A year of blogging

The BWC Blog just reached its one year anniversary in October. We launched this blog back in 2015 and named it Prevention & Care to demonstrate our commitment to both preventing workplace injuries and caring for workers who are injured on the job. We’ve enjoyed sharing all the most recent updates from BWC, and helpful information and tips on a range of topics here on the blog in 2016.

Celebrating our first full year, we pulled our most popular blogs and found they cover a range of issues from fraud to safe outdoor grilling. Click through the top five to see our most popular blogs of the year:

  1. Lima business owner conspires with acquaintance to evade workers’ comp coverage
  2. Ohio border no longer a barrier
  3. There is no “all states” endorsement
  4. OSC16 – a look back in photos
  5. Before you start to grill – remember hank hill

Now we invite you to peruse the entire blog for much more you may have missed this year!

Thank you for following the BWC Blog. It’s been a great year and we look forward to digging even deeper into workers’ comp issues here on this blog in 2017.

Columbus woman who stole relative’s workers’ comp check pleads to theft charge

A Columbus woman who stole a relative’s workers’ comp check pleaded guilty to theft in a Franklin County courtroom last week.

Kelly Clark, 38, became the subject of an investigation after an injured worker contacted BWC’s Special Investigations Department to report he did not receive a benefits check he was expecting in the mail. He suspected it had been stolen and cashed by another party.

Investigators found that Clark, who had been living with the injured worker, her relative, stole the check and endorsed and cashed it without permission.

Clark pleaded guilty to a first degree misdemeanor count of theft on Dec. 15. She was sentenced to 90 days in the Franklin County Jail, including 30 days credited for time served and 60 days suspended as long as she pays $862 in restitution by Sept. 13, 2017.

The Court will hold a review hearing on March 23 to check on her progress toward paying off the restitution.

Winter is here! Protect your workers from icy perils

By Rich Gaul, BWC Safety Technical Adviser

Winter is officially here. Are you and your employees ready for the harsh conditions of the season?

Taking some simple steps can help protect your employees from ailments caused by exposure to low temperatures, wind and moisture.

The two primary health risks in cold weather are hypothermia and frostbite. Hypothermia occurs when the body loses heat faster than it can replace it, causing your core body temperature to drop below 95 degrees Fahrenheit (35 degrees Celsius). Frostbite is a condition where human tissue freezes. Frostbite most commonly affects the face, ears, fingers and toes.  It is important to recognize the early warning signs of hypothermia and frostbite and take necessary precautions to prevent them.

Early warning signs of hypothermia include feeling extremely cold; shivering; cold or numb fingertips or toes; impaired fine-motor control; slurred speech; confusion or disorientation; drowsiness. You should train employees to recognize these early warning signs and how to take the necessary precautions to prevent hypothermia.

Treatment for hypothermia includes getting the person indoors or to other warm shelter; removing wet or damp clothing; wrapping them in warm dry blankets; getting them to drink warm, sweet liquids; monitoring their condition closely and calling for emergency medical attention if needed.

Early warning signs of frostbite include skin that appears slightly swollen, waxy looking and feels cold or numb. More severe frostbite affects deeper layers of tissue. Skin may become completely numb and blister. Deep tissue, including muscle, blood vessels and bone may freeze and turn black.

Treatment for frostbite includes getting the victim indoors or to other warm shelter; removing any wet or damp clothing; removing jewelry or constrictive clothing that could restrict blood flow; gently and slowly warming the superficial frostbite by covering affected areas with warm dry towels or submerging in lukewarm water (100 to 105 degrees Fahrenheit); seeking immediate medical attention for moderate to severe frostbite.

Prevention – employers should:

  • Train employees;
  • Provide engineering controls;
  • Implement safe work practices;
  • Consider protective clothing that provides warmth.

Training – at a minimum employers should train workers on:

  • Recognizing the symptoms of cold stress and frostbite and prevention measures;
  • The importance of self-monitoring and monitoring coworkers for symptoms;
  • First-aid procedures and how to call for medical assistance in an emergency;
  • How to select and wear proper clothing for cold, wet and windy conditions.

 Engineering controls – employers should:

  • Provide shields around outdoor work areas to reduce wind chill;
  • Add radiant heaters if feasible;
  • Apply de-icing materials to prevent slips and falls.

