Happy Anniversary to Us!

On Nov. 14, 2019, our BWC Special Investigations Department celebrated the second anniversary of its Fraud Hotline system.

We launched this system during Fraud Awareness Week 2017 as an important new customer service tool for external sources to report their suspicions of workers’ compensation fraud. What a successful launch and two years it has been!

We’ve received more than 3,300 calls since then, an average of nearly seven each work day!

If you suspect workers’ compensation fraud in Ohio, call us on it.

We look forward to hearing from you. Give us a call at 1-800-644-6292. We will conduct an investigation and determine the facts. Together, we are successfully combatting workers’ compensation fraud in Ohio – one most important call at a time.

Today, during International Fraud Awareness Week 2019, we thank you for your support!

Fraud of the Day during Fraud Awareness Week

By Jeff Baker, BWC Special Investigations Department

When the Ohio Bureau of Workers’ Compensation (BWC) created its Special Investigations Department (SID) in 1993, investigative professionals in the new department knew they would need to do more than detect, identify and investigate suspected workers’ compensation fraud. To fully meet the department’s mandate and mission, SID professionals would need to also deter fraud.

We felt one of the most effective ways to deter fraud might be to raise public awareness of what we do by reaching out to the media about our latest cases. In the years since, SID has collaborated with BWC’s Communications Department to issue news releases on many of the nearly 3,000 subjects convicted and sentenced as a result of our work.

To reach an even wider audience, we created our first social media accounts in 2011 and launched our Fraud Awareness Series via ohiobwcfraud and
twitter.com/ohiobwcfraud. Through our YouTube channel, we added videos showing undercover surveillance footage of subjects caught in act of committing their crimes.

The success of our Fraud Awareness Series can be measured by its reach beyond our initial audience. That is why we take note (ok, we admit we are thrilled) whenever one of our prosecution news releases is shared or re-Tweeted by a follower. Since 2014, we have seen this occur 39 times from just one follower — Larry Benson.

Larry has used our news releases as the basis for 39 of his Fraud of the Day blogs published by LexisNexis. Larry sees news releases for countless other successful fraud investigations by government agencies within hundreds of jurisdictions (local, state, and federal), so we are always delighted when he takes note of ours. We also appreciate his Fraud of the day website permits users to select their favorite examples by fraud type and state. For example, here is a filtered link to the Fraud of the Day articles for Ohio, including the 39 (and counting) articles pertaining to BWC.

Conveniently, E-mail subscribers to Fraud of the Day blogs may “get their fraud fix” by “waking up five days a week to the most current fraud article delivered straight to their inbox.”

But no matter how you access the Fraud of the Day blogs, you will note Larry’s clever use of headlines and tags referencing the subject’s type of fraud. A few of our favorites include:

Of course, as humorous as these titles may be, we know that no fraud is a matter for laughter. We certainly take all crime seriously. That is why we have dedicated our careers to detecting, identifying, investigating, prosecuting, and deterring fraud. Like Larry, we, too, are willing to deploy clever or funny headlines in news releases, but that’s only to increase the likelihood that the media and general public will take note and read and heed the releases as the cautionary tales they are.

Widening our reach, getting our word out, deters fraud. In the spirit of International Fraud Awareness Week, we invite all of you to join us in combatting crime by continuing to follow this blog and Larry’s Fraud of the Day series this week and beyond.

A letter from Jim Wernecke – Director of BWC Special Investigations

As Director of the BWC Special Investigations Department (SID), I am honored to kick off Fraud Awareness Week. I invite you to view my video message, “Fraud Hurts Us All.

In the video I discuss how workers’ compensation fraud increases premiums for employers, which reduces the money employers can invest in their employees, community and future growth. I explain how BWC employees are improving workplace health and safety, getting injured workers back to work, and keeping premium rates low for employers. I describe how SID employees protect the State Insurance Fund by detecting, investigating, and deterring fraud.

Lastly, I invite viewers to report, via an online form, suspected workers’ compensation fraud.

I also invite you to check back daily as we share success stories in our efforts to combat workers’ comp. fraud. Some stories we will highlight are:

We would not have achieved these successes without the dedicated staff members who serve our department with great skill, resourcefulness, and determination to bring justice to those who cheat our system. Their efforts create safer workplaces and ensure those who attempt to commit fraud in workers’ compensation are held accountable to the fullest extent of the law. Since our inception in 1993, we have identified over $1.9 billion in savings, as well as:

  • Completed over 69,000 investigations
  • Referred 5,420 subjects for prosecution
  • Secured 2,941 criminal convictions

We are honored and eager to join our fraud-fighting colleagues around the country and abroad each November to participate in International Fraud Awareness Week.

