totally disabled from work.

A Shelby County judge sentenced David Juillerat on June 8 to five years of probation in lieu of jail time and a fine of $1,000 for his conviction on a reduced charge of attempted tampering with records, a fourth-degree felony. Juillerat’s wife, Wendy Juillerat, was sentenced three days earlier on a similar charge, attempted complicity to tampering with records, also a fourth-degree felony. A judge sentenced her to five years of probation in lieu of jail time and to pay court costs.

David Juillerat applied to BWC in 2018 for permanent total disability benefits, claiming a work injury left him unable to drive a car or walk without the assistance of a walker. Acting on a tip that he might be faking his injury, agents with BWC’s Special Investigations Department surveilled David for several weeks in 2019. They filmed him on multiple occasions entering and leaving medical offices with a walker. Away from a medical office, however, agents filmed him walking, shopping, working on his car, chopping wood, and other activities, all without the use of a cane or walker.

As for Wendy Juillerat, agents say she admitted to helping her husband complete his application for permanent total disability and accompanied him to numerous doctor’s appointments in which she would exaggerate his physical limitations in order for the disability to be granted.

Based on BWC’s investigation, David Juillerat’s application for disability benefits was denied in late 2019, saving BWC an estimated $233,668 in benefits over the projected life of the claim.

 

Other cases in June and July include:

 

Joseph Ferguson of Toledo

Ferguson pleaded guilty July 24 in Franklin County Common Pleas Court to one count of workers’ compensation fraud, a first-degree misdemeanor, after a BWC investigation revealed he was working as a web development supervisor while receiving benefits from BWC from October 2017 to January 2018. The judge sentenced Ferguson to five years of community control and ordered him to pay restitution of $6,473 to BWC. If he violates the terms of his community control, he will serve 60 days in jail.

 

Ruth Asamoah of Columbus

On July 13, Asamoah pleaded guilty to one count of workers’ compensation fraud, a fifth-degree felony, for working while receiving BWC disability benefits. BWC investigators found Asamoah worked for eight employers, performing the same or similar jobs she was doing when she was injured. A Franklin County judge ordered her to pay $15,020 in restitution and sentenced her to an 11-month jail sentence, suspended for five years of probation.

 

Jeffrey Berkley of Taylor, Michigan

BWC investigators found Berkley working as a driver, transporting cars around the Midwest, while receiving BWC benefits from July 2014 to September 2014. On July 7, Berkley pleaded guilty in Franklin County to one count of workers’ compensation fraud, a first-degree misdemeanor. The judge sentenced him to a 12-month suspended jail sentence and ordered him to pay restitution of $2,668 to BWC. Berkley paid the full amount of restitution to the clerk of courts prior to the plea.

 

Marguerite Cervantes of Perrysburg

Cervantes pleaded guilty July 2 to one count of workers’ compensation fraud, a fifth-degree felony, in the Franklin County Court of Common Pleas. A BWC investigation revealed Cervantes had returned to work as a clinical nurse from April to October 2016 while collecting temporary total disability benefits. The judge sentenced her to an 11-month suspended jail sentence, five years of probation, and ordered her to pay restitution of $16,885.

 

Angela Berardelli of North Canton

A BWC investigation revealed Berardelli was working at a restaurant while receiving BWC benefits from January 2016 to June 2017. On June 30, Berardelli pleaded guilty to one count of workers’ compensation fraud, a first-degree misdemeanor. She received a sentence of 90 days in jail suspended for 12 months of community control. The judge ordered Berardelli to pay restitution of $10,194 to BWC. She made a payment of $6,500 at the time of plea.

 

Patricia Black of Cincinnati

Black pleaded guilty June 16 in Franklin County to one count of workers’ compensation fraud, a fifth-degree felony. An investigation by BWC found Black working as an office cleaner while receiving BWC benefits from January 2018 to October 2018. Black was ordered to pay $18,407 in restitution and sentenced to 12 months in prison, suspended for three years of non-reporting community control.

 

To report suspected workers’ compensation fraud, call 1-800-644-6292 (Option 4, Option 0, Option 1) or visit bwc.ohio.gov.

 

BWC SID: Our Journey to Excellence – Part 1 of 3

October 30, 2015 Leave a comment

0005 -- Administrator Buehrer -- Introductory Remarks -- IMG_2876In our constant quest for improvement, all members of the Bureau of Workers’ Compensation Special Investigations Department (SID) gathered on October 22, 2015 at our Mansfield service office to successfully complete annual in-service training. The theme of this year’s training event was “Our Journey to Excellence: Past, Present and Future.”

BWC Administrator/CEO Steve Buehrer welcomed the 125 attendees and opened the meeting. In his opening remarks, Administrator Buehrer praised the department’s more than 20 years of success, noting that throughout its history SID has generated more than $7 in savings for every budgetary dollar expended. He cited other SID performance results, lauding SID for having annually identified more than $55 million in savings to the State Insurance Fund during each of the last five consecutive years.

“Investigating fraud is a vital part of the workers’ compensation business,” Administrator Buehrer said. “Identifying fraud puts dollars back into the State Insurance Fund and supports our efforts to keep premiums as low as possible.”

SID Mtg 2015

Pictured left to right: James Wernecke, Jennifer Saunders, Tamela Dixon, Sarah Morrison and Steve Buehrer.

Following these remarks, Administrator Buehrer, Chief Legal Officer Sarah Morrison, SID Director James Wernecke and SID Assistant Director Jennifer Saunders presented service pins to 14 SID employees. These recipients included seven employees with 20 years of service and one, Assistant Special Agent in Charge Tamela Dixon, with 25 years of service to the State of Ohio.

Subsequently, SID Director James Wernecke thanked Administrator Buehrer for his executive leadership, ongoing support for SID’s mission, and presence at the annual event. All of members of the Special Investigations Department joined Director Wernecke in thanking Administrator Buehrer for inspiring us to realize our departmental mission to deter, detect, investigate and prosecute workers’ compensation fraud.

In the coming two weeks, we will offer more details from October 22 training event. Stay tuned for part two of the series, which acknowledges specialized training we received at the event.

In the meantime, you can read the past posts about our SID Director here and our most recent annual report here.

Geauga County workers’ comp fraudster later found guilty of much more serious charge

October 9, 2015 Leave a comment

An agent with BWC’s Special Investigations Department recently testified at the trial of a woman facing murder charges.  On Oct. 1, in the Geauga County Court of Common Pleas, Dorretta Scheffield was found guilty of murdering her husband, Randy.

SID opened an investigation into Scheffield and her daughter, Beth Rowles, in 2009 after receiving an allegation.  Rowles, was receiving benefits for a workplace injury that allowed her to work but required her to report earnings to determine benefit levels.  Investigators found Scheffield was writing checks to her daughter, Beth Rowles, for her work as a secretarial assistant at her husband’s company, Scheffield Lawns Inc. The only problem was Rowles wasn’t actually working and Scheffield wrote the checks from the business’s account so Rowles could submit copies to BWC in order to continue receiving her benefits.

Both women pleaded guilty in 2013 to felony counts of workers’ compensation fraud and served one year of community control.

Read more about Scheffield’s trial here: http://www.geaugamapleleaf.com/news/guilty-guilty-guilty-2/

Categories: News Articles

Spotlight: Our college interns

July 24, 2015 Leave a comment

BWC’s Special Investigations Department (SID) created its college relations program in 1995 to promote the study and practice of criminology, criminal justice, law enforcement and public administration. On college and university campuses throughout Ohio (and beyond), SID staff members exchange insights with students, faculty and staff members on how to combat crime.

Since the program began 20 years ago, SID has recruited, selected and trained more than 300 paid interns and unpaid externs. Many have gone on to become law enforcement officers, criminal investigators, special agents, digital forensic analysts, assistant special agents in charge and special agents in charge.

We currently employ nine SID interns, many of whom were interviewed for this article.

The SID college relations program has expanded to a variety of universities, including The Ohio State University, Ohio Dominican University, the University of Akron, Columbus State Community College, Cuyahoga Community College and Champlain University.

The current SID interns work in specialized units, such as the digital forensics, intelligence, security and special investigations units (SIUs).

“I liked sitting with each member and having them walk us through what they do and how they do it,” said intelligence unit intern Courtney Kozak.

These interns aren’t simply getting coffee or food for their co-workers either; they have many important duties for the SID. As an intern for both the Columbus SIU and the digital forensics unit, Carlos Gonzalez has great deal of responsibilities and duties.

“I have assisted with investigations to document fraudulent activities, gathered information for case support, documented research and acquisition, assisted with translation, analyzed internet-based software and collected intelligence using open-source tools to assist ongoing investigations,” said Columbus special investigations unit and digital forensics unit intern Carlos Gonzalez.

Many of the interns, such as Jennifer Thomas from the intelligence unit, have deemed their work to be a beneficial experience due to exposure to a variety of areas within the department, such as healthcare and digital forensics.

Security intern Brad Horstman appreciated getting the chance to visit the Ohio Department of Homeland Security headquarters as well as the Ohio State Highway Patrol Criminal Intelligence Center.

“It was a beneficial experience to get a firsthand look at how these different departments and centers operate,” Horstman said.

Most of our current interns are studying criminology and criminal justice, but there are exceptions. One, for example, is double majoring in accounting and finance.

Career goals and aspirations are diversified among these interviewed interns.

Taylor Scarberry, a college intern on a regional claimant SIU team, wants to work for a federal government agency. Kozak, on the other hand, hopes to eventually become a forensic accountant for a government agency. Horstman is keeping his options open.

The SID college relations program has been successful in hiring interns with a variety of backgrounds, majors and career goals who quickly become vital assets to BWC’s efforts to fight workers’ compensation fraud. We use feedback like this from our interns to continually improve our program.

If you’re enrolled at a college or university and interested in joining our team as an intern, contact our college relations program coordinator, Jeff Baker.

Categories: News Articles

Coming soon…SID’s annual report

July 17, 2015 Leave a comment

Each year, we furnish an annual report of SID’s performance, strategic initiatives and fraud trends, and this year isn’t any different.

The SID team is currently reviewing operations, assessing performance outcomes and tallying the results achieved throughout fiscal year 2015, which concluded June 30. Since fiscal year 2001, this year-end process has culminated in the annual late July publication of our SID annual report.

Although we’re still finalizing the latest report, we’re pleased that it appears we will surpass our outstanding results from fiscal year 2014. View the entire 2014 annual report here.

SID diligently works behind the scenes. Our investigative staff makes sure that those with legitimate work-related injuries are receiving needed benefits and medical care, and that employers and medical providers are fulfilling workers’ compensation requirements. Those who do not follow the law are handled accordingly. In this upcoming report, we will draw attention to some of our successes in the past year, profile interesting and noteworthy fraud cases, and provide a preview of our new strategic practices and initiatives.

The report will also offer achievements of respective teams and task forces, as well as shine a spotlight upon their operational trends and strategies. This year’s report will include a summary of presentations facilitated by SID employees.

As we create and finalize the annual report, we continue to deter, detect and investigate fraudulent behavior. On July 1, we commenced the work that will be included in our fiscal year 2016 annual report.