 Safe work practices

  • Schedule routine maintenance and repairs during warmer months.
  • Schedule cold-weather jobs in the warmer part of the day.
  • Monitor weather conditions and avoid exposure to extremely cold temperatures.
  • Limit the amount of time outdoors in cold weather.
  • Provide warming areas for use during breaks.
  • Provide warm liquids to drink.
  • Acclimatize employees gradually to allow them to build up tolerance to cold environments.
  • Monitor employees and provide means of communication.

Protective clothing
Although there is no Occupational Safety and Health requirement for employers to provide workers with ordinary clothing or other items solely for protection from cold weather, many employers provide workers with winter weather gear such as winter coats, hats, gloves, etc.  Regardless of whether the employer or the employee provides protective clothing, employers should encourage employees to wear proper clothing for cold-weather conditions. This includes wearing:

  • Several layers of loose fitting clothing, allowing workers to add or remove layers as needed;
  • A hat that covers your ears;
  • Mittens or gloves;
  • Thick wool socks and waterproof boots to keep your feet warm and dry.

Other considerations
When performing outdoor work activities:

  • Warm up and stretch before any strenuous physical exercise, including snow shoveling;
  • Drink plenty of water to stay hydrated;
  • Protect your back by using good lifting techniques;
  • Pace yourself to avoid sweating;
  • Adjust your clothing layers according to your physical activity;
  • Take frequent breaks and go indoors to warm up;
  • Move slowly and carefully to avoid slipping on icy pavement.

Working in cold winter weather conditions or indoor cold environments may be unavoidable, but following the practices outlined above will help keep employees safe when they are exposed to cold conditions.

Landscaper cuts corners, gets workers’ comp fraud conviction

maguireA Cincinnati man who ran his landscaping business for at least five years without workers’ compensation coverage pleaded guilty to two fifth-degree felony counts of workers’ compensation fraud Dec. 6.

Acting on a tip in 2014, investigators with the Ohio Bureau of Workers’ Compensation conducted surveillance and interviewed employees of William T. Maguire’s Grass Roots Landscaping & Lawn Care to determine Maguire continued to operate his business after his BWC policy lapsed in September 2009. Maguire, 35, owes premiums to BWC totaling $92,447.

Maguire’s sentencing is scheduled for Jan. 18 in the Hamilton County Court of Common Pleas. Penalty guidelines for a fifth-degree felony in Ohio include six to 12 months in prison and fines of up to $2,500. A judge also could order Maguire to pay restitution to BWC.

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

BWC investigators net 8 fraud convictions in November

BWC investigators secured eight convictions in November on cases involving workers’ compensation fraud, including two cases where suspects were found living and working in Florida.

“These cases demonstrate the skill and diligence of our investigators to track down and hold accountable those who try to cheat the workers’ compensation system,” said BWC Administrator/CEO Sarah Morrison. “We will find cheats whether they are residing in Ohio or in the far corners of another state.”

As of Nov. 30, BWC’s Special Investigations Department had secured 99 convictions for the calendar year. November’s convictions include:

Jarrod Lewis of Palm Bay, Florida – Working and Receiving
Lewis pleaded guilty to workers’ compensation fraud Nov. 28 after BWC investigators found him working as a carpet cleaner in Florida while collecting injured workers’ benefits from BWC. A judge ruled Lewis, formerly of Chillicothe, must pay $5,300 in restitution to BWC and serve five years probation in lieu of a 12-month prison sentence for committing the fifth-degree felony.

William Numbers, Sr., dba Nycom Inc., of Lima, Ohio (Allen County) – Operating without Coverage
Numbers pleaded guilty Nov. 21 to two second-degree misdemeanor counts of failure to comply after agents discovered he was operating his automobile transmission shop without valid BWC coverage. Numbers was sentenced to 30 days in jail (suspended), fined $300 and ordered to have no further failure to comply charges for the next two years.

Manuel Perez of West Portsmouth, Ohio (Scioto County) – Working and Receiving
Perez pleaded guilty Nov. 21 to misdemeanor counts of workers’ compensation fraud and theft. He must pay $132,239 in restitution to BWC and serve five years probation. He paid $10,000 toward his restitution at his sentencing. He also was sentenced to six months in jail, which was suspended so long as he complies with the terms of his probation.

Agents determined Perez collected injured workers’ benefits for four years while running an automobile repair shop out of his residence.