The campaign, which runs through Saturday, was established by the Association of Certified Fraud Examiners to highlight the issue of fraud and minimize its impacts.

Most weeks, you’ll find us sharing our fraud news on #FraudFriday. But this week, we’ll have a new fraud feature each day! So keep an eye here on our blog and on our Facebook and Twitter pages!

Happy Fraud Awareness Week!

Northeast Ohio business owners owe BWC nearly $1.3 million following fraud convictions

Two northeast Ohio businessmen must pay the Ohio Bureau of Workers’ Compensation (BWC) nearly $1.3 million in restitution following their recent convictions on multiple fraud charges in separate, unrelated cases.

“We look forward to recouping these dollars and directing them where they belong — taking care of injured workers, creating safe workplaces, and giving employers excellent coverage and service,” said BWC Administrator/CEO Stephanie McCloud.

Sentenced Monday in a Cuyahoga County courtroom, Robert E. Fitz must pay BWC $961,956 in monthly installments and serve five years of probation for his Sept. 30 conviction on a fourth-degree felony charge of workers’ compensation fraud.

Fitz, an attorney and owner of Action Maids residential cleaning company in Westlake, Ohio, had refused to cooperate with BWC to bring his lapsed policy into compliance, leaving the agency to pick up the costs on 43 injury claims since 2003, five in the last five years.

On Oct. 21 in Stark County, a judge ordered an Alliance man to pay BWC $300,230 in restitution after BWC found him defrauding the agency in multiple ways, including working at two businesses he owned while collecting workers’ compensation for work injuries he claimed left him permanently and totally disabled.

Roger L. Kale, Jr., 51, also must serve five years of probation and perform 100 hours of community service. BWC’s Special Investigations Department also found the following:

  • To establish his compensation rate for his 2009 workplace injury, Kale reported wages for himself that were higher than what he reported on his BWC payroll reports for all of his employees combined.
  • Kale operated A-1 Brosch Tree Service without workers’ compensation coverage required by Ohio law.
  • Kale under-reported his payroll and misclassified his employees to lower the cost of his BWC premiums.
  • Kale presented clients an altered BWC certificate of coverage to make it appear his business had coverage when it did not. One client reported Kale to BWC.

Video obtained from the Ohio State Highway Patrol shows Kale operating a tow truck while claiming to be permanently disabled.

Kale pleaded guilty to one count of tampering with records, a fourth-degree felony; three counts of workers’ compensation fraud, all fourth-degree felonies, and two first-degree misdemeanor charges of workers’ compensation fraud.

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

Cincinnati caterer convicted of workers’ comp fraud

Woman ran catering business while collecting disability benefits

A Cincinnati woman claiming to be permanently disabled from work owes the Ohio Bureau of Workers’ Compensation (BWC) nearly $41,000 after her felony conviction Oct. 24 for workers’ compensation fraud.

Michelle D. Smith, 57, pleaded guilty to the fifth-degree felony in the Franklin County Common Pleas Court after BWC discovered she owned and ran two businesses, Expression Unique LLC and Later in Life Brides, while collecting BWC benefits for workers deemed permanently and totally disabled.

“Our Special Investigations Department found records indicating Ms. Smith worked 35 hours per week at her businesses,” said BWC Administrator/CEO Stephanie McCloud. “I don’t think that meets anyone’s definition of ‘permanently and totally disabled,’ let alone BWC’s.”

Smith, who was injured on a job in 2000, declined through her attorney to be interviewed by BWC investigators about her case. Investigators gleaned much of their evidence from customer interviews and a catering contract Smith had with the city of Cincinnati.

A Franklin County judge ordered Smith to pay BWC $40,873 dollars in restitution and serve five years of non-reporting community control (probation). If she violates her probation, she must serve a year in prison.

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

Make Halloween safe, not scary

By Erik Harden, BWC Public Information Officer

Halloween is an annual favorite for kids, right up there with Christmas. Unfortunately, it is also one of the deadliest.

Fading daylight, dark costumes, and excited kids darting into the street make children twice as likely to be struck by a car and killed on Halloween than any other day of the year.* Because excited trick-or-treaters often forget about safety, motorists must be extra careful.

Follow these Halloween driving safety tips.