Criminals do not take time off, and neither do we.

Categories: News Articles

Ohio State Highway Patrol veteran to lead BWC fraud unit

June 23, 2015 2 comments

James WerneckeCOLUMBUS – Ohio Bureau of Workers’ Compensation (BWC) Administrator/CEO Steve Buehrer today announced the appointment of a 25-year Ohio State Highway Patrol veteran as director of BWC’s Special Investigations Department. James Wernecke began his duties yesterday, overseeing 123 employees who work to deter, detect and investigate workers’ compensation fraud. The department pursues cases of claimant, medical provider and employer fraud by identifying savings, disallowing claims and referring criminal matters for prosecution.

“With more than 25 years of law enforcement experience, Jim is a public safety and criminal investigation expert who is exceptionally qualified to lead our fraud prevention efforts,” said Buehrer. “We look forward to having Jim join our outstanding team of skilled, professional investigators and take the lead in identifying wrongdoing to protect the State Insurance Fund, keep employer premiums as low as possible and provide the best care possible to Ohioans injured on the job.”

A Tuscawaras County native, Wernecke began his career as a trooper in Massillon in 1990 and later served as an investigator in Massillon and Bucyrus, and commander at the Mansfield Patrol Post. He was appointed in 2012 commander of the Ohio Investigative Unit, which is charged with enforcing the state’s liquor laws and is the only state law enforcement agency specifically tasked with investigating food stamp fraud crimes. Agents also investigate tobacco violations.

Wernecke served as an investigative team leader with the Ohio Inspector General’s Task Force and was also assistant commander of the Special Operations Office of Investigative Services from 2006 to 2012.

Wernecke completed advanced law enforcement and investigative training at a number of law enforcement agencies in and outside of Ohio, including the United States Army War College, the West Virginia and Delaware State Police, the New York State Police Academy, Ohio University and the Ohio State University. He also attended the Northwestern University for Public Safety and North Central State College.

From January 2011 to present, BWC’s Special Investigations Department obtained 601 convictions, identifying a total of $260 million in savings for the State Insurance Fund.

Workers’ comp fraud presentation educates OSC15 attendees

April 3, 2015 Leave a comment

More than 100 people attended the workers’ compensation fraud educational session offered Wednesday at the 2015 Ohio Safety Congress & Expo (OSC15). SID assistant special agents in charge Mike Fannon and Doug Risley offered an overview of workers’ compensation fraud and answered questions about how fraud is investigated and when to report it.

The session was titled, “Workers’ Compensation Fraud: Do You Know if it’s Happening to You?”

Those who attended the session represent a number of industries, including manufacturing, insurance, health care, construction, service and transportation.

Fannon and Risley covered the different types of workers’ compensation fraud – employer, medical provider and claimant fraud.

SID’s average savings per case is $65,000, according to Fannon.

“In the state of Ohio, it is a law that you have workers’ compensation coverage, if you have one or more employees,” Fannon said, adding that if an employer isn’t paying premiums, BWC works with them to try to bring them into compliance. “You must report your payroll and you must pay your premiums. It’s only fair that all of the employers with employees in the state of Ohio pay their premiums.”

Risley shared surveillance footage from several cases, including that of Randy and Robin Hammond, of Galion, who were ordered in 2012 to repay BWC more than $173,000.

“A lot of people think fraud’s okay, but it isn’t,” Risley said. “If you think you have something going on, please call us.”

To report suspected workers’ compensation fraud, visit bwc.ohio.gov or call BWC’s fraud hotline at 1-800-644-6292.

Categories: News Articles

Sign up now for upcoming workers’ comp fraud presentation

March 20, 2015 Leave a comment

BWC’s Special Investigations Department speaks to groups about workers’ compensation fraud year-round. You can hear how to identify if workers’ comp fraud is happening to you from our special investigations unit during the 2015 Ohio Safety Congress & Expo later this month, and there’s still time to sign up.

The largest regional safety and health conference in the U.S., OSC15 will be held March 31 to April 2. The event aims to help Ohio employers prevent workplace injuries OSC15fc.and achieve better outcomes for injured workers.

The April 1 session, “Workers’ Compensation Fraud: Do You Know If It’s Happening to You?” will include workers’ compensation fraud statistics, the process for tipsters to identify and report suspected fraud, and case summaries of recently prosecuted subjects.

An April 2 session, ‘Safety Violation Investigations,” will cover BWC’s role in investigating potential safety code violations.

A full schedule of sessions is available by clicking here.

There’s no charge for Ohio employers and their employees to attend OSC15. An Ohio workers’ compensation policy number is required to register.

Register for OSC15 today!

Categories: News Articles

Ohio workers’ comp fraud case featured on CBS This Morning

February 3, 2015 Leave a comment

Social media aids in fraud investigations of all kinds, and BWC was pleased to be included in CBS This Morning’s story about the ways investigators use social media to reveal insurance scams.

The BWC case referenced in the CBS story involves Jason Dross, of Celina, who was sentenced in 2013 for workers’ compensation fraud. BWC had received an allegation that Dross did heavy weightlifting while receiving workers’ compensation benefits, and investigators found that he posted about it on social media. He was ordered to repay BWC more than $30,000.

Our fraud investigators do check the Internet, including social media websites, when looking into allegations. Some evidence they collect is posted online for the public to see.

On Friday, we’ll share details of a case where social media played a critical role. Stay tuned!

Categories: News Articles

Fraud Finders follow-up: More BWC employees trained and recognized

January 22, 2015 1 comment

For two decades, we’ve conducted regular fraud red-flag training for BWC’s claims, medical and employer service specialists. Fraud FindersWe’ve provided them with knowledge in detecting fraud as well as reviewed the various means to most efficiently refer their allegations to our department. This includes a “Report Fraud” icon on every desktop.

Why?

Since the mid-1990s, our internal Fraud Finders program has annually generated hundreds of cases and millions of dollars in savings. BWC employees furnished allegations that resulted in 581 cases closed by the Special Investigations Department (SID) during fiscal year 2014 alone. These cases identified a whopping $7.2 million in savings.

“We’ve found that educating staff about the red flags of fraud really helps them understand the many ways in which someone may attempt to commit workers’ compensation fraud,” said SID Director Jennifer Saunders.  “We’re grateful for the partnership of our staff and the general public who report their suspicions. Our success in uncovering fraud is due largely in part to them for taking action when something just doesn’t seem right.”

SID recently completed its latest round of fraud red-flag presentations and Fraud Finder recognitions at BWC’s 12 service offices around Ohio. Each event was led by a team of three special agents in charge, assistant special agents in charge and investigators. The SID facilitators thanked all fraud allegation sources within BWC for supporting our efforts to deter, detect and prosecute workers’ compensation fraud.

If you suspect workers’ compensation fraud, call 1-800-644-6292, visit bwc.ohio.gov, or visit facebook.com/ohiobwcfraud.

For more articles from our blog, please visit ohiobwcfraud.wordpress.com.

Categories: News Articles

Workers’ compensation fraud: Learn about it and protect yourself

January 15, 2015 Leave a comment

Find out how BWC’s Special Investigations Department successfully investigates worker’s compensation fraud at the 20OSC15fc.15 Ohio Safety Congress & Expo (OSC15), which runs March 31 to April 2 at the Greater Columbus Convention Center.

This annual event hosted by BWC helps Ohio employers prevent workplace injuries and achieve better outcomes for injured workers.

The April 1 session, “BWC Special Investigations Department: Partnering with You to Combat Workers’ Compensation Fraud,” will offer a presentation by representatives from the department. They’ll cover the process for participants to identify and report suspected workers’ compensation fraud, and offer case summaries of recently prosecuted subjects.

These fraud investigators will discuss how workers’ compensation fraud impacts Ohio employers and employees as well as red flag indicators of fraud by subject type – claimant, employer and medical provider – while covering the ways that participants can report suspected fraud to BWC.

An April 2 session, “Safety Violation Investigations,” will explain BWC’s role in investigating potential safety code violations. Other session topics at OSC15 include ergonomics, construction safety, emergency planning and safety program development.

There’s no charge for Ohio employers and their employees to attend OSC15, which is the largest regional safety and health conference in the U.S. A full schedule of sessions is available by clicking here.

Register for OSC15 today!

Categories: News Articles

The reason we collaborate with law enforcement agencies

January 9, 2015 1 comment

As a criminal justice agency, we regularly consult and partner with law enforcement and criminal justice agencies for our investigations. Municipal police departments, county sheriff’s offices, state agencies and federal offices, prosecutors at the city, county, state and federal level – BWC’s Special Investigations Department works with all types of agencies to investigate workers’ compensation fraud.

The reason is simple: One of the most effective ways to discover alternate methods of fraud detection and investigation is to consult or partner with other criminal justice and law enforcement agencies. Such collaboration allows SID to learn ways to accomplish tasks more efficiently and glean new strategies and technologies for conducting investigations.

Most frequently, our fraud investigators collaborate with other agencies to conduct joint criminal investigations of fraud suspects. They often execute search warrants with local, state and federal law enforcement agencies as well.

Here are just three examples of cases in which we received assistance from other law enforcement agencies:

  • Joseph Curto, of Conway, South Carolina, who had worked for seven employers since 1999 and used his wife’s Social Security number to report his earnings in an effort to conceal his income to continue receiving workers’ comp benefits. The Social Security Administration, Office of Inspector General assisted in the out-of-state investigation;
  • Lawanna Porter, of Shaker Heights, who operated Palladium Healthcare, a home healthcare agency with more than 100 employees, failed to report having employees to various state agencies or to secure workers’ compensation, and failed to report her payroll to BWC. SID conducted this joint investigation with the Ohio Attorney General’s Office, Medicaid Fraud Control Unit;
  • Daren L. Snyder, of Chillicothe, who was convicted of workers’ compensation fraud in 2011. However, when Snyder failed to meet the conditions of his probation, a warrant was issued for his arrest. On Nov. 25, 2014, the Franklin County Sheriff’s Office arrested Snyder.

We are honored to be associated with other criminal justice and law enforcement agencies, and the many professionals who make up these organizations. We respect and appreciate their dedication to serving and protecting the citizens of Ohio.

Want to learn more? You can read the past posts about our history here and our current efforts here.

Thank you for your help in 2014!

December 26, 2014 Leave a comment

It’s been an exciting year.

BWC’s Special Investigations Department conducted more than 60 fraud presentations to groups of internal and external stakeholders throughout the state. These include BWC employees, public and private employers, third-party administrators, medical providers and members of associations, such as chambers of commerce, safety councils and bar associations.

In April, SID and the Ohio State Highway Patrol hosted in Columbus hundreds of law enforcement professionals from around Ohio and the U.S. for the first Electronic Surveillance and Equipment Symposium.

