By Jeff Baker, Program Administrator, BWC Special Investigations Department
We’re pleased to announce that SID identified $56.6 million in savings for the State Insurance Fund over the past year due to workers’ compensation fraud committed by claimants, employers and medical providers.
Recovered funds will go back to the State Insurance Fund to care for workers injured in Ohio. The Special Investigations Department Fiscal Year 2016 Annual Report was released today, and includes an overview of statistics and strategies for preventing and detecting fraud.
Since its inception in 1993, SID has completed nearly 64,000 investigations and identified $1.7 billion in savings to the Ohio workers’ compensation system.
Among the more than 1,500 cases that were closed during FY 2016, 668 were closed founded, meaning the original allegation was proven. The average savings identified among the 668 cases was more than $84,000. This average savings identified per closed case was the second highest annual average generated by SID. Nearly 200 of these cases were referred for prosecution, or 29.6 percent of the founded cases. SID obtained 119 indictments and 127 convictions.
SID employees are able to generate these results because of their effective and efficient day-to-day investigative techniques and tactics, including collaboration within the law enforcement community. SID employees maintain effective partnerships with our colleagues within local, state and federal investigative bodies. These benchmarking partners recognize that SID embraces technology, such as electronic surveillance equipment and data analysis, including predictive modeling, to proactively detect fraud. During FY 2016, the total savings identified from allegations detected by our intelligence unit and referred to field teams for investigation exceeded $36 million.
However, enforcement is not the only method used by SID to achieve its departmental mission. SID employees promote fraud prevention strategies to internal and external stakeholders by means of articles in periodicals, presentations, and social media, such as this article. These efforts educate, inform and build understanding of BWC’s overall mission “to protect Ohio’s workers and employers through the prevention, care and management of workplace injuries and illnesses at fair rates.”
Thank you for supporting our agency’s mission and efforts. Please keep those tips coming!