Thomas Gallagher of Dublin, Ohio (Franklin County) – False Claim
Gallagher pleaded guilty Nov. 16 to one first-degree misdemeanor count of workers’ compensation fraud after investigators determined he had filed false injury reports twice in recent years to obtain painkillers at local hospital emergency departments. He was sentenced to six months probation and ordered to pay BWC $620 for the cost of investigating him.

Theodore Philput, dba as Berwick Electric Company, of Canal Winchester, Ohio (Fairfield County) – Operating without Coverage
Philput pleaded no contest Nov. 14 to four counts of workers’ compensation fraud, all first-degree misdemeanors, and a judge found him guilty on all charges. Investigators determined Philput’s BWC policy had been lapsed since October 2009. They served Philput compliance materials, but Philput failed to reinstate his coverage.

Philput provided BWC $29,609 in restitution at sentencing. A judge sentenced him to two years community control and warned he would serve 180 days in jail on each count if he violated terms of his probation.

Michael Mitchell of Whitehall, Ohio (Franklin County) – Working and Receiving
Mitchell pleaded guilty Nov. 7 to a fifth-degree felony count of workers’ compensation fraud during a court appearance that was delayed after he failed to appear for his 2013 arraignment. He was sentenced to 11 months of incarceration, suspended for five years of community control, and ordered to pay BWC $5,000 in restitution.

Investigators discovered Mitchell was self-employed as a painter and sub-contracted multiple jobs from various painting companies while also collecting benefits from BWC. They also determined Mitchell did not have current workers’ compensation coverage and that he altered his BWC certificate of coverage in order to secure painting jobs.

Nikitas Xipolitas of Tarpon Springs, Florida – Working and Receiving
Xipolitas, formerly of Mahoning County, pleaded guilty Nov. 4 to a fifth-degree felony count of workers’ compensation fraud after agents found him working in Florida while receiving workplace injury benefits and using multiple aliases to cover his crime. A judge sentenced Xipolitas to six months in jail, suspended for five years of community control, under the condition that he pay $23,601 in restitution to BWC.

Danielle Cheeks of Groveport, Ohio (Franklin County) – Working and Receiving
Cheeks pleaded guilty Nov. 3 to a fifth-degree felony count of workers’ compensation fraud after investigators discovered she had been working as a home health aide as far back as 2010 while receiving injured workers’ benefits from BWC. A judge ruled she must pay $51,590 in restitution to BWC and serve five years probation in lieu of a six-month jail sentence.

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

Five things you need to know about BWC’s provider fee schedules

By Yvette Christopher, Technical Medical Manager, Medical Policy

The Ohio Bureau of Workers’ Compensation (BWC) relies on a network of medical professionals to care for Ohioans injured on the job so they can return to work as quickly as possible. Competitive fees are essential to maintaining an excellent network of providers to deliver hands-on, quality care.

A fee schedule lists the maximum cost for which BWC will pay for services rendered. A fee schedule should provide a reasonable reimbursement for services rendered, while still maintaining a forum for the provision of cost effective, medically necessary services.

The Reimbursement and Coding Department within BWC’s Medical Services’ Division is responsible for development of fee schedules. The department partners with our providers and provider associations to develop appropriate methodologies to reimburse for services provided to Ohio’s injured workers.

Here are five things you need to know about BWC’s provider fee schedules:

  1. BWC has five fee schedules: The Professional Provider Fee Schedule, Outpatient Hospital, Inpatient Hospital Fee Schedule, Ambulatory Surgical Center Fee Schedule and the Vocational Rehabilitation Provider Fee Schedule.
  2. The fee schedules are implemented and changes are applied through the Ohio Administrative Code rule-making process annually. Rules applicable to the BWC fee schedules can be found on the BWC Web at www.bwc.ohio.gov.
  3. The fee schedules are modeled using the Centers for Medicare and Medicaid as a basis. BWC inflates the Medicare fee schedule by a set percentage often referred to as a Payment Adjustment Factor (PAF). The professional provider fee schedule PAF is between 125% and 220% of Medicare, depending on the procedure code.  The Ambulatory Surgical Center PAF is between 100-112%, depending on the procedure code. For February 2017, the inpatient PAF will be 112.7% for MS-DRG and DGME and 175.4% for outliers. Also proposed for May 2017, the outpatient PAF for children’s hospitals will be 266.9% and for non-children’s hospitals, 152.9%.
  4. BWC accepts stakeholder comments related to the annual implementation of the fee schedule. The proposed annual updates are published on the BWC web and comments are accepted for two weeks. The typical timeframe is approximately five months prior to the annual effective date of the rule. Stakeholders can request to be on the notification mailing list by contacting BWC at feedback.medical@bwc.state.oh.us.
  5. Each fee schedule has an annual rule effective date. The professional provider fee schedule is effective January 1 of each year. The outpatient hospital fee schedule and inpatient hospital fee schedules are effective May 1 and February 1, respectively. The ambulatory surgical center fee schedule is effective May 1. The vocational rehabilitation fee schedule is reviewed, but may not be updated annually.