We also shared a number of claimant, provider and employer workers’ compensation fraud cases with you this year. Here are a few of them:

  • Brooklynn Mieczkowski of Columbus, who inaccurately reported her symptoms and the extent of her injuries to improperly collect workplace injury benefits;
  • Glenn Jones of Cleveland, whose workplace security camera caught him faking a workplace injury;
  • Nelsonville chiropractor Michael L. Brown, whose patients were not at his office on days that he billed BWC for treating them, including dates his office was closed, and who fabricated the amount of treatment he provided to patients to receive a higher payment for services;
  • Lawanna Porter of Shaker Heights, who operated Palladium Healthcare, a home healthcare agency with more than 100 employees, but failed to report those employees to various state agencies.

We thank you for your support in 2014.

If you suspect workers’ compensation fraud, call 1-800-644-6292, visit bwc.ohio.gov, or visit facebook.com/ohiobwcfraud.

For more articles from our blog, please visit ohiobwcfraud.wordpress.com.

Categories: News Articles

Fraud investigators learn new tools for preventing and detecting drug diversion

November 26, 2014 1 comment

Four of our fraud analysts and investigators at the Ohio Bureau of Workers’ Compensation’s Special Investigations Department attended the four-day 25th annual conference of the National Association of Drug Diversion Investigators (NADDI) last week in Cincinnati. During the conference, NADDI members exchanged the latest information on preventing and detecting drug diversion.

Ultimately, BWC investigators hope to apply what they learned at this training seminar to their drug-related investigations.

The investigators will also share what they’ve learned with their colleagues, and use those strategies while conducting joint investigations with other law enforcement professionals, some of whom also attended last week’s milestone conference.

Congratulations to NADDI on 25 years of training, collaboration and partnerships! We’re pleased to say that one of our fraud analysts is an officer of this association.

For more articles from our blog, please visit ohiobwcfraud.wordpress.com.

Categories: News Articles

Our most popular workers’ comp fraud cases of the year

November 20, 2014 1 comment

Our most popular workers’ compensation fraud cases this year include claimant, provider and employer subjects:

  • Brooklynn Mieczkowski of Columbus, who inaccurately reported her symptoms and the extent of her injuries to improperly collect workplace injury benefits;
  • Michael Meekins of Akron, who engaged in professional wrestling matches while receiving disability benefits for a back injury;
  • Glenn Jones of Cleveland, whose workplace security camera caught him faking a workplace injury;
  • Nelsonville chiropractor Michael L. Brown, whose patients were not at his office on days that he billed BWC for treating them, including dates his office was closed, and who fabricated the amount of treatment he provided to patients to receive a higher payment for services;
  • Lawanna Porter of Shaker Heights, who operated Palladium Healthcare, a home healthcare agency with more than 100 employees, but failed to report those employees to various state agencies.

These subjects have at least one thing in common. Thanks to the sources who reported their suspicions of fraud, each subject was convicted for their crime.

If you suspect workers’ compensation fraud, call 1-800-644-6292, visit bwc.ohio.gov, or visit facebook.com/ohiobwcfraud.

For more articles from our blog, please visit ohiobwcfraud.wordpress.com.

Throwback Thursday: Investigating workers’ comp fraud is very different from 20 years ago

November 20, 2014 Leave a comment

The world of fraud investigations here at the Ohio Bureau of Workers’ Compensation (BWC) is constantly changing due to technology. Today, we compare the way we used technology in 1994 and how we use it today.

THEN: Here’s a 2002 cover of our magazine, BWC Focus, which is no longer printed.

Data management

  • Then: We used paper files to contain most data.
  • Now: We remotely access data from smart phones and quickly analyze datasets with millions of records using customized data mining software.

Equipment

  • Then: We used pagers to communicate and bulky audio and video recording devices to capture evidence.
  • Now: We use smart phones and Multi-Agency Radio Communication System (MARCS) radios to communicate, conceal covert equipment in everyday items, and deploy advanced surveillance techniques to optimize an undercover agent’s safety and effectiveness.

Training

  • Then: We traveled to training sessions.
  • Now: More effective ways to complete training exist, including computer-based training, webinars and podcasts. Today, via video-conferencing, we inexpensively connect dozens of professionals located throughout the state to exchange demonstrations of best practices.

NOW: Our Facebook page, this blog and other social media efforts help us share workers’ comp fraud news.

Lastly (how could we forget?), we use social media and this blog to share our latest news. For more articles from our blog, please visit ohiobwcfraud.wordpress.com.

Social media helps to deter, detect and investigate workers’ comp fraud

November 19, 2014 2 comments

Since 2011, the Ohio Bureau of Workers’ Compensation has used social media to highlight our Special Investigations Department’s efforts to deter, detect and investigate workers’ compensation fraud. And in August 2013, we took it a step further and created Fraud Fridays.

The social media campaign notifies the public of outstanding fugitives, prosecutions, anti-fraud efforts and job postings. SID Facebook content furnishes surveillance video footage, booking photos of convicted subjects and descriptions of their fraud schemes.

That’s right – each week, we share meaningful content on newsworthy fraud topics. Many of the Fraud Friday articles educate our readers on how to detect various types of fraud committed by claimants, employers and providers. We teach our readers how to recognize fraudulent behaviors using real examples of common fraud schemes. We furnish our friends with multiple means to easily report their suspicions to us, including a link to a Report Fraud form. Each article reminds readers that if they suspect workers’ compensation fraud, they may call 1-800-644-6292, visit bwc.ohio.gov, or visit facebook.com/ohiobwcfraud.

We’re certain that all of the above deter would-be criminals from committing fraud against the State Insurance Fund, which pays for injured worker benefits.

In addition to educating the public and deterring future fraud, SID uses social media to conduct our investigations. The SID digital forensics unit uses social media research to support investigations conducted by other SID teams. During fiscal year 2014, the unit also responded to 139 such requests. The unit’s social media analysis assisted SID teams in locating claimants, providers and employers. Through this analysis, the DFU identified the employment information of claimant subjects, as well as potential suspects, witnesses and co-conspirators.

To maximize the impact of our social media campaign, we offer readers a variety of ways they may connect with us and receive news releases, videos, articles and other updates:

And finally, for more articles from our blog, please visit ohiobwcfraud.wordpress.com. Thank you for your support of our efforts!

Our sources say the darndest things

November 18, 2014 Leave a comment

Sources say the darndest things

International Fraud Awareness Week: BWC and workers’ comp fraud

November 17, 2014 1 comment

We’re the Ohio Bureau of Workers’ Compensation and we’re tough on fraud.Fraud Awareness Week 2014

BWC is partnering with the Association of Certified Fraud Examiners for International Fraud Awareness Week to educate the public and prevent future occurrences of fraud.

Since 1993, BWC’s Special Investigations Department has researched and reviewed more than 112,405 allegations of workers’ compensation fraud, and completed 61,359 investigations and identified $1,621,856,667 in savings.

Workers’ compensation fraud can be committed by an injured worker faking an injury to get some time (and money) away from work, a medical provider who is overbilling, or an employer isn’t truthful about the amount of payroll reported for workers’ compensation premiums. These are merely a few examples.

For Fraud Week, we’re expanding our usual Fraud Friday coverage into a week’s worth of tips, articles and new cases here on our blog, ohiobwcfraud.wordpress.com, and also on Twitter, Facebook and YouTube. Stay tuned!

Fraud, integrity the focus of recent conference

November 13, 2014 Leave a comment

Two of our investigators at the Ohio Bureau of Workers’ Compensation’s Special Investigations Department attended the two-day Targeting Fraud: Safeguarding Integrity conference in Columbus. During the conference, they gleaned ideas from the latest information on specialized investigative topics, such as deception, organizing complex cases into electronic files, examining dangers and repercussions of counterfeit products and the increasing use of virtual currencies in illegal and fraudulent activities.

“My favorite speaker spoke about exploring the scientific truths and lies about telling truths and lies,” one fraud analyst said afterward. “He gave us the opportunity to test our skills at spotting lies, and he also taught us clues to look for that may be related to deception.”

The investigators will share what they’ve learned with their colleagues, and use those strategies while conducting joint investigations with other law enforcement professionals, some of whom also attended last week’s conference.

Ultimately, using what they learned at this and other training seminars, the BWC investigators seek to secure even more results than the $60.1 million in savings they identified last year, as outlined in our FY 2014 annual report.

For more articles from our blog, please visit ohiobwcfraud.wordpress.com.

Categories: News Articles

Ohio Attorney General Law Enforcement Conference 2014

October 31, 2014 1 comment

AG LE Conf - 10-29-2014

Investigators at the Ohio Bureau of Workers’ Compensation’s Special Investigations Department wear many hats. When they’re not digging into casework, conducting surveillance or researching leads, they’re either educating the public about workers’ compensation fraud or learning how to advance their skills to become more effective in the future.  Earlier this week, for example, more than one dozen SID professionals attended the Ohio Attorney General (OAG) Law Enforcement Conference 2014 here in Columbus.

For their personal and professional development, they gleaned ideas from the conference’s four keynote speakers:

  • Bobby Smith, a retired Louisiana state trooper and internationally recognized speaker;
  • James A. White Sr., a senior master training coach and owner of Performance Consulting Services in Columbus;
  • Michael LaRiviere, a member of the Salem (MA) Police Department; and
  • Ursel McElroy Drake, deputy director of education and policy for the Ohio Attorney General’s Crime Victim Services Section.

To acquire the latest information on specialized investigative topics, each investigator attended five of the conference’s 30 workshops, including two related to social media:

  • Social Media and Law Enforcement, presented by David Oliver, chief, Brimfield (OH) Police Department; and
  • Social Media Evidence: What is There and How Do I Get It? presented by Michael Sullivan, assistant U.S. attorney, U.S. Attorney’s Office.

Here is how one investigator from the Columbus Special Investigations Unit (SIU) described the conference:

“I met many people including personnel from the US Attorney’s Office, Common Pleas Court Judges, investigators from other state agencies and law enforcement personal from various departments.  This will be valuable in the SIU’s continued efforts to build relationships with others in the law enforcement community.”

Having completed the productive two-day conference, the investigators are now back on the street, increasingly protecting the State Insurance Fund. They are ready to deploy more and better strategies to deter, detect, investigate and prosecute workers’ compensation fraud. These strategies include conducting joint investigations with other law enforcement professionals, such as those who attended this week’s OAG Law Enforcement Conference 2014 and the hundreds of law enforcement professionals from around Ohio and the U.S. who gathered on April 17 in Columbus for the Electronic Surveillance and Equipment Symposium (ESES14), co-sponsored by SID and the Ohio State Highway Patrol.

And, they are even better prepared as presenters to educate and inform stakeholders about how they may help us to deter and detect fraud, as we advised our blog readers last September.

Ultimately, using what they learned at this and other training seminars, the BWC investigators seek to secure even more results than the $60.1 million in savings they identified last year, as outlined in our FY 2014 annual report.

For more articles from our blog, please visit ohiobwcfraud.wordpress.com.

Fraud Fridays: Sharing our good news, exploring workers’ comp fraud issues

October 24, 2014 Leave a comment

At the Ohio Bureau of Workers’ Compensation, we see Fridays as an opportunity to highlight our Special Investigations Department’s efforts to deter, detect and prosecute workers’ compensation fraud. We started Fraud Fridays in August 2013 and each week, we share news releases, videos, articles and other updates.

Not following us regularly yet? There are a variety of ways you can connect with us and receive updates:

Thanks for reading, and for following and liking and subscribing to our updates. We appreciate it! We hope to see you next Fraud Friday.

Categories: News Articles

Workplace security cameras reduce fraud, capture evidence

October 16, 2014 2 comments

A person’s character may be best measured by how they act when they think no one is looking. BWC’s fraud investigators routinely find that criminals act as if no one is looking.

However, it is increasingly likely that many people are looking and recording actions. The number of installed and active security cameras has increased, capturing more surveillance video evidence 24/7. These cameras protect the safety and security of all – both law-abiding citizens and criminals alike – in public areas, at workplaces and in residences. It only takes one video clip to bring a criminal to justice. Such was recently the case with one our fraud subjects.

Last week, we reported that Glenn Jones of Cleveland faked a workplace injury that was captured on his employer’s security video. Jones can be seen stomping a hole in the wooden floor the night before he said he was injured. On the following day, he lowers his foot into the floor and lies down on the platform, feigning injury.

Jones claimed he suffered multiple significant injuries. As part of a thorough investigation, BWC’s fraud investigators reviewed the security video provided by the employer. The video evidence confirmed that the injury did not occur as Jones had reported, and that a false claim had been filed. Jones pleaded guilty to and was sentenced Sept. 30 in Cleveland Municipal Court on one count of workers’ compensation fraud, a first-degree misdemeanor.

As the security video shows, before lying down on the platform to complete his staged accident, Jones looked around. He apparently sought reassurance that he was not being observed by co-workers. Fortunately, he overlooked the security camera that was constantly observing him.

For more details pertaining to our fraud prevention efforts, view our current annual report.

To report suspected workers’ compensation fraud, call 1-800-644-6292 or visit bwc.ohio.gov.

Claimant fraud: Is all the world a stage for actors?

October 9, 2014 Leave a comment

In law enforcement circles, criminals are casually referred to as bad actors.

While onstage, actors need audiences and are motivated by applause. However, the Ohio Bureau of Workers’ Compensation’s subjects pretend off stage, consider audiences optional and seek compensation, both as performers and as BWC claimants.

Two recent cases illustrate this point.

On the stage:

First, we had our musical impersonator, Ricky Gantz, of Elyria in Lorain County. An investigation by our Special Investigations Department and surveillance video revealed that Gantz played in a Beatles tribute band while receiving temporary total disability benefits. Investigators found Gantz continued sustained remunerative employment with Abbey Road between April 2012 and August 2013. The Industrial Commission of Ohio found Gantz was overpaid $13,277.24 in benefits. On the day of the hearing, Gantz’s attorney provided BWC with a check for the complete overpayment amount.

On May 9, Gantz pleaded guilty to one misdemeanor count of workers’ compensation fraud. Gantz was fined $120 and ordered to pay court costs.

In the ring:

And there was wrestler Michael Meekins, of Akron in Summit County. Our investigation and surveillance video revealed that Meekins was a professional wrestler who engaged in wrestling matches while receiving temporary total disability benefits for a lumbar sprain to his back. Investigators witnessed Meekins while he participated in highly physical wrestling matches that included numerous blows to his injured back. A convincing actor outside of the ring, Meekins had concealed his wrestling activities and ability to work from the BWC and his treating physician.

On Sept. 19, Meekins pleaded guilty to workers’ compensation fraud, a fifth-degree felony. Meekins was sentenced to community control for one year and ordered to pay restitution to the BWC in the amount of $1,111.60.

When they were out, especially at medical appointments, our subjects pretended to be injured and unable to work. In this sense, while their behaviors are dishonest, their acting is apparently convincing. On a stage or inside a ring, however, they ceased pretending and demonstrated their full capacity to work.

To report suspected workers’ compensation fraud, call 1-800-644-6292 or visit bwc.ohio.gov.

Categories: News Articles

Intelligence unit identifies $29.5 million in fraudulent benefits received

October 3, 2014 Leave a comment

Double-dippers of state benefits might double-dare the Ohio Bureau of Workers’ Compensation’s Special Investigations Department to catch them, and the department’s intelligence unit is up for the challenge.Fraud image for blog post 10-3-14

The IU, which reviews BWC data about claimants, medical providers and employers to uncover fraud on a daily basis, detected 1,072 fraud allegations, resulting in $29,512,151 in savings. These results were generated in the 12 months of fiscal year (FY) 2014 alone. In their spare time, members of the unit also completed 3,991 data requests from the SID’s special investigation units and analyzed case information. With the help of IU, SID was able to identify a total of $60.1 million in savings over the past year, according to statistics outlined in the SID FY 2014 annual report.

The IU served as the source of the allegation that resulted in the recent criminal conviction of Sandy Durieux. Durieux, of Stow (Summit County), who was convicted on Sept. 15 in Franklin County Court of Common Pleas of workers’ compensation fraud, was ordered to pay $57,803.62 in restitution to BWC. Our SID investigation proved that Durieux was working as a licensed individual provider for the Ohio Department of Developmental Disabilities while receiving temporary total disability benefits and advising BWC she was unable to work at all.

We explained earlier this year how IU’s data analysis and detection efforts examine not only information provided to BWC, but also that of our external partners. The IU exchanges data with other state agencies to detect fraud.

For more articles from our blog, please visit ohiobwcfraud.wordpress.com.

If you suspect workers’ compensation fraud, call 1-800-644-6292, visit bwc.ohio.gov, or visit facebook.com/ohiobwcfraud.

Any law enforcement or other criminal investigative agency interested in partnering with the SID should contact an IU criminal investigator at 614-752-4174.

Categories: News Articles

The road more traveled: SID spreads the word about workers’ comp fraud

September 26, 2014 1 comment

The Ohio Bureau of Workers’ Compensation (BWC) Special Investigations Department’s (SID) employees recognize the importance of educating and informing stakeholders about how they may help us to deter and detect fraud.

We reported last July that we schedule and conduct dozens of fraud presentations to groups of internal and external stakeholders throughout the state each year. These groups include BWC employees, public and private employers, third-party administrators, medical providers, managed care organizations and members of associations, such as chambers of commerce, safety councils and bar associations.

We advised our blog readers last July that we welcome requests for fraud presentations from all interested organizations, and request you did. This month alone, SID employees shared examples of successful cases and the means to detect and report suspected fraud with the Ohio State Bar Association, the Huron County, Portage County and Marietta safety councils, and the International Association of Special Investigation Units.

And there are more. We have presentations scheduled monthly through March 2015, including multiple sessions at the Ohio Safety Congress & Expo at the Greater Columbus Convention Center.

To schedule a fraud presentation for your group, simply e-mail us and we will promptly contact you to discuss your event.

For more details pertaining to our fraud prevention efforts, view our SID fiscal year 2014 annual report.

Categories: News Articles

Ode t’ pirates, founders o’ workers’ compensation

September 19, 2014 Leave a comment

Today, on International Talk Like a Pirate Day, we tip our hats t’ pirates. After all, pirates o’ t’ 18th century helped with developin’ t’ concept o’ workers’ compensation.Pirate blog post image 9-19-14

Injury and death were risks of the trade. PiratesInfo.com says that losing an eye or a finger was worth 100 pieces of eight; an arm was worth 500 to 600 (more for the right, less for the left); a leg was worth 400 to 500 pieces of eight.

Colonial Americans around that time earned an average of two pieces of eight per week, according to Insurance Journal. In addition to compensation, injured pirates were offered less strenuous duty in their place of employment, like a return-to-work program.

We wonder if workers’ compensation fraud existed back then. In such close quarters, we imagine it would be difficult to feign injury. If there were any, offenders were surely punished.

Nowadays, it’s easy t’ report workers’ compensation fraud and keep yourself anonymous. For workers’ compensation fraud tips in Ohio, please call t’ Ohio Bureau o’ Workers’ Compensation at 1-800-644-6292 or visit bwc.ohio.gov.

 

 

Categories: News Articles

Health care provider team identifies $19.5M in savings for Ohio workers’ comp system

September 12, 2014 Leave a comment
Booking photo of Joseph Yurigan

Booking photo of Joseph Yurigan

With staff throughout the state, the Ohio Bureau of Workers’ Compensation (BWC) Special Investigations Department’s (SID) health care provider team (HCPT) exclusively investigates alleged fraud committed by health care providers, pharmacies, durable medical equipment companies, third-party administrators and managed care organizations. We reported last October that with the hiring of additional special agents, BWC SID had expanded the bureau’s health care provider fraud program in fiscal year (FY) 2012 and FY 2013.

They delivered impressive results over the past fiscal year, identifying $19.5 million in savings for Ohio’s workers’ compensation system. That’s 64.7 percent – $7.6 million – more than the results generated in FY 2013. The team referred 32 subjects for criminal prosecution, 300 percent more than last year. Of course, these referrals generated criminal convictions.

During FY 2014, the HCPT aggressively investigated providers – including pill mills and injury mills – that commit fraud against the state workers’ compensation system. The team acted as both a lead and support agency to identify and investigate provider fraud subjects. Throughout Ohio, the HCPT launched joint investigations and search warrants with local, state and federal law enforcement agencies.

Our OhioBWCFraud Facebook page, our blog and the media are filled with examples of successfully prosecuted providers who committed workers’ compensation fraud.

With the help of HCPT, SID was able to identify $60.1 million in savings over the past year, according to statistics outlined in the SID FY 2014 annual report.

For more articles from our blog, please visit ohiobwcfraud.wordpress.com.

If you suspect workers’ compensation fraud, call 1-800-644-6292, visit bwc.ohio.gov, or visit facebook.com/ohiobwcfraud.

Categories: News Articles

[Not] Back to school fraud

September 5, 2014 Leave a comment

It’s September, and many are now back at school, including some who have sadly lost a loved one to a workplace accident or injury. The surviving dependents of these lost workers are eligible for BWC benefits between 18 and 25 years of age, if they are enrolled full-time at an accredited educational institution. Claimants themselves also attend college to achieve their return to work goals.

Unfortunately, some benefit recipients falsify the college records they submit. They attempt to deceive us by enrolling in, but not completing, the courses. They seek to receive the benefits without actually attending the classes. Of course, we know how to detect, investigate and prosecute this crime.

This is how Ryan Strohm, of Cocoa Beach, Florida, was convicted, and why he was sentenced to pay BWC $8,472.08 in restitution. In a July 25 press release, we reported that Strohm withdrew from his BWC-paid college courses, but submitted grades to BWC as if he had completed those courses to prepare to return to work. In fact, he had fraudulently returned to work.

The majority of these recipients of such important benefits act honestly, and we wish that all of them would. Each benefit recipient should return to school and complete their coursework, as promised.

Then, it truly is return to school season.

Categories: News Articles

Fraud Finders: BWC employees root out suspicious activity

August 29, 2014 Leave a comment

FraudFindersYou  might think that the Ohio Bureau of Workers’ Compensation (BWC) relies solely upon external sources to detect and report workers’ compensation fraud. We are fortunate, however, to have well-established strategies to educate and encourage BWC employees to recognize and report suspected fraud.

Enter the BWC Fraud Finders program, which recognizes BWC employees for their roles in detecting and reporting potential workers’ compensation fraud. Since the mid-1990s, the program has annually generated hundreds of cases and millions of dollars in savings. During fiscal year (FY) 2014 alone, our internal fraud finders furnished allegations that resulted in 28.3 percent of our 2,055 cases closed last year, and identified a whopping $7.2 million in savings. BWC employees were the sources of 581 cases closed by BWC’s Special Investigations Department (SID) during FY 2014.

From the start, we’ve conducted fraud red-flag training for our agency colleagues. These training sessions furnish claims, medical and employer service specialists with knowledge in detecting fraud and several means to most efficiently refer their allegations to our department. Several of these cases have already resulted in criminal convictions in 2014. In a July 25 press release, we reported that David Delvecchio was convicted of one count of workers’ compensation fraud, a fifth-degree felony, after a BWC claims specialist furnished a fraud allegation to our department. Delvecchio was ordered to pay $26,580.77 in restitution to the BWC, court costs, and to continue mental health counseling. He was also sentenced to five years of basic supervision community control. Due to this particular internal fraud finder’s diligence and fraud referral, justice was served.

Members of BWC’s SID intelligence unit, who are not eligible for the Fraud Finders program,  also detect and refer fraud allegations. During FY 2014, intelligence unit professionals detected 1,072 fraud allegations, which resulted in the identification of $29.5 million in savings.

Thank you to all of our fraud allegation sources – internal and external – for supporting our efforts to deter, detect and prosecute workers’ compensation fraud. Keep those tips coming! If you suspect workers’ compensation fraud, call 1-800-644-6292, visit bwc.ohio.gov, or visit facebook.com/ohiobwcfraud.

We look into every allegation we receive.

For more articles from our blog, please visit ohiobwcfraud.wordpress.com.

Categories: News Articles

Spotlight update: Digital Forensics Unit

August 22, 2014 2 comments

In a Jan. 17 article, we spotlighted the Ohio Bureau of Workers’ Compensation (BWC) Special Investigations Department’s (SID) digital forensics unit (DFU). We described how BWC agents rely on the DFU to extract data from the devices criminals use while committing workers’ compensation fraud. We reported that in fiscal year (FY) 2013, DFU shattered its own record of success by processing more than 27 terabytes of data. Thus, in FY 2013, the unit more than doubled the level of performance it achieved during FY 2012.

Chart to accompany 8-22-14 blog post

We’ve done it again! The most recent fiscal year was the DFU’s fifth consecutive record year. The unit previewed, imaged and seized more than 44.3 terabytes of data, 64.1 percent more than in FY 2013, and 527 percent more than in FY 2010, as shown in the figure, at right.

The unit imaged and commenced analyzing more than 90 storage devices consisting of hard disks, optical disks and removable media devices in FY 2014. That’s equivalent to four times the printed content stored in the U.S. Library of Congress.

As we noted in January, many criminals believe their level of technical knowledge will ensure that their actions remain hidden. However, using digital forensics, the DFU may be able to recover critical evidence. The DFU supports BWC agents through forensic imaging as well as analysis and processing of electronic data. Through their combined experience, specialized training and certification as Certified Forensic Computer Examiners, the digital forensic analysts of the DFU have proven themselves to be invaluable to SID’s operations.

A case in point: In June 2014, a BWC agent asked DFU to assist the SID Fugitive Task Force in tracking down a fugitive who was thought to have relocated out of state. The subject had been indicted on felony counts of theft and workers’ compensation fraud in May 2013, but failed to appear at her arraignment. The court had issued a warrant for her arrest. A DFU analyst reviewed social media sites and located the subject in Birmingham, Alabama. The task force agent immediately contacted the Birmingham Police Department and the subject was arrested at her home that day.

BWC agents congratulate their DFU colleagues for the unit’s record FY 2014 results. With the help of DFU SID was able to identify $60.1 million in savings over the past year, according to statistics outlined in the SID FY 2014 annual report.

We 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.

Complete an online form or contact BWC’s toll-free fraud hotline, 1-800-644-6292, to report any suspicion of Ohio worker’s compensation fraud.

For more articles from our blog, please visit ohiobwcfraud.wordpress.com.

Categories: News Articles

Cash under the table: The customer as a witness to fraud

August 8, 2014 1 comment

MoneyIt happened again last month: Claimants were convicted of felonies and brought to justice after working for cash under the table while receiving lost time benefits from the Ohio Bureau of Workers’ Compensation (BWC). They knew they were not entitled to receive those benefits while working.

They thought that by demanding their unsuspecting customers pay them only in cash, they would fly under our radar while eliminating physical evidence of their crime.

Well, that “under the table” biz may seem like a plausible ploy, but it is mere malarkey.

When a contracted laborer requests to be paid in cash (or by check made payable to someone else), the customer should be immediately suspicious. John Q. Public knows by intuition, if not experience, that a cash payment may be a laborer’s attempt to hide from the work performed. By requesting payment in cash the criminal invites, rather than avoids, scrutiny.

Some dubious customers immediately contact BWC. They contact us online, by mail or by calling our fraud hotline at 1-800-644-6292. Other concerned customers may not know to contact us. However, when BWC Special Investigations Department agents approach them, they will be only too glad to tell us what they know. Typically, they even have documents (including written estimates, quotes and business cards), photos and video evidence of the work performed. And they can readily confirm the identity of the subject when shown a photo.

This is how Shannon Rager was convicted and why he was sentenced to 12 months of community control and ordered to pay $2,376 in restitution and $1,000 in investigative costs to the BWC. In our July 9 press release, we reported that “several witnesses confirmed that Rager was working as a tow truck driver and mechanic” during our investigation.

The cash may be under the table, but the customers are not. Their signed statements are compelling evidence in court.

If you are suspicious of any request for cash business transactions in Ohio, please let us know. We will ensure the contracted laborer is not scamming BWC!

For more articles from our blog, please visit ohiobwcfraud.wordpress.com.

Categories: News Articles

The long arm of the law

August 1, 2014 1 comment

Some of our convicted subjects operated under the false assumption that they could evade fraud detection, investigation or prosecution by leaving Ohio. Perhaps they assumed the BWC’s Special Investigations Department (SID) had a reach that ended at the state border. Maybe they assumed agents would not remotely follow them, if they put enough states between themselves and BWC. Or, they assumed out-of-state law enforcement officers would be too busy to apprehend and arrest them. Perhaps they hoped prosecutors in Ohio would not care to extradite them to stand trial back in Ohio for their crimes. But, as we showed you in August 2012, Randy and Robin Hammond learned that they couldn’t avoid the consequences of their actions by fleeing Ohio.

SID teams coordinated and closed cases pertaining 86 claimant, provider and employer subjects who relocated beyond our state borders in the last year alone. These out-of-state investigations yielded $622,235 in identified savings. We have been successful with remote investigations since our department’s inception. We conducted our first large-scale campaign in the mid-1990s. Dubbed Operation Long-Arm, our agents surprised more than a few suspects when we showed up at their out-of-state residences to bring them to justice. From this operation, we determined we would continue the practice of conducting out-of-state investigations.

We hire private investigative firms throughout the U.S. to conduct undercover surveillance as needed. The firms investigate non-Ohio residents suspected of committing fraud against our agency. These private investigators are our local eyes and ears. SID analysts and agents review the preliminary evidence these private investigative firms collect. We secure additional evidence, determine the truth, conclude the investigation, and refer subjects for criminal prosecution.

If defendants fail to appear in Ohio for arraignment, then our fugitive task force is deployed. They locate fugitives and coordinate arrests with local law enforcement officers or the U.S. Marshals Service. Prosecutors extradite these defendants to stand trial in court. These steps were used to secure the conviction and sentencing of the Hammonds.

Collaborating with our colleagues extends our reach: the law does indeed have a long arm.

Categories: News Articles

The numbers are in: SID identified $60.1 million in savings last year

July 25, 2014 Leave a comment

SID annual report FY 2014We are pleased to report that SID identified $60.1 million in savings over the past year, according to statistics outlined in BWC’s Special Investigations Department (SID) fiscal year (FY) 2014 annual report. The report, which was published today, reflects upon and reviews recent performance statistics, trends, and strategies for preventing and detecting fraud.

Since our department’s inception in 1993, we have closed nearly 61,000 cases and identified more than $1.5 billion in savings to the Ohio workers’ compensation system.

Among the more than 2,055 cases that were closed in FY 2014, 924 were closed-founded, meaning the original allegation was proven. The average savings identified among the 924 cases was more than $65,000. More than 250 of these cases were referred for prosecution, resulting in 149 indictments and 132 convictions. These 149 indictments were an 11 percent increase over last year.

During the last 12 months, SID staff continued their focus on technological advancements as well as emerging trends pertaining to fraud and abuse. Additionally, SID continued to use effective digital forensics and social media to root out otherwise undetected fraudulent activity, and to bring public attention to workers’ compensation fraud.

Comparatively, SID achieved the following in FY 2014:

  • Lowest number of cases open at year end in the last 15 years;
  • Lowest number of investigative lag days per closed case in the last seven years;
  • Highest savings identified in the last four years;
  • Highest savings identified per closed and per founded case in the last seven years;
  • Highest number of terabytes of data processed by our digital forensics unit;
  • Highest number of referrals in the last six years;
  • Third highest number of indictments in the last 15 years;
  • Highest percentage of founded cases referred for criminal prosecution in the last seven years.

Looking forward, FY 2014 marks the beginning of SID’s fourth strategic plan, which will serve as an operational guide for the next five years. The results of this level of planning are responsible for the success SID experienced in this past fiscal year.

Thank you for supporting our efforts to deter, detect and prosecute workers’ compensation fraud. Keep those tips coming!

Sources say the darndest things

July 18, 2014 1 comment

We’ve seen movies with anonymous phone calls, tipping off the authorities to criminal activities, or even TV crime dramas with worried tipsters, who are reluctant to give their names to the police. In reality, scenes like this rarely happen. Callers to our fraud hotline willingly provide us with information without hesitation.

Typically, our sources are so infuriated by the subject’s criminal behavior that they are willing to risk having their identities known. They offer to assist with our investigation by capturing audio and video evidence, which could serve as admissible evidence in court.

To illustrate this, here are a few examples of the countless real statements sources have provided to our fraud hotline agents during their initial calls to us:

  • I have over 1,000 videotapes of the subject I secured from a permanent, continuous (24/7 year-round) stationary surveillance camera I installed three years ago overlooking his property;
  • I have audiotapes of the subject bragging to her sister about working more than 40 hours weekly while fraudulently receiving lost time benefits. I intercepted her cellular phone conversations. (The source then played several recordings through the phone.)
  • You are welcome to video the subject from my guest bedroom. It offers an unobstructed view of the subject’s residence and vehicles.
  • Do you want me to provide you with the plate numbers of the subject’s vehicles? I can easily get them for you and would be happy to do so.
  • Do you want me to follow and video the subject traveling to and from work? I have a good camcorder and I know how to use it.
  • Your agents will have a great view of the subject if they check into room number…of the…hotel. I know because I tested it yesterday. It is perfect.
  • I know you won’t need me to testify in court. However, I want you to know I am willing to testify against him or do whatever else you need to bring him to justice.
  • I don’t need any confidentiality. In fact, I want the subject to know who turned him in. I would like to tell him to his face that I reported him to BWC.

There is no question how far our sources willing to go. They get involved because they are hard-working citizens and believe that others should be, too.

Despite this willingness to share information, we instruct each source to protect their personal safety and if there are callers who worry about being subpoenaed to testify in court, we assure them this will not be the case.

Additionally, we ask them to avoid contact with the subject and to permit us to independently conduct a thorough and objective investigation. We advise sources that we will re-contact them regarding the investigative outcomes. We thank our sources for their interest in justice and willingness to join us in protecting the integrity of the workers’ compensation system in Ohio.

If you suspect workers’ compensation fraud, call 1-800-644-6292, visit bwc.ohio.gov, or visit facebook.com/ohiobwcfraud.

Categories: News Articles

Overt or covert?

July 11, 2014 1 comment

Summertime in the northern hemisphere means movie time in the USA. This is the season when new blockbusters are released. Some of these releases – especially the crime dramas – include scenes of undercover operatives conducting covert operations, or “espionage,” on the internOvert or covert picture 1 7-11-14ational stage, deploying undercover surveillance to capture stills and video of their target’s criminal behavior. But are they realistic?

Typically, these surveillances are predictably portrayed. The lead actor and his/her partner set up in a dark sedan parked directly across the street from the villain’s hide-out. Typically, this occurs at dusk. At night, we see coffee cups and a newspaper or two on the vehicle’s dashboard. In the next scene, it is dawn, and the heroes sit up, sleepily stretch and yawn. Three seconds later, it happens.

The target exits the building and proceeds down the sidewalk, carrying something of apparent evidentiary importance (e.g., a package or a briefcase) and glancing furtively over each shoulder…twice. A super sleuth quickly lowers the front passenger window, extends the camera’s long distance lens, then the camera body, and lastly, his entire head. He quickly focuses the device — we see the lens turning clockwise, then counterclockwise. Then, he commences firing away — we hear the rapid, emphatic (and interminable) click, click, click, click. A nod to the driver signifies to the audience that the evidence has been secured. The critical scene concludes with the driver squealing the undercover vehicle’s tires as she abruptly pulls away from the curb and into a U-turn, adroitly avoids a pedestrian, and accelerates to pursue the oblivious (but otherwise brilliant) fleet-footed fugitive.

The scene is so commonplace that we hardly question its realism. But shouldn’t we? Is this truly how successful undercover agents secure evidence, determine the facts and bring criminals to justice? No.

To counter this stereotype, we considered showing you stills of our agents conducting actual undercover surveillance. However, that would be foolish.

Instead, check out SID’s own blockbuster, Workers’ Comp Fraud: Raising Awareness, which highlights examples of surveillance video captured by our agents using their covert knowledge, skills and Overt or covert picture 3 7-11-14experience.Overt or covert picture 2 7-11-14

Successful undercover surveillance agents are not seen, heard or even sensed. That’s why they are effective. Their surveillance is covert.

Covert as in these images (see right).

BWC SID uses a variety of effective tools and techniques in our investigations, including undercover operations. In fact, a picture really does say a thousand words.

 

 

 

Categories: News Articles

Have presentation, will travel

July 3, 2014 2 comments

Blog photo for 7-3-14As we craft our Fiscal Year 2014 Annual Report, we are reviewing our most successful strategies and key accomplishments. Once again this year, we recognize the importance of educating and informing our stakeholders about how they may join us to combat fraud.

We annually schedule and conduct dozens of fraud presentations to groups of internal and external stakeholders throughout the state. These groups have included other BWC departments, public and private employers, third party administrators, medical providers, MCOs and members of associations, such as chambers of commerce, safety councils and bar associations.

During fiscal year 2014, we conducted more than 45 presentations describing and demonstrating how we accomplish our mission: To effectively and proactively prevent losses to the workers’ compensation system and to deter, detect, investigate and prosecute workers’ compensation fraud. Our SID employees share examples of successful cases and furnish all attendees with the means to detect and report suspected fraud.We know these fraud presentations make a difference. Attendees tell us so. For example, a participant at a March 28 fraud presentation posted the following feedback to our OhioBWCFraud Facebook timeline: “Your guys did a great job with the Ohio Welfare Fraud Conference presentation today! Thank you!”

We welcome requests for fraud presentations from all interested organizations. To schedule a fraud presentation, simply e-mail BWC SID Training and we will promptly contact you to discuss your group’s event.

For more details pertaining to our fraud prevention efforts, view our SID FY 2013 Annual Report here. Also, stay tuned for the late July release of the SID FY 2014 Annual Report.

Categories: News Articles

Under the table: Summertime fraud

June 20, 2014 Leave a comment

Summer officially begins tomorrow, and warmer weather draws people outdoors.

For most of us, summer means barbeques, gardening, vacations and freshly cut grass. Some of us don’t like those summer chores and would rather pay the young person down the street to weed the flowerbeds and clear the gutters before the next big summer downpour.

It’s a pretty simple transaction, really. The neighbor isn’t an “employee” in the official sense, and you hand him the cash when the job is done.

A problem arises, however, if instead of a high school sophomore trimming your trees and bushes, the work is done by an injured worker receiving workers’ compensation benefits.

If that’s the case, there’s a big problem. There are two acts of fraud taking place. The first lies with the worker who is working while receiving compensation benefits. If you’re on comp, you can’t work.

The second would apply to you, the person who hired the injured worker. If you knowingly employ a worker who is simultaneously receiving workers’ compensation benefits, you are also liable and you could also face charges of fraud and conspiracy to conceal wages. This is precisely why attorney Otha Jackson was convicted in federal district court of one felony count of mail fraud and one felony count of conspiracy to commit an offense against the United States. Our investigation proved that Jackson had knowingly hired an injured worker, Renee Jefferson, and conspired to conceal her wages. Jefferson was sentenced to serve 18 months in federal prison. Jackson was sentenced to serve 21 months in federal prison.

BWC’s Special Investigations Department (SID) is constantly on the lookout, especially during the summer months, for fraudulent companies operating in the great outdoors with claimants receiving workers’ comp and trying to hide their earnings by taking cash under the table. SID is able to track official wage reports, and we’re also aware of ways those who commit fraud try to work around them. Our investigators are also out in full force. We know the extended daylight hours that draw injured workers into public view act as a spotlight to shine attention upon their activities. Cameras capture evidence of their crimes.

Don’t let fraud get in the way of a summer that should be about sunshine, family and fun.

Categories: News Articles

“Fraud Red” Flag Day

June 13, 2014 Leave a comment

For the winter holidays, it might be a Christmas tree. Thanksgiving has the turkey and Easter has its egg.  And as Americans celebrate Flag Day this June 14, they, as you may have guessed, will certainly put their flags on display.

The point is that the actions we deliberately choose to perform are often accompanied by signs that communicate those actions to others.

Unlike the patriotic reasons many choose to celebrate Flag Day, those who commit workers’ compensation fraud send up flags that indicate their activities.

These “red flags” often alert BWC’s Special Investigations Department’s (SID) investigators to suspicious behavior by claimants, employers, and even providers.  After choosing to commit fraud, something in their behavior begins to shift. Their day-to-day actions begin to change, leaving tell-tale signs for SID to follow.

A situation might arise when someone you know was truly injured at one time and are receiving compensation, but now you suspect them of working at the same time. Are there red flags in this instance? You bet.

Injured workers who may be working while fraudulently receiving BWC benefits could give themselves away by being seen leaving their home in the morning and not returning until late in the afternoon, parking a work truck at their residence, or having many visitors at their house during the day, suggesting they are running a home business.

Employer red flags could include discouraging employees from filing valid workers’ compensation claims and requiring newly-hired employees to complete 1099 forms to declare themselves independent contractors.

When it comes to reporting fraud, it is important that we remember that spotting red flags is only the beginning. SID investigative staff still needs to conduct an investigation based upon the facts to determine if a crime was actually committed. The identification of any of these indicators does not mean that fraud was committed.

You play an integral role as our eyes and ears in helping us weed out people committing workers’ compensation fraud. Your efforts will help those who are truly injured receive the benefits to which they’re entitled. To report workers’ compensation fraud, click here or call our Fraud Hotline at 1-800-644-6292. To discover more about fraud red flags for employers and health care providers, click here.

While fraudsters might fly a special red flag for all the wrong reasons, remember those good reasons to raise the red, white and blue this weekend.

Happy Flag Day!

Categories: News Articles

Spotlight: SID college relations program – Current interns speak for themselves

June 6, 2014 Leave a comment

Interested in getting coffee? Making photocopies?

You won’t find that at the Ohio Bureau of Workers’ Compensation’s (BWC) Special Investigations Department (SID). SID interns are real employees who do real work.

In the recent weeks, we’ve discussed various aspects of the SID college relations program, from our two-part history, which can be found by clicking here and here, to the testimonials of those who have graduated from the program here.

Today, we share thoughts from our current interns and advice for those who wish to be considered for future opportunities.

“I know I’m always doing real work when I head into the office each day and included in projects with the rest of the team,” said Hillsdale College student Dantan Wernecke, who interns in SID’s intelligence unit. “They’re always willing to help and teach. It really is unbelievable to imagine everything I’ve learned in the time I’ve been with SID and IU. The bottom line is that here, interns are trusted to do work that matters.”

Matthew Near, a student at The Ohio State University, said being an intern in SID’s intelligence unit has helped expand his critical thinking skills.

“The people here have enabled me to think outside of the box to identify fraud in new ways not previously done before,” he said.

We’re pleased to add that our college relations program attracts students from a variety of backgrounds, schools and experiences. Our current interns are here for the same reasons that our past interns have interned at SID: they want a challenge.

Are you enrolled at a college or university and interested in joining our team as an intern? If so, simply contact our training coordinator, Jeff Baker at Jeffrey.B.1@bwc.state.oh.us

We look forward to improving our program and it is because of the feedback we receive from interns, past and present that allow us to add to our success. Ultimately, we know that whatever success we do have lies with the talented students we attract. If you are interested, we encourage you to reach out and request more information.

 

Categories: News Articles

Prescription Drug Awareness: Stay Informed, Take Control

May 30, 2014 1 comment

Opioid sidebar final 5-30-14Getting hurt shouldn’t lead to physical dependence on medication or death. We’re working to prevent that.

In 2007, unintentional drug poisoning became the leading cause of injury death in Ohio, surpassing motor vehicle crashes, according to the Ohio Department of Health (ODH).  Furthermore, ODH indicates 4 to 5 Ohioans die daily due to drug overdose, which includes both illegal and prescription drugs.

Ohio is not alone as this is a national epidemic.  Dr. Danesh Mazloomdoost, a Johns Hopkins University graduate and medical director of Pain Management Medicine in Lexington, Kentucky, notes in a recent article that over the last decade “opiate overdoses have killed more than 125,000 Americans.”  That’s twice the number of Americans killed during the Vietnam War.  Even more startling is his reference to the fact that “for every opiate overdose, there are 825 recreational opiates users at risk for addiction or overdose.”

Through our investigations, we’ve found that people addicted to prescription medicine may commit crimes. A few weeks ago, we released an investigation summary about a man who was sentenced for receiving opioids from multiple doctors.

Deception to obtain, often called doctor shopping, is a crime where a person attempts to conceal their addiction by seeing multiple doctors to obtain prescriptions for the same or similar drugs.

Addicts may fake injuries and go to an emergency room just to get a few days’ worth of narcotic drugs. To further conceal their doctor shopping, people sometimes use multiple pharmacies in an attempt to avoid any questions about the volume or frequency of filling their prescriptions. These illegal actions result when either the person is abusing the drugs by taking more than prescribed or diverting/trafficking the drugs for money.

BWC initiatives

In response to these trends, BWC made several changes to its pharmacy program over the past several years, including implementation of a medication formulary, standardized drug utilization reviews and a lock-in program to limit doctor and pharmacy shopping.  These efforts have resulted in opiate doses dropping 10.9 million since 2010 and drug cost savings of more than $20 million since 2011.

BWC’s Special Investigations Department (SID) has also amped up its efforts to detect fraudulent activity of drug seekers and of medical providers overprescribing prescription painkillers.

Opioids

Opioids are “remarkable drugs” and “the best way to relieve excruciating pain in the short run after injury or surgery,” according to Webility Corp., which partnered with BWC to develop and test new ways to communicate and provide assistance to injured workers, all with the goal of quicker recovery and return-to-work outcomes.

When taken regularly for months or years, however, they can cause more harm than good.

“With prolonged everyday use, they have actually worsened pain and disability for many people who should have been able to resume a relatively normal life,” according to a Webility Corp. brochure.

Fortunately, most doctors hold the care of their patients as their highest priority. However, there are those who are concerned only with enriching themselves by feeding the drug habits of their patients. Examples of this are all too prevalent and all too recent. Consider this mother’s reaction to her son’s death here and what happened to the responsible doctor, Terry Dragash here.  Like doctor shopping, conspiracy to distribute drugs is another crime SID takes very seriously.

Even as SID seeks out those who improperly use or distribute prescription medications, we understand opioids are often a legitimate part of an injured worker’s treatment and recovery plan.  That’s why BWC strongly encourages injured workers to talk through the pros and cons of starting an opioid treatment program, and ask as many questions of their physicians as possible. When it comes to opioids, asking questions is crucial, and an open and frank conversation with your physician will help you determine the best course of action.

SID’s fraud investigators and analysts see the effects of long-term prescription opioid use, and others do, too. The Ohio Department of Health has launched Prescription for Prevention, a campaign to combat the epidemic of prescription drug overdose and abuse. Learn more about that campaign here.

 

Categories: News Articles

Spotlight: SID college relations program – Where are they now?

May 30, 2014 1 comment

Since 1995, hundreds of our college externs and interns have accrued criminal investigative experience, graduated from the program and commenced meaningful professional careers.

Ten are current SID employees serving in various roles. To protect their undercover identities, we offer the following list:

  • A criminal investigator with a claimant special investigations unit (SIU);
  • Five field agents in various parts of the state, who conduct claimant and health care investigations;
  • Two digital forensic analysts;
  • Two special agents in charge, one supervising the SID intelligence unit and the other supervising a claimant SIU.

Understandably, the above-listed professionals think highly of their department and our college relations program that introduced them to their careers. But, what do former college interns who now work elsewhere have to say about their experience with us? Here is a sampling of thoughts and insights from recent graduates:

While a college intern:  “The most exciting aspect of my internship with the BWC is the fact that my work has a very real impact on so many individuals and on society as a whole. I actually take part in identifying real cases of potential fraud, many of which go on to be investigated and eventually convicted. It’s a great feeling knowing that even though I’m only a college undergrad, the work I do changes lives.”

Since graduating:  “I would not be where I am today if not for my experience there. Thank you.”

-Allison Whitacre Berberick – Case manager position at North Central Mental Health Services.

“The work that I perform at BWC is quite educational and relevant to what I’m learning in my classes. It is also work that positively impacts and improves citizen’s lives, and that is something that makes me proud, and more eager.”

-Catho Ba – 2012 – 2013 college intern with the SID intelligence unit.

“Working at BWC has given me valuable work experience. I have made important contacts as well. My duties are relevant to my education. My internship this quarter has helped point me in the direction of a future career in detecting fraudulent behavior. I feel that my internship has gone beyond my expectations.”

-Jessica Esmurria – A June 2009 graduate of The Ohio State University.   

Before graduating and accepting a fellowship with the Ohio Legislative Service Commission: “One of many things that I enjoy here at the BWC is practicing self-management and self-directed learning and being treated as any “permanent” member of the agency would be treated. I truly believe working for BWC through the Work Study Program was and still is one of the best decisions I have ever made.” 

-Parvinder Singh– A 2007 graduate of The Ohio State University.

“I’m sure my experience at the BWC will certainly come in handy this summer [interning at a Columbus-based law firm], not only the workers’ comp knowledge I gained, but also the professional skills… Again thank you for the opportunity you gave me.”

-Estevan J. Tobias Molina – A J. D. candidate at the University of Cincinnati College of Law.

We are grateful for the significant contributions of each college intern and humbled by their kind words. Naturally, we know that we cannot rely upon past reputation. Each day, we must improve our college relations program. Stay tuned for part four of this series, in which current college interns describe their work with us, and find out how you can apply for an internship.

Categories: News Articles

Partnering with other agencies, ‘Fraud costs all of us’

May 23, 2014 Leave a comment

BWC’s Special Investigations Department (SID) routinely conducts data cross-matches with other agencies to detect instances of workers’ comp fraud. We work with law enforcement agencies around the state to investigate allegations. The Ohio Attorney General’s Office handles the prosecution of many of our cases.

It’s essential that we all work together. Fraud costs all of us.

That’s the tagline of a new website recently launched by the Ohio Department of Jobs & Family Services (ODJFS), since May is “Public Assistance Fraud Awareness Month.” Their new website allows tipsters to report public assistance fraud of all types.

We work with ODJFS to find instances of injured workers who are off of work and receiving workers’ comp benefits. Data cross-matches with the agency allow us to detect wages for injured workers who are believed to be off of work while recovering from a workplace injury and receiving BWC benefits.

Congratulations to our friends at ODJFS on launching such an important site. Don’t forget to report suspected workers’ compensation fraud by calling us at 1-800-644-6292 or visiting bwc.ohio.gov.

Categories: News Articles

Spotlight: SID college relations program — 20 years of working with higher education

May 23, 2014 1 comment

In 1995, BWC’s Special Investigations Department (SID) created its college relations program to promote the study and practice of criminology, criminal justice, law enforcement and public administration.

First, we created BWC-paid internships. These successfully permitted SID supervisors to furnish practical work experience to qualified students. Next, we created unpaid college externships for OSU students; several of these internships allowed students to earn course credit based upon the number of hours worked with us. Today, we offer similar course-credit externships with other colleges and universities. Most recently, we began offering college externships to Columbus State Community College students studying criminal justice. Some students join us as college externs and then are deemed the most qualified candidates for BWC paid internships.

For the past 12 years, we’ve offered federal work-study program internships to OSU students who were awarded federal grants based on need. As an off-campus community service employer, we’ve worked with dozens of these talented college interns.

No matter which type of position best meets the needs of the student, our job is to furnish the mentoring and work experience that graduates tell us have served as a stepping stone to future opportunities in their careers. That’s why we continue to offer all four types of college relations positions.

Stay tuned for part three of this series, in which graduates describe their professional career experiences.

Categories: News Articles

That’s a wrap: Electronic surveillance symposium captured the very image of success!

May 2, 2014 Leave a comment

Hundreds of law enforcement professionals from around Ohio and the U.S. gathered on April 17 in Columbus for the Electronic Surveillance and Equipment Symposium (ESES14). Investigators, special agents, officers and deputies discussed the latest electronic surveillance tools and trends.eses14

Subsequently, dozens of the attendees furnished useful feedback pertaining to this first-ever event, co-sponsored by BWC’s Special Investigations Department (SID) and the Ohio State Highway Patrol.

Attendees specified the following as their favorite part of the event:

  • An aviation surveillance seminar presented by Sgt. Justin Cromer, Ohio State Highway Patrol, Aviation Unit;
  • A seminar about concealing cameras in everyday items presented by Jonathan Banks, special agent supervisor, Ohio Attorney General’s Medicaid Fraud Control Unit;
  • Legal issues regarding electronic surveillance presented by Mary Beth Young, assistant U.S. attorney in the Southern District of Ohio;
  • A drone surveillance seminar and demonstration presented by five SIERRA Project team members from the University of Cincinnati and University of Toledo;
  • Equipment exhibits and demonstrations by more than two dozen vendors during the afternoon’s trade fair.

Most importantly, more than 90 percent of attendees who completed a post-event survey indicated they would attend a similar symposium again. In fact, several respondents proposed topics for us to consider for a potential ESES15.

All agreed that effective surveillance plays an important role in law enforcement and criminal investigations. Accordingly, they appreciate a secure environment in which law enforcement professionals share best practices and advice in hopes of strengthening our efforts to contribute to safer communities.

Thank you to all who participated in and made ESES14 a success!

Follow BWC’s SID on Twitter @OhioBWCFraud and on Facebook at facebook.com/ohiobwcfraud to stay up-to-date on our continuing efforts to detect, deter, investigate and prosecute all types of workers’ compensation fraud in Ohio.

Categories: News Articles

Going after every dollar: Fraud investigators at OSC 2014

March 28, 2014 3 comments

OSC14_FoxThe 2014 Ohio Safety Congress (OSC) came to a close yesterday and, in one of the final sessions, three supervisors from the Ohio Bureau of Workers’ Compensation (BWC) Special Investigations Department (SID) gave their presentation on Workers’ Compensation fraud, its “red flags” and what employers can do if they are suspicious. . Over the two-day conference, SID staff twice presented “Workers’ Compensation: Do You Know if it’s Happening to You?” to a crowded room.

Special Agents in Charge (SACs) Phill Brickman, Shawn Fox, and Doug Fisher took turns presenting an overview of SID, who we are, and what we do. Attendees were presented a breakdown of all the types of complaints SID receives, as well as the differences between claimant, provider, and employer fraud.

Though a serious topic, the session wasn’t without humor. “Our investigators love finding fraud and some people just love talking about how clever they are, so it works out” quipped SAC Shawn Fox, referencing those who brag on Facebook or to their friends about their crime.

The trio also fielded a variety of questions from the audience. One attendee asked what the cost of one investigation is and if it’s even worth it. SAC Doug Fisher replied investigations are indeed worth the effort, sharing the fact that each dollar spent on investigative costs brings five dollars back to BWC.”

OSC14_FraudAnother audience member relayed a story of a co-worker they suspected of filing a false claim and noted that had she known there was a dedicated fraud team in place at BWC, she would have dealt with her suspicion differently. While SID has been around for 20 years, we are still reminded that part of our mission is spreading awareness of who we are. “This is what we do,” stated SAC Phill Brickman, “we will go after every dollar and dime. Call us and put us to work.”

SID agents were eager to use their time presenting at OSC 2014 as an opportunity to explain workers’ compensation fraud and let employers know there is a dedicated team in place to combat fraud. When asked to summarize the purpose of the presentation in one sentence, SAC Fox offered that it was to “educate employers on what services the Special Investigations Department can provide to them to deter, investigate, and prosecute workers’ compensation fraud.”

Like maintaining a safe work environment, weeding out fraud and abuse of disability benefits may lead to lower premiums for employers and ensure that BWC remains an efficient system to aid those workers who are truly injured.

Categories: News Articles

Workers’ comp fraud supervisors to speak at Ohio Safety Congress

March 7, 2014 1 comment

OSC14logoclrBecome more aware of workers’ comp fraud, learn how to recognize it at your workplace and stop it from happening to you by attending the Ohio Safety Congress & Expo 2014 (OSC14) later this month.

Supervisors from BWC’s Special Investigations Department will present “Workers’ Compensation Fraud: Do You Know If It’s Happening to You?” twice, Session 614, March 26 from 1:15-2:15 p.m. and Session 634, March 27 from 1:15-2:15 p.m.

During these sessions, attendees will learn how and when to report suspected workers’ comp fraud, signs of possible injured worker, employer and provider fraud, the differences between civil and criminal workers’ comp fraud cases, actions to deter and prevent workers’ comp fraud in the workplace, and how workers’ comp fraud increases the costs of medical services, premiums and doing business.

Admission to OSC14 is free to all Ohio employers and employees.

OSC14 will be held March 25 to 27 in Columbus, at the Greater Columbus Convention Center. The three-day event will include 175 expert-led educational sessions. In addition to fraud, other topics being covered include ergonomics, construction safety, emergency planning and safety program development. OSC14’s two-day Expo marketplace will offer workplace solutions and ideas.

A full schedule of sessions is available by clicking here.

Register for OSC14 today!

Categories: News Articles

Workers’ compensation fraud is bad for business

February 21, 2014 Leave a comment

Learn how investigators detect fraud at the 2014 Ohio Safety Congress & Expo (OSC14) next month.OSC14logoclr

A panel of experts from BWC’s Special Investigations Department will discuss the signs of workers’ compensation fraud. The fraud presentation, “Workers’ Compensation Fraud: Do You Know If It’s Happening to You?”  will be offered twice:  Session 614, March 26 from 1:15-2:15 p.m. and session 634, March 27 from 1:15-2:15 p.m. Admission is free to all Ohio employers and employees.

The event will take place in Columbus at the Greater Columbus Convention Center.

Attendees will learn:

  • How and when to report suspected workers’ compensation fraud;
  • Warning signs of injured worker, employer and provider fraud;
  • Differences between civil and criminal workers’ comp fraud cases;
  • Actions to deter and prevent workers’ comp fraud in the workplace;
  • How workers’ comp fraud raises the costs of medical services, premiums and doing business.

These are among 175 expert-led educational sessions being held during the three-day event. Other topics include ergonomics, construction safety, emergency planning and safety program development. A two-day Expo marketplace allows attendees to shop for workplace solutions and gather ideas.

Come for a few hours or attend sessions on all three days. All sessions offer free continuing education credits. A full schedule of sessions is available by clicking here.

Register for OSC14 today!

Categories: News Articles

What to expect at ESES 2014

February 14, 2014 2 comments

eses14We’re two months away from the first Electronic Surveillance and Equipment Symposium (ESES).  We have slated a list of panels, speakers and presentations we believe you will respect and appreciate.

The symposium will take place on April 17 at the Rhodes Center in the Ohio Expo Center. Here are the five expert-led seminar sessions tentatively scheduled:

  • “Cell Phone Tracking Equipment” will feature David Rosenblatt and Joseph Turley from the Harris Corporation;
  • “Concealing Cameras in Everyday Items” will be presented by Assistant Attorney General Jonathan Banks from the Ohio Attorney General’s Office;
  • Sgt. Justin Cromer of the Ohio State Highway Patrol will speak about “Aviation Surveillance;”
  • “Legal Issues Regarding Electronic Surveillance” will be addressed by a representative from the U. S. Attorney’s Office;
  • “Drone Surveillance” will be presented by Kelly Cohen, associate professor of aerospace engineering and engineering mechanics at the University of Cincinnati,  Manish Kumar, associate professor of  mechanical engineering at the University of Toledo, Larry Bennett, professor and program chair of the fire science and emergency management program at the University of Cincinnati, Wei Wei, a Ph.D. student at the University of Cincinnati, and Bryan Brown, a graduate student leading the Surveillance for Intelligent Emergency Response Robotic Aircraft (SIERRA) team at the University of Cincinnati.

Following the final session, the exhibition hall will feature a number of surveillance equipment vendors displaying the latest gear the industry has to offer.

Beverages, lunch and other refreshments will be available for purchase throughout the day at the onsite cafeteria.

We hope you will join us for what will certainly be a productive and informative day.  If you are a law enforcement official interested in attending, click here to register.  For more information, we also encourage you to read our previous articles on the ESES, “Electronic Surveillance Equipment Symposium: Calling Equipment Vendors!” and “In Law Enforcement? Attend Our Free Symposium!

Categories: News Articles

In Law Enforcement? Attend Our Free Symposium!

February 7, 2014 2 comments

ESES14 imageAre you a member of Ohio’s law enforcement community? Are you interested in keeping up with new trends and technology to deter, detect and investigate crime? If so, the Special Investigations Department of the Ohio Bureau of Workers’ Compensation and the Ohio State Highway Patrol invite you to attend our first-ever Electronic Surveillance Equipment Symposium on April 17, 2014 from 9 a.m. to 4 p.m. To register, click here.

We’re excited to host this event at the Ohio Expo Center’s Rhodes Center, 717 East 17th Avenue, Columbus, OH 43211. Our partners from a full spectrum of agencies, including county sheriffs, local chiefs of police, federal law enforcement officials and other state organizations, have all been invited.

The entire symposium consists of presentations and equipment demonstrations by law enforcement experts. Presentation topics will include legal considerations regarding electronic surveillance and the use of cell phones in investigations. Additionally, there will be time to browse the exhibition area, where a variety of surveillance vendors from across the country will have equipment, like the latest GPS devices, on display. Surveillance vehicles will also be displayed.

The event is free to attendees, but will be restricted to personnel from governmental and public law enforcement agencies due to the sensitive nature of the information presented. Proper law enforcement credentials will be required at check-in.
We hope that together, our collective knowledge and expertise will drive all of us to better our efforts to contribute to safer, more prosperous and crime-free communities.

Categories: News Articles

Cincinnati Enquirer analyzes impacts of heroin

March 27, 2013 2 comments

A recent four-day special report in The Cincinnati Enquirer examined the impacts of heroin. The first article explained two recent trends we’re facing, a spike in prescriptions for opioid painkillers and a dramatic increase in the supply of heroin, which is overwhelming law enforcement, medical authorities and social service agencies. 

We’re working hard to combat prescription fraud! Check out our annual report for details…Drug related complaints continue to top the charts.

Categories: News Articles

Thieves and liars

August 28, 2012 Leave a comment

Thieves and liars. Those who cheat Workers’ Comp cheat all Ohioans. http://ow.ly/dhFD9

Categories: News Articles

Watch Watchdog10’s Kurt Ludlow’s Special on SID

May 11, 2012 Leave a comment

Watchdog10’s Kurt Ludlow: Group Catches Worker’s Comp Cheaters In The Act http://ow.ly/aQtkL

Categories: News Articles

Hannah News reported: “State Secures First Pill Mill Conviction of 2012”

January 11, 2012 Leave a comment

On January 6, 2012, Hannah News reported as follows:

‘Another Ohio pill mill has fallen to a multi-agency initiative launched by the Ohio Attorney General’s Office, the Ohio Pharmacy Board and State Medical Board, the Ohio Bureau of Workers’ Compensation, the Regional Agencies Narcotics & Gun Enforcement Task Force (R.A.N.G.E.), as well as local and federal authorities. Dr. Han M. Yang is the latest conviction, pleading guilty Thursday to eight felony counts.

Yang, 69, could get 17 years in jail and $80,000 in fines for his trouble. That would add to $100,000 in drug profits he has already surrendered.

State, local and federal officers raided his Dayton and Bethel Township offices in Montgomery and neighboring Clark counties in October as part of a year-long investigation into prescription drug abuse, medical fraud, and money laundering. (See The Hannah Report, 10/3/11.) Authorities found would-be customers lined up outside for quick prescriptions, though facilities were largely bereft of exam tables and other equipment needed for legitimate medical services. Undercover agents previously witnessed Yang writing prescriptions within minutes of a patient’s arrival, and with no examination.

Formerly affiliated with Good Samaritan Hospital and Miami Valley Hospital in Dayton, Yang was since charged with six counts of trafficking in prescription drugs, including five fourth-degree felonies and one fifth-degree felony; one second degree count of engaging in a pattern of corrupt activity; and one fourth-degree count of theft by deception involving health care fraud. Clark County Common Pleas Court Judge Richard O’Neill accepted Yang’s guilty plea Thursday.

“We are committed to driving pill mills, and their trail of suffering and death, out of Ohio,” Attorney General Mike DeWine said in a statement. “More work remains, but rest assured we will continue the fight.”

In addition to state and federal officials, the investigation involved Clark County Sheriff Gene Kelly, Montgomery County Sheriff Phil Plummer, Clark County Prosecutor Andrew Wilson, and Montgomery County Prosecutor Mat Heck. A local pharmacist had alerted authorities in October 2010 after a woman nine months pregnant showed up with a prescription written by Yang for powerful painkillers.

DeWine said sentencing will be announced later, but indicated Yang faces penalties ranging up to 18 years in prison and fines up to $77,500.

The arrest and conviction follows at least four convictions, investigations and/or license revocations involving Ohio physicians in 2011, including Dr. James Lundeen, Dr. Victor Georgescu, Dr. George D.J. Griffin, and a fourth doctor who colluded in a prescription drug scheme with former Cincinnati attorney Kenneth Lawson, who was stripped of his law license in September. (See The Hannah Report, 4/5/11, 9/20/11, 12/15/11, 12/20/11.)

The governor, state Legislature and DeWine launched the coordinated offensive against pill mills and over-prescribing doctors in early 2011. (See The Hannah Report, 2/8/11, 2/9/11, 2/21/11.)’

For more information about the BWC Special Investigations Department be sure to read our SID FY 2011 Annual Report.

If you suspect anyone is committing workers’ compensation fraud, let us know. You may report it online at http://bit.ly/reportfraud or you may speak with a fraud hotline agent by calling 1-800-OHIOBWC.