  • Avoid distractions, so you can stay alert. Put your cell phone away and don’t reach for things until you’re safely stopped.
  • Slow down in residential neighborhoods and obey all traffic signs and signals. Drive at least 5 mph below the posted speed limit to give yourself extra time to react to children who may dart into the street.
  • Scan your surroundings and be extra alert. Kids may not be paying attention to traffic and will cross the street mid-block or between parked cars and in dark costumes. At twilight and later in the evening, watch for children in dark clothing.
  • Don’t pass other vehicles that have stopped in the roadway. They could be picking up or dropping off children, so wait several seconds before attempting to pass, and only if you see there are no people near the car.
  • Exit driveways and pull onto streets with extreme caution. Children have a harder time judging how a driver will react and are more likely to think they have the okay to go ahead.

Follow these tips when sending kids out trick-or-treating.

  • Don’t send young children out unsupervised. A responsible adult should accompany younger children on the neighborhood rounds.
  • Make them easier to see. Have children wear reflective tape, use glowsticks, or carry a flashlight.
  • Make safe choices. Remain on well-lit streets, always use the sidewalk, cross the street in crosswalks and intersections.
  • Have a plan. If your older children are going alone, plan and review a route acceptable to you. Agree on a time for them to be back home.

Visit the National Safety Council’s website for more Halloween safety tips. *Statistic provided by Safe Kids Worldwide.

BWC to cover drug disposal bags for opioid prescriptions

By Miranda Williams, PharmD, RPh, Director of BWC’s Pharmacy Program

In our latest step to mitigate the opioid epidemic on Ohio’s workforce, we will provide injured workers with drug disposal bags that destroy leftover opioids.

Governor Mike DeWine, BWC Administrator/CEO Stephanie McCloud and RecoveryOhio Director Alisha Nelson announced this new statewide effort Thursday, Oct. 17, in Columbus at a local pharmacy.

You may view the announcement on BWC’s Facebook page. In addition, many media outlets attended the event. Here are some of the stories: Click here for WSYX-TV, ABC 6, in Columbus and here for the Statehouse News Bureau story.

Starting Nov. 1, retail pharmacies will automatically issue the disposal bags to Ohio injured workers receiving an opioid prescription for the first time within the last 12 months.

The bags destroy opioid pills, liquids, and patches in a chemical process rendering them useless.

Unused medications
“Newly injured workers don’t always need every opioid pill in their prescription, and this new effort will simplify the process for safely disposing of these dangerous drugs,” said Governor DeWine, who praised BWC for the initiative. “By giving these drug disposal bags to injured workers at the time they fill a prescription, we can not only educate them about the dangers of opioid addiction, but also reduce the risk that unused pills will end up where they shouldn’t – in the hands of children, for example.”

We’re covering the cost of every disposal bag, so there is no cost to the pharmacy, the injured worker, and the employer. “The bag is extremely simple to use and it’s completely biodegradable,” noted Administrator McCloud.

The bags destroy the drugs in a simple process, as Administrator McCloud and Governor DeWine demonstrated during the news conference:

  1. Toss any unused medication into the bag.
  2. Fill it with warm water and wait 30 seconds.
  3. Seal it and shake it. Throw the bag out.

“Along with the Governor’s RecoveryOhio initiative, we want to safeguard our community’s medicine cabinets from becoming gateways to youth and adult drug experimentation,” said Administrator McCloud.

Gov. DeWine and Administrator/CEO Stephanie McCloud demonstrate how to use the drug disposal bag.

Here’s a sobering statistic from the National Survey on Drug Use and Health: Nearly one-third of people ages 12 and over who used drugs for the first time began by using a prescription drug for non-medical purposes.

The disposal bags are one more tool in BWC’s comprehensive program to mitigate the opioid epidemic’s impact on Ohio’s workforce. Earlier this year, we dropped Oxycontin from our formulary and replaced it with opioids that have stronger abuse-deterrent technology.

We estimate up to 175 injured workers a month will be eligible for a drug disposal bag. That’s not a huge number — we covered 164,761 opioid prescriptions in calendar year 2018 — but if it saves one life, it’s worth doing. As Governor DeWine has often said, the opioid and substance-use epidemic is a complicated public health issue. There is no easy solution, and it requires all of us, from state leaders to you and our next-door neighbors, to fight this battle.

In addition, we are a leader in our industry. Other state agencies and workers’ comp systems across America look to us for guidance on a host of issues, from building strong pharmacy and safety programs to fighting fraud. Let’s hope they follow our lead on this effort, too.

For more information about drug disposal bags, email or call BWC’s Pharmacy Department at 877-543-6446,  8 a.m. – 4:45 p.m., EST, Monday – Friday.