Our network of medical professionals serves as the foundation for Ohio’s workers’ comp system. We’ll continue to regularly review our fee schedules so that Ohio’s injured workers have access to a variety of excellent providers who can put them on the road to recovery and a return to work.

Give the gift of safety!

Our handy holiday gift guide has lots of ideas

By Erik Harden, Public Information Officer, BWC Communications Department

The holidays will be here before you know it! And if you’re like us, maybe you’re not quite done with your shopping. Well, we’ve got you covered with gift ideas to keep your adventurers, your do-it-yourselfers and your loved ones safe and healthy throughout the year.

This year, the experts in BWC’s Division of Safety & Hygiene who staff the Ohio Center for Occupational Safety & Health (OCOSH) have compiled this handy Safety & Health Gift Guide to help you give the gift that keeps on giving – safety and wellness.

The guide includes ideas for gifts to keep your friends and family safe at home and on the road. It also includes reminders about creating or reviewing plans in case of emergencies in the home.

Do you have weekend warriors at home? Check out the section dedicated to these handy folks for ideas ranging from proper footwear and hearing protection to task lighting and eye safety.

How about outdoor adventurers? From new harnesses and carabineers for rock climbers to gun safety classes for hunters, there are plenty of options to choose from.

The guide will also help you keep your kids safe with tips for buying the safest toys and products, from toddlers to teenagers.

Finally, it provides travel tips to keep you safe when travelling over the river and through the woods to grandmother’s house.

From all of us at BWC, we wish you a happy and SAFE holiday season and new year!

Cleveland painter guilty of workers’ comp fraud

reillo-photoA Cleveland-area man caught working while receiving injured workers’ benefits from BWC pleaded guilty Dec. 1 to a misdemeanor count of workers’ compensation fraud.

Angelo Reillo Sr., 32, of Garfield Heights, paid $3,354 in restitution to BWC at the time of his guilty plea in Franklin County Common Pleas Court. A judge fined him $50.

Acting on a tip, agents with BWC’s Special Investigations Department found Reillo working as a painter and supervisor from Oct. 20, 2014, until Dec. 3 that year while receiving living maintenance benefits from BWC. Living maintenance compensation is designed for workers who are actively participating in a BWC-approved vocational rehabilitation plan. The benefits are supposed to end after the injured worker returns to full-time work.

Agents determined Reillo engaged in “ongoing and regular substantially gainful remunerative employment, which was inconsistent with the receipt of LM benefits and contrary to entitlement.”

Coverage in other states: do you have it?

By Kendra DePaul, BWC Other States Coverage Managerkendra

With the New Year approaching, now is the time to begin planning for 2017. We encourage businesses to evaluate their current workers’ compensation coverage to ensure there are no potential coverage gaps.

Each state has different laws and requirements for workers’ compensation coverage. Consider each state where you send employees, and make sure proper coverage is in place.

We have many resources on our website to help employers work through requirements for work outside of Ohio. In addition, we work with a private insurer to offer optional coverage to employers with out-of-state exposures.

Through our Other States Coverage offering, employers can secure coverage nationwide in 46 states. From implementation in March 2016 through November 2016, more than 200 employers have secured coverage. These businesses have eliminated potential coverage gaps and compliance issues, which may arise when working out of state.

If your business is looking to expand outside Ohio, please contact BWC’s Other States Coverage unit to discuss your coverage options. We want you to have the proper coverage upfront, so that you can avoid any coverage issues and focus on having a successful 2017.

Contact the Other States Coverage unit at 614-728-0535 or via email bwcotherstatescoverage@bwc.state.oh.